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Cialis Dosage Guide: What Is The Right Dosage?

Mike Bohl, MD, MPH, ALM

Reviewed by Mike Bohl, MD, MPH, ALM

Written by Geoffrey Whittaker

Published 08/11/2021

Updated 12/12/2023

Pop quiz time, fellas: You have a handful of Cialis pills and a hot date in six hours. If your date is traveling at 35 miles per hour toward your place from a distance of 70 miles, how many pills would you need to take to end up in the emergency room before she arrives?

Cialis® and its fellow erectile dysfunction (ED) medications have a reputation for helping you get and maintain an erection safely. But what the average person doesn’t know about these magic boner pills is how many would actually be harmful. 

Cialis (also available as the generic medication tadalafil) is different from the others in a way that can complicate things. Tadalafil can be used as needed or taken daily — one dose can last up to 36 hours compared with sildenafil (the active ingredient in Viagra®), vardenafil (Levitra®) or avanafil (Stendra®).

With all these options to choose from, you’re probably wondering which dosage of Cialis might be right for you.

To help make the decision easier, we’ll walk you through:

  • How Cialis works

  • The Right dosages for different circumstances

  • Whether you should take tadalafil daily

  • How much you should take

Read on to learn more about this medication and how much you might need to take.

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Medications that reduce the effects of phosphodiesterase-5 (PDE5) are called PDE5 inhibitors. By inhibiting the effects of PDE5, medications such as Cialis relax and expand the blood vessels near the penis and increase blood flow, allowing for easier, more reliable erections.

Jack-of-all-trades Cialis is also used to treat a couple of other medical conditions, namely:

  • Benign prostatic hyperplasia (BPH, or enlarged prostate)

  • Pulmonary arterial hypertension (PAH)

Of course, the dosage your provider prescribes to treat one thing may be entirely different than the dosage they prescribe to treat something else.

We’ll discuss the different uses of Cialis below, as well as how the medication works to treat these conditions.

Cialis Dose for ED 

Cialis is best known as a treatment for erectile dysfunction — but it’s more about working plumbing than starting the motor on sexual stimulation.

Like other ED medications, Cialis works by inhibiting the effects of an enzyme called PDE5, which is responsible for controlling the flow of blood to your penis. 

Healthy erections are all about blood flow. When you feel sexually aroused, blood flows to your corpora cavernosa — the soft, sponge-like erectile tissues inside your penis — causing it to become firm and enlarged.

The Cialis tablet can be taken for different purposes (more on those later) in four different FDA-approved doses: 2.5mg, 5 mg, 10mg and 20mg (milligrams).

Cialis Dose for Benign Prostatic Hyperplasia (BPH)

Your ED medication of choice is also used to treat benign prostatic hyperplasia — a condition in which the prostate gland grows in size. BPH is commonly referred to as benign prostate enlargement or simply enlarged prostate.

BPH is common in older men. Although it isn’t a cancerous form of growth, it can cause certain irritating issues. Symptoms of benign prostatic hyperplasia include an increased need to urinate, dribbling at the end of urination and pain during urination or after ejaculation.

According to the FDA (U.S. Food and Drug Administration), a daily dose of 5mg tablets of Cialis has been shown to be effective in treating this disorder, though other brands of tadalafil may actually be what’s prescribed.

Tadalafil Dosage for Pulmonary Arterial Hypertension (PAH)

Tadalafil and other PDE5 inhibitors treat PAH by dilating the arteries inside the lungs, reducing blood pressure and improving blood flow.

When used to treat pulmonary arterial hypertension, tadalafil is usually sold under the brand name Adcirca®. To learn more, read our blog on Adcirca vs. Cialis.

Pulmonary arterial hypertension can develop on its own or with other cardiovascular diseases, such as left heart disease (LHD), sickle cell disease (SCD) and its variants, chronic obstructive pulmonary disease (COPD) and conditions such as pulmonary embolism (PE).

According to the FDA, Adcirca is typically prescribed in doses of 40mg for the treatment of PAH, and we’re not fans of the idea of exceeding the ol’ gov guidelines.

The most appropriate Cialis dose for you will depend on your needs, your healthcare provider's assessment and how well you respond to the medication. 

Cialis is available in two forms:

  • As a daily-use medication in dosages of 2.5mg and 5mg

  • For use as needed in dosages of 5mg, 10mg and 20mg

Cialis Daily Dosage

If you’re prescribed this medication for daily use, it’s important to take it at approximately the same time every day. In other words, don’t take it based on your lovemaking time block on iCal.

Taking Cialis every day is a good option if you’ve already responded well to PDE5 inhibitors or if you have sex more than two times per week.

Your healthcare provider may prescribe Cialis for daily use at a daily dosage of 2.5mg. This may be increased to 5mg if you don’t respond to the lower dosage or need a more significant effect from the medication.

Cialis Dosage for Occasional Use 

For those of you who like to follow your heart, Cialis is also available to take as needed. This means you can take it just before you plan to have sex.

Like other medications for ED, tadalafil starts working quickly. In most cases, you’ll start to notice the effects of Cialis in 30 to 60 minutes. 

The medication reaches its maximum concentration in your body approximately 30 minutes to six hours after use.

When prescribed for as-needed use, it’s available in 5mg, 10mg and 20mg doses.

The recommended starting dose of Cialis for use as needed is 10mg. This may be increased to 20mg if you still find it difficult to get or maintain an erection at a 10mg dose or reduced to 5mg if you develop side effects.

Some words of caution about how you take it:

  • Tadalafil is designed for use one time per day, so you shouldn’t take it (or any other ED medication) more than once per day.

  • You can take tadalafil on its own or with a meal without affecting the amount of time it takes for the medication to start working. However, fatty foods can sometimes reduce its effect, so go with the filet instead of the bone-in ribeye if you’re planning a different bone-in treat for later.

Daily-use and on-demand Cialis each have advantages and disadvantages, so there’s no “best” option for everyone. Like the other details of your sex life, what works for you will be unique to your needs.

That said, those needs will dictate the best way to take it, so we’ll go over the major benefits and drawbacks of each dosing option below.

Advantages of Daily Cialis

Taking Cialis on a daily basis offers the convenience of a daily routine and the ability to have sex spontaneously — without having to worry about taking medication right before.

We could bore you with jargon, but here are the highlights:

  • Taking a daily dose of Cialis means you’ll be able to enjoy spontaneous sex without having to worry about carrying tadalafil with you or waiting 30 to 60 minutes after taking your medication because the medication is in your system at all times.

  • It’s a set-it-and-forget-it strategy. You can take it at the same time every day, without any need to think about other factors.

  • So if you’re on vacation or just suddenly feel in the mood, the “always on” effects of daily Cialis can be a major upside. You're always on and ready to go, without any need to schedule sex around your medication.

Since daily-use Cialis is typically taken at a 2.5mg or 5mg dosage, it may also be less likely to cause side effects than a higher-dose, as-needed Cialis.

Disadvantages of Daily Cialis

Despite its advantages, taking a daily dose of this ED medication also has a few minor downsides. The first is that, because of the lower dosage, it often takes several days to become fully effective.

Before tadalafil can reach a steady state in your system, you’ll need to have administered a daily dose of the drug over the course of five days. That’s a small problem if you’ve already been waiting for some time.

Another potential disadvantage of daily-use Cialis is that the medication is always working — and so are the side effects. If you’re prone to side effects from tadalafil, such as nasal congestion, headache or muscle pain, this could become an annoyance.

Advantages of On-Demand Doses of Cialis

Using Cialis on an as-needed basis offers several advantages. The first is that you gain more autonomy when it comes to treating ED. Consider that:

  • Tailoring your usage based on when you plan to have sex can be helpful if you only see your partner a few days per week and don’t need your medication every day.

  • There’s no need to wait several days for the medication to reach a steady state in your body. Thanks to the higher dose, as-needed Cialis starts working quickly and typically reaches its peak concentration within two hours.

  • If you have sex infrequently, only taking Cialis when it’s needed could reduce the total amount you spend on ED treatments (and potentially increase the amount you spend on lube and sex toys).

Disadvantages of On-Demand Cialis

The main disadvantage of taking Cialis on demand is that you’ll need to plan ahead when you want to have sex. This can be difficult for men who, for instance, aren’t great at reading signals.

Since Cialis usually takes 30 to 60 minutes to start working, you’ll need to time your medication to make sure it’s active when you need it. Otherwise, you could be knocking over glassware at the dinner table — or unable to roll over and go to sleep after everyone’s had their fun.

But you don’t have to be that specific with the timing. Because tadalafil has a long half-life, it’s okay to take it several hours before you have sex. This makes timing as-needed Cialis much easier than shorter-acting ED medications, such as sildenafil, vardenafil or Stendra®.

A bigger disadvantage of as-needed Cialis is the higher dosage. This isn’t an issue for everyone, but if you’re prone to side effects, the higher dose might make certain side effects more intense and severe.

If you develop any side effects while using Cialis or other ED medications, it’s important to tell your healthcare provider.

Both forms of Cialis are well tolerated and effective at treating ED. Ultimately, the best option depends on your needs, lifestyle and preferences. 

Our guide to daily-use Cialis goes into greater detail about how you can choose between a daily or as-needed dose to treat ED.

If you’re prescribed tadalafil for daily use, it’s far from uncommon to sometimes forget to use your medication. What to do when you forget to take tadalafil depends on the time of day you actually remember.

If you forget to take Cialis, take the missed dose as soon as you remember. If it’s close to the time for your next dose, skip the missed dose and continue using tadalafil as normal. 

But generally speaking, don’t take a double dose of tadalafil or use this medication more than once per day.

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Erectile function isn’t about loading up with a massive dose to get the full effects of tadalafil. Cialis maximum dosage is never something you should exceed.

The max dosage of Cialis for erectile dysfunction is 20mg per day when taken as needed or 5mg when taken on a daily basis — but a healthcare professional will almost certainly start you on a lower dose.

Adcirca, a version of tadalafil used to treat pulmonary arterial hypertension, should be taken one time per day at a dose of 40mg.

Don’t exceed the recommended dose of Cialis. If you’re prescribed Cialis and don’t notice any improvements at the dose you’re prescribed, make sure to consult with your healthcare provider before making any changes to your dosage or use of this medication. 

Choose your chew

As you’ve probably gathered, even the right dose might lead to some common side effects, so taking the wrong dosage will cause problems too (that’s why we have guidelines, fellas). Take too little and you won’t see results — take too much and things could get very, well…hard.

Yes, Cialis is a safe and effective medication for most people, but even at the right dosage, it can cause a list of adverse reactions.

Common Cialis side effects include:

  • Indigestion or heartburn

  • Headaches

  • Nausea

  • Diarrhea

  • Flushing

  • Coughing

  • Stuffy nose

  • Back pain

  • Muscle, stomach and/or limb pain

Though uncommon, Cialis can cause more severe side effects too. If you develop any of the serious side effects listed below, contact your healthcare provider or seek emergency medical care as soon as possible:

  • Blurred vision or vision impairment

  • Sudden loss of vision

  • Sudden hearing loss

  • Ringing in the ears

  • Angina or chest pains

  • Dizziness

  • Difficulty breathing or swallowing

  • Hives and/or skin rash

  • Blistering or peeling of the skin

  • Swelling that affects your face, throat, mouth, eyes or limbs

Instances of priapism and cardiovascular events are typically considered rare Cialis side effects, but they do occur. Some side effects may also happen as a result of an allergic reaction to the medication (or its ingredients).

You also need to worry about drug interactions from prescription drugs. 

Cialis (and other medications used to treat erectile dysfunction) may interact with medications used to treat other medical conditions. The list of contraindicated meds includes nitrates, alpha-blockers and other medications used to treat hypertension (high blood pressure). 

The list also includes medications that can increase the concentration of tadalafil in your blood by affecting the cyp3a4 enzyme. These include doxazosin, erythromycin, itraconazole and ketoconazole. FYI, grapefruit juice also has this effect, so watch your breakfast beverage intake if you’re a morning sex guy.

Some recreational drugs, such as “poppers” that contain amyl nitrate or butyl nitrate, can also interact with Cialis and cause a sudden decrease in blood pressure — and low blood pressure could lead to your heart stopping.

Make sure to inform your healthcare provider about all medications you currently use or have recently used before taking Cialis. You should also let them know about any liver problems or renal (kidney) issues or if you suffer from Peyronie’s disease.

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Cialis is one of the most popular medications used in the treatment of erectile dysfunction — and for good reason. Not only is it effective at treating ED, but its long duration of action means it only needs to be taken once a day to provide lasting effects.

But don’t take the convenience and safety track record as excuses to mess around.

Here’s some important medical advice you need to know about how to take Cialis. It could save your sex life — or your actual life: 

  • Unlike supplements, tadalafil must be prescribed by a healthcare professional.

  • There are two options for using this medication: take a low dose on a daily basis or take a slightly higher dose as needed. 

  • If your sexual activity is limited to once or twice a week, taking Cialis as needed may be the best choice for you.

  • If you’re more sexually active and have sex multiple times a week — or if you prefer the convenience of being able to have sex when you want to — taking a daily dose of Cialis may offer more advantages for your situation.

We offer brand name Cialis and generic tadalafil online, following a consultation with a licensed healthcare provider who’ll determine if a prescription is appropriate.

Our range of erectile dysfunction medications also includes other options, such as sildenafil (the active ingredient in Viagra) and Stendra, a new, faster-acting ED treatment with a favorable side effect profile.

14 Sources

  1. Frajese, G.V., Pozzi, F. & Frajese, G. (2006, December). Tadalafil in the treatment of erectile dysfunction; an overview of the clinical evidence. Clinical Interventions in Aging. 1 (4), 439–449. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699638/
  2. Tadalafil. (2016, April 15). Retrieved from https://medlineplus.gov/druginfo/meds/a604008.html
  3. Erection Ejaculation: How It Occurs. (2020, November 27). Retrieved from https://my.clevelandclinic.org/health/articles/10036-erection-ejaculation-how-it-occurs
  4. Dhaliwal, A. & Gupta, M. (2021, June 25). PDE5 Inhibitors. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK549843/
  5. Prostate Enlargement (Benign Prostatic Hyperplasia). (2014, September). Retrieved from https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/prostate-enlargement-benign-prostatic-hyperplasia
  6. Pulmonary Hypertension. (n.d.). Retrieved from https://www.nhlbi.nih.gov/health-topics/pulmonary-hypertension
  7. Symptoms & Causes of Erectile Dysfunction. (2017, July). Retrieved from https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes
  8. Karabakan, M., Keskin, E., Akdemir, S. & Bozkurt, A. (2017, March-April). Effect of tadalafil 5mg daily treatment on the ejaculatory times, lower urinary tract symptoms and erectile function in patients with erectile dysfunction. International Brazilian Journal of Urology. 43 (2), 317–324. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5433372/
  9. CIALIS (tadalafil) tablets, for oral use. (2011, October). Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/021368s20s21lbl.pdf
  10. Washington, S.L., 3rd & Shindel, A.W. (2010). A once-daily dose of tadalafil for erectile dysfunction: compliance and efficacy. Drug Design, Development and Therapy. 4, 159–171. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2939761/
  11. ADCIRCA (tadalafil) tablets for oral administration. (2009, May). Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/022332lbl.pdf
  12. Dhaliwal A, Gupta M. PDE5 Inhibitors. (2022, May). Treasure Island (FL): StatPearls Publishing. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK549843/
  13. Highlights of prescribing information ... - food and drug administration. (n.d.). Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/022351lbl.pdf
  14. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. (2017, Aug.) Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK547910/
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Mike Bohl, MD, MPH, ALM

Dr. Mike Bohl is a licensed physician, a Medical Advisor at Hims & Hers, and the Director of Scientific & Medical Content at a stealth biotech startup, where he is involved in pharmaceutical drug development. Prior to joining Hims & Hers, Dr. Bohl spent several years working in digital health, focusing on patient education. He has also worked in medical journalism for The Dr. Oz Show (receiving recognition for contributions from the National Academy of Television Arts and Sciences when the show won Outstanding Informative Talk Show at the 2016–2017 Daytime Emmy® Awards) and at Sharecare. He is a Medical Expert Board Member at Eat This, Not That! and a Board Member at International Veterinary Outreach.

Dr. Bohl obtained his Bachelor of Arts and Doctor of Medicine from Brown University, his Master of Public Health from Columbia University, and his Master of Liberal Arts in Extension Studies—Journalism from Harvard University. He is currently pursuing a Master of Business Administration and Master of Science in Healthcare Leadership at Cornell University. Dr. Bohl trained in internal medicine with a focus on community health at NYU Langone Health.

Dr. Bohl is Certified in Public Health by the National Board of Public Health Examiners, Medical Writer Certified by the American Medical Writers Association, a certified Editor in the Life Sciences by the Board of Editors in the Life Sciences, a Certified Personal Trainer and Certified Nutrition Coach by the National Academy of Sports Medicine, and a Board Certified Medical Affairs Specialist by the Accreditation Council for Medical Affairs. He has graduate certificates in Digital Storytelling and Marketing Management & Digital Strategy from Harvard Extension School and certificates in Business Law and Corporate Governance from Cornell Law School.

In addition to his written work, Dr. Bohl has experience creating medical segments for radio and producing patient education videos. He has also spent time conducting orthopedic and biomaterial research at Case Western Reserve University and University Hospitals of Cleveland and practicing clinically as a general practitioner on international medical aid projects with Medical Ministry International.

Dr. Bohl lives in Manhattan and enjoys biking, resistance training, sailing, scuba diving, skiing, tennis, and traveling. You can find Dr. Bohl on LinkedIn for more information.

Publications

  • Younesi, M., Knapik, D. M., Cumsky, J., Donmez, B. O., He, P., Islam, A., Learn, G., McClellan, P., Bohl, M., Gillespie, R. J., & Akkus, O. (2017). Effects of PDGF-BB delivery from heparinized collagen sutures on the healing of lacerated chicken flexor tendon in vivo. Acta biomaterialia, 63, 200–209. https://www.sciencedirect.com/science/article/abs/pii/S1742706117305652?via%3Dihub

  • Gebhart, J. J., Weinberg, D. S., Bohl, M. S., & Liu, R. W. (2016). Relationship between pelvic incidence and osteoarthritis of the hip. Bone & joint research, 5(2), 66–72. https://boneandjoint.org.uk/Article/10.1302/2046-3758.52.2000552

  • Gebhart, J. J., Bohl, M. S., Weinberg, D. S., Cooperman, D. R., & Liu, R. W. (2015). Pelvic Incidence and Acetabular Version in Slipped Capital Femoral Epiphysis. Journal of pediatric orthopedics, 35(6), 565–570. https://journals.lww.com/pedorthopaedics/abstract/2015/09000/pelvic_incidence_and_acetabular_version_in_slipped.5.aspx

  • Islam, A., Bohl, M. S., Tsai, A. G., Younesi, M., Gillespie, R., & Akkus, O. (2015). Biomechanical evaluation of a novel suturing scheme for grafting load-bearing collagen scaffolds for rotator cuff repair. Clinical biomechanics (Bristol, Avon), 30(7), 669–675. https://www.clinbiomech.com/article/S0268-0033(15)00143-6/fulltext

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