How To Choose The Right Dose of Cialis (Tadalafil)

written by Joseph W. Prows, M.D.
reviewed by Mason S. Shamis, M.D.
published october 30, 2024

Full Course

The drug is to be taken not oftener than once a day. Cialis is administered only after consultation by a specialist, andrologist or sexologist. The maximum recommended dose of Cialis is 20mg. A tablet is taken before sexual intercourse.

A patient should observe the following recommendations:

If a person has renal disease, the recommended dose of Cialis is 10 mg. This dose can be increased to 20 mg. For patients with severe renal failure, 10 mg is maximally recommended dose.
If a man has a hepatic disorder, the recommended dose of Cialis is 10 mg. Patients with severe hepatic impairment should be guided by their physician’s advice.
For elderly people or people with diabetes, no special dosage is required.
With symptoms associated with benign prostatic hyperplasia, the recommended dose of the drug is 5 mg.
Tablets are taken once a day. A tablet should be washed down with a full glass of water.
Cialis requires in average 2 hours for reaching its maximum concentration, compared with approximately 50 minutes needed for sildenafil and vardenafil.

Nuances of Tadalafil Administration

Differences in gastrointestinal absorption of fatty food explain different maximum plasma concentration of between three PDE5 inhibitors (Cialis, Viagra and Levitra). The intake of Viagra and Levitra with fatty food is characterized by their low efficiency, whereas the absorption of Cialis affects neither by fatty food, nor by the consumption of alcohol. This unique pharmacokinetic feature of Cialis is the result of a slower absorption and a longer elimination half-life.

Composition of Cialis tablet

One tablet of Cialis contains 5, 10, 20, or 40 mg of Tadalafil + auxiliary components: croscarmellose sodium, hydroxypropyl cellulose, hydroxypropyl methylcellulose, ferrum oxide, lactose monohydrate, magnesium stearate, microcrystalline cellulose, sodium lauryl sulfate, talc, titanium dioxide and triacetin. This medicine does not contain sucrose, gluten, tartrazine, or any other colorants.

Mode of Action

The enzyme phosphodiesterase type 5 prevents from erection by cleavage of the cyclic guanosine monophosphate (cGMP). The substance of cGMP is needed to expand the arteries of penis so that they are better filled with blood and supplied with oxygen. Inhibitors of phosphodiesterase type 5, such as tadalafil, do not give PDE5 to cleave cGMP. This allows penis to be filled with blood and stay erected long enough for sexual intercourse. Advantage of Cialis pill lies in the fact that tadalafil remains active in body much longer than other drugs. Viagra and Levitra function for about four to five hours (and sometimes up to 12 hours), whereas Cialis action ranges from 24 to 36 hours.

Forms and Dosages of Cialis

There are following forms of the preparation Cialis:

Cialis 2.5 mg: yellow-orange, almond-shaped, film-coated tablets. They contain 2.5 mg of tadalafil;
Cialis 5 mg (to be applied once a day): yellow, almond-shaped tablet with film coating. It contains 5 mg of tadalafil.
Cialis 10 mg: each yellow, almond-shaped tablet with film coating contains 10 mg of tadalafil.
Cialis 20 mg: orange, almond-shaped tablets with film coating contain 20 mg of tadalafil.

Posology and Administration

The recommended dose for a single dose of Cialis is 20 mg. This dosage is not changed for patients of different ages and can be used both in 18 years and after 65.
Depending on the severity of erectile dysfunction, concomitant diseases and tolerability of the drug, the dose can be reduced to 10, 5 or 2.5 mg.
For men with a violation of liver function from mild to moderate degree, the maximum dose of Cialis should not exceed 10 mg.
Dosage recommended for patients with renal dysfunction is 5 mg or 10 mg once per 2 days. As per recommendation of a doctor for these diseases, the dose of tadalafil can be reduced to 2.5 mg.
If a patient is treated with strong inhibitors of cytochrome P3A4, such as ketoconazole, erythromycin, itraconazole, ritonavir and others, the maximum dosage of tadalafil should be 10 mg once per 3 days.

Tadalafil in the composition of Cialis has a long range of action. A man with ED is able to perform sexual intercourse within 36 hours. This unique feature of tadalafil allows Cialis to be considered as the best regulator of potency among its counterparts. For comparison: Viagra’s action lasts up to 6 hours, Levitra’s one – up to 10 hours.

Time after taking Cialis before the onset of erection is 20-30 minutes. Cialis can be taken with food, alcohol or without them. However, drinking alcohol can affect men’s ability to achieve erection, so excessive consumption of alcohol should be refused.

Therapy course with Cialis for erectile dysfunction should be performed with the dose of 10 mg or 20 mg of tadalafil. A pill is to be taken at least 30-60 minutes before the expected sexual activity. The amount of time it takes for a drug to work out varies from person to person. For some men, Cialis takes action in 16 minutes after taking the pill, but for the first time it is recommended to take it at least an hour before sex. Cialis is effective for 36 hours, that is, after its reception, you can achieve an erection (with sexual stimulation) in any time for 36 hours.

Preparations related to inhibitors of PDE5 are designed for regular episodic administration. A certain course with Cialis does not exist. Many things, such as body weight, illnesses and taking medications can affect the dose of medicine that is needed by a person. If your doctor recommends a dose different from that indicated in the article, follow the advice of the doctor. After three months of taking Cialis, erectile function improves in the form of spontaneous erections.

Cialis is the only drug for impotency the low dose of which is suitable for daily use. The initial dose is 2.5 mg; if this dosage does not work, the daily dose can be increased to 5 mg.

Biography of Joseph W. Prows, M.D.

joseph Dr. Joseph Prows is a North American mutt, having traveled a circuitous path to Fort Collins involving Alaska, Louisiana, California, Oregon, Massachusetts, and Texas. He graduated from Tulane University School of Medicine in New Orleans as a member of the “Katrina Class” of 2009 with an MD and a Master’s in Public Health specializing in Epidemiology. In 2012 he graduated from the Alaska Family Medicine Residency Program and subsequently practiced at Anchorage Neighborhood Health Center with an esteemed group of passionate colleagues. His training emphasized full-spectrum care of complex patients in rural and underserved settings. Learn more here.

Disclaimer

The content, products and services offered herein are here to help provide information to consumers on health care and medical issues that may affect their daily lives. Nothing in the content, products or services should be considered, or used as a substitute for, medical advice, diagnosis or treatment. This site and its services do not constitute the practice of any medical, nursing or other professional health care advice, diagnosis or treatment. You should always talk to your health care provider for diagnosis and treatment, including your specific medical needs. None of the services or information offered through this website represents or warrants that any particular service or product is safe, appropriate or effective for you. We advise users to always seek the advice of a physician or other qualified health care provider with any questions regarding personal health or medical conditions. If you have or suspect that you have a medical problem or condition, please contact a qualified health care professional immediately. If you are in the United States and are experiencing a medical emergency, please call 911 or call for emergency medical help on the nearest telephone.