Erectile Dysfunction Treatment

When Roman started, 80% of Viagra sold online was counterfeit. It became our mission to make it safe and simple for people to get medication they can trust from a licensed pharmacy, prescribed by a real, US-licensed physician. All from the comfort of home.

Free 2-day shipping

Starting at $2/dose

Free + unlimited doctor follow ups

No commitment / cancel anytime

What is ED?

Erectile dysfunction is the inability to get or maintain an erection adequate for sex. There are many different causes, but ED ultimately occurs when there is too little blood flow into the penis and too much blood flow out, partially due to an enzyme called PDE5. Oral ED medications block PDE5 to increase blood flow into the penis and decrease blood flow out.

Can it be treated?

Yes. ED medication interferes with the breakdown of chemicals required to obtain and maintain an erection. This interference keeps more of those chemicals in action longer, improving the ability to get and maintain an erection.

Treatments

Over 50% of men in America will experience ED

Treatments for ED

A physician in our network will evaluate whether ED treatment is appropriate for you. If prescribed, we’ll ship it to you in discreet, unmarked packaging.

Sildenafil

Do not use Viagra/sildenafil if you aren’t healthy enough for sex or if you take nitrates for chest pain. It may cause an unsafe drop in blood pressure. Side effects may include headache, flushing, upset stomach, nasal congestion and abnormal vision. To avoid injury, seek immediate attention if you have an erection lasting longer than 4 hours. Stop taking Viagra/sildenafil and seek care if you experience a sudden loss or decrease in vision or hearing. read more…

Do not use Viagra if you aren’t healthy enough for sex or if you take nitrates for chest pain. It may ca use an unsafe drop in blood pressure. Side effects may include headache, flushing, upset stomach, nasal congestion and abnormal vision. To avoid injury, seek immediate attention if you have an erection lasting longer than 4 hours. Stop taking Viagra and seek care if you experience a sudden loss or decrease in vision or hearing. read more…

Do not take Cialis if you aren’t healthy enough for sex or if you take nitrates for chest pain. It may c ause an unsafe drop in blood pressure. Do not drink alcohol in excess. Side effects may include headache, upset stomach, delayed backache, or muscle ache. To avoid injury, seek immediate attention if you have an erection lasting longer than 4 hours. Stop taking Cialis and seek care if you experience a sudden loss or decrease in vision or hearing or if you experience an allergic reaction like rash, hives, swelling of the lips, tongue or throat, or difficulty breathing or swallowing. To learn more about Cialis, please see the Important Safety Information. read more…

What to expect

A physician in our network will evaluate which (if any) ED treatment is appropriate for you. Then we’ll ship it to you in discreet, unmarked packaging.

Beginning treatment

Many people get great results the first time they use the medication. For some, it can take 2-3 uses to see results, and research shows that best results occur after 8 uses.

Treatment updates

If you still don’t see results, your doctor may be able to increase your dose or switch you to a different medication. This is not uncommon.

Help with side effects

If you experience side effects, message your doctor and they’ll help determine if a different medication or dose is better for you.

Let’s take care of it

Sexual health and overall health are inherently related. If erectile dysfunction is interrupting your sex life, your general wellbeing (and that of your partner) is impacted greatly. We want to help.

1. The online visit

Report your symptoms and medical history to a US-licensed physician for evaluation.

2. Free deliveries

Your treatment will be sent in discreet packaging, always with free 2-day shipping.

3. Ongoing care

Send your doctor a message any time to discuss updating your treatment, solving for side effects, or any other questions or concerns.

Over 50% of men with diabetes experience ED

For more information about erectile dysfunction, Roman, Ro and more, visit our FAQ page. To speak to a care representative, give us a call at (888) 798-8686 or email us at [email protected] .

How does ED treatment work on the Roman platform?

Roman uses telemedicine technology to provide a discreet, convenient, and affordable way for you to receive erectile dysfunction treatment from a U.S. Licensed physician. All without leaving the couch. Complete the dynamic onboarding, submit your photo, ID, and recent blood pressure reading, and our physicians will determine if you’re a candidate for telemedicine.

Erectile dysfunction is often a symptom of a more serious underlying condition—like heart disease, diabetes, high blood pressure, or even depression. That’s why we strongly recommend optional laboratory tests.

These tests aren’t required to receive treatment on the Roman platform. But they help identify the underlying cause of your ED. We want you to get the most comprehensive treatment possible. That’s why we’ll analyze your results for free. Just send us your most recent blood test and we’ll add it to your account information to help our physicians give you the most comprehensive care from the convenience of your phone.It might sound funny but regular erections are a great barometer of your overall health. Learn why paying attention to the strength and frequency of your erection might actually save your life.

Which medications do doctors on the Roman platform prescribed for ED?

The American Urological Association claims that oral PDE-5 inhibitors should be offered as the “first line of therapy for erectile dysfunction.” So that’s what we do.

Is ED medication effective?

Viagra’s FDA approved prescribing information claims that “82% of patients reported an improvement in their erections.” Other PDE-5 inhibitors (Cialis, Levitra) showed similar results.

Oral ED medication is generally considered extremely effective and studies show it works on the majority of men. But ED medication doesn’t work for everyone. It’s important to note that everyone’s reaction to a medication is unique.

Can a doctor diagnose erectile dysfunction remotely?

Yes, in most cases. Erectile dysfunction can be diagnosed by a physician based on a patient self-reporting their symptoms and medical history.

Why do I need to know my blood pressure to get an ED prescription?

Your blood pressure is an important part of determining whether it’s safe for you to take ED medication. It can be dangerous to take ED medication if your blood pressure is above or below a certain value.

To complete a comprehensive medical history during your online visit, you need to enter your most recent blood pressure reading within the last 6 months. If you haven’t had your blood pressure taken within the last 6 months, you can get a free blood pressure reading at thousands of locations across the country.

Enter your location into higi or Pursuant Health to find a place near you that offers free, clinically verified blood pressure readings.

How do I take my blood pressure at home?

If you’re measuring your blood pressure at home, make sure the device has been “clinically validated.” You can purchase a device online or at your local pharmacy. We recommend an upper arm cuff over a wrist or finger blood pressure monitor.

Before taking your blood pressure, it’s important to avoid the following factors that may cause your blood pressure to temporarily rise:

  • Cold temperatures
  • Exercise
  • Caffeine
  • Stress
  • Smoking
  • Certain medications (check the label on your device)

When you’re ready, find a quiet place and sit for 5-10 minutes. Make sure you’re relaxed and have recently urinated (a full bladder can affect your reading). Roll up your sleeve so that your arm is bare. Apply the cuff on your upper arm and following the directions on the device.Please make sure to take at least two readings. Enter the higher of the two readings during your online dynamic visit.

Do you offer alternative treatments for erectile dysfunction?

Oral ED medications are extremely effective, but they don’t work for everyone.

Other treatment options for ED include lifestyle improvements (like exercise, diet, quitting smoking, and limiting alcohol use), surgery, penile vacuum pumps, and other ED medications. Every treatment comes with risks and benefits that you should fully understand before moving forward with any treatment plan.

Currently, the only erectile dysfunction treatment we offer are oral PDE-5 inhibitors in the form of:

If you’d like to pursue alternative ED treatment, we recommend speaking with a physician in-person. Contact our team at [email protected] and we can recommend a doctor in your area.

How does my order ship?

Orders ship in discreet boxes, with all medication in single use packs. These single use packs are not child proof. Child proof packaging is available upon request by emailing [email protected]

Orders are shipped 2 Day Air to ensure medication is received as soon as possible. Postal Boxes and Mail Forwarding addresses will receive standard postal shipping and not 2 Day Air at this time.

Where can I get my blood pressure measured for free?

Enter your location into higi or Pursuant Health to find the nearest location to get a free, clinically verified blood pressure reading. Higi Stations are available free of charge at Rite Aids nationwide, and Pursuant Health stations are available free of charge at Walmarts nationwide.

What type of ED medication do you prescribe?

According to the American Urological Association, oral PDE-5 inhibitors should be offered as the “first line of therapy for erectile dysfunction.” So that’s what physicians on the Roman platform use to treat ED. The most common PDE-5 oral medications they prescribe are:

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What We Treat

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Roman-affiliated physician practices are independently owned and operated by licensed physicians who provide services utilizing the Roman telehealth platform. To learn more about Roman, please visit www.ro.co.

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Important safety information

Sildenafil 20mg (generic revatio)

Read this Patient Information before you start taking sildenafil 20 mg (Revatio) and each time you get a refill. There may be new information. This information does not take the place of talking with your doctor about your medical condition or treatment. If you have any questions about sildenafil, ask your doctor or pharmacist.

What is the most important information I should know about sildenafil 20 mg tablets (Revatio)?

Never take sildenafil with any nitrate medicines. Your blood pressure could drop quickly to an unsafe level. Nitrate medicines include:

  • Medicines that treat chest pain (angina)
  • Nitroglycerin in any form including tablets, patches, sprays, and ointments
  • Isosorbide mononitrate or dinitrate
  • Street drugs called “poppers” (amyl nitrate or nitrite)

Ask your doctor or pharmacist if you are not sure if you are taking a nitrate medicine.

What is sildenafil 20 mg tablets (Revatio)?

20 mg sildenafil is a prescription medicine used in adults to treat pulmonary arterial hypertension (PAH). With PAH, the blood pressure in your lungs is too high. Your heart has to work hard to pump blood into your lungs. It improves the ability to exercise and can slow down worsening changes in your physical condition.

  • Sildenafil is not for use in children
  • Adding sildenafil to another medication used to treat PAH, bosentan (Tracleer®), does not result in improvement in your ability to exercise.
  • 20 mg sildenafil tablets contain the same medicine as VIAGRA® (sildenafil), which is used to treat erectile dysfunction (impotence). Do not take 20 mg sildenafil tablets with VIAGRA or other PDE-5 inhibitors.

Who should not take sildenafil 20 mg tablets (Revatio)?

Do not take sildenafil if you:

  • Take any medicines called nitrates, often prescribed for chest pain, or guanylate cyclase stimulators like Adempas (riociguat) for pulmonary hypertension. Your blood pressure could drop to an unsafe level
  • Are allergic to sildenafil, as contained in VIAGRA® and REVATIO®
  • You’ve ever had blockage of veins in your lungs, which is called pulmonary veno-occlusive disease
  • Are a women or a child

Before you take sildenafil, tell your healthcare provider if you:

  • Have or have had heart problems such as a heart attack, irregular heartbeat, angina, chest pain, narrowing of the aortic valve, or heart failure
  • Have had heart surgery within the last 6 months
  • Have pulmonary hypertension
  • Have had a stroke
  • Have low blood pressure, or high blood pressure that is not controlled
  • Have a deformed penis shape
  • Have had an erection that lasted for more than 4 hours
  • Have problems with your blood cells such as sickle cell anemia, multiple myeloma, or leukemia
  • Have retinitis pigmentosa, a rare genetic (runs in families) eye disease
  • Have ever had severe vision loss, including an eye problem called NAION
  • Have bleeding problems
  • Have or have had stomach or intestinal ulcers
  • Have liver problems
  • Have kidney problems or are having kidney dialysis
  • Have any problem with the shape of your penis or Peyronie’s disease
  • Have any other medical conditions

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

  • Medicines called nitrates
  • Medicines called guanylate cyclase stimulators such as Adempas® (riociguat)
  • Medicines called alpha-blockers such as Hytrin® (terazosin HCl), Flomax® (tamsulosin HCl), Cardura® (doxazosin mesylate), Minipress® (prazosin HCl), Uroxatral® (alfuzosin HCl), Jalyn®(dutasteride and tamsulosin HCl), or Rapaflo® (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients, the use of VIAGRA® with alpha-blockers can lead to a drop in blood pressure or to fainting
  • Medicines called HIV protease inhibitors, such as ritonavir (Norvir®), indinavir sulfate (Crixivan®), saquinavir (Fortovase®or Invirase®), or atazanavir sulfate (Reyataz®)
  • Oral antifungal medicines, such as ketoconazole (Nizoral®) and itraconazole (Sporanox®)
  • Antibiotics, such as clarithromycin (Biaxin®), telithromycin (Ketek®), or erythromycin
  • Other medicines that treat high blood pressure
  • K antagonists (like coumadin or warfarin)
  • Other medicines or treatments for ED
  • Sildenafil is the same medicine found in VIAGRA® and REVATIO®. REVATIO® is used to treat a rare disease called pulmonary arterial hypertension (PAH). VIAGRA® should not be used with REVATIO® or with other PAH treatments containing sildenafil or any other PDE5 inhibitors (such as Adcirca [tadalafil])

Know the medicines you take. Keep a list of your medicines and show it to your doctor and pharmacist when you get a new medicine.

  • Take sildenafil exactly as your doctor tells you.
  • Sildenafil may be prescribed to you as tablets or an oral suspension
  • Take sildenafil tablet or oral suspension 3 times a day about 4 to 6 hours apart
  • Take sildenafil tablets or oral suspension at the same times every day.
  • Sildenafil oral suspension will be mixed for you by your pharmacist. Do not mix sildenafil oral suspension with other medicine or flavoring. Shake well for at least 10 seconds before each dose.
  • If you miss a dose, take it as soon as you remember. If it is close to your next dose, skip the missed dose, and take your next dose at the regular time.
  • Do not take more than one dose of sildenafil at a time.
  • Do not change your dose or stop taking sildenafil on your own. Talk to your doctor first.
  • If you take too much sildenafil, call your doctor or go to the nearest hospital

What are the possible side effects of sildenafil 20 mg tablets (Revatio)?

  • low blood pressure. Low blood pressure may cause you to feel faint or dizzy. Lie down if you feel faint or dizzy.
  • more shortness of breath than usual. Tell your doctor if you get more short of breath after you start REVATIO. More shortness of breath than usual may be due to your underlying medical condition.
  • decreased eyesight or loss of sight in one or both eyes (NAION). If you notice a sudden decrease or loss of eyesight, talk to your doctor right away.
  • sudden decrease or loss of hearing. If you notice a sudden decrease or loss of hearing, talk to your doctor right away. It is not possible to determine whether these events are related directly to this class of oral medicines, including REVATIO, or to other diseases or medicines, to other factors, or to a combination of factors.
  • heart attack, stroke, irregular heartbeats, and death. Most of these happened in men who already had heart problems.
  • erections that last several hours. Tell your doctor right away if you have an erection that lasts more than 4 hours.

The most common side effects with sildenafil 20 mg tablets (Revatio) include:

  • Nosebleed
  • Headache
  • upset stomach
  • getting red or hot in the face (flushing)
  • trouble sleeping
  • Fever
  • erection increased
  • respiratory infection
  • Nausea
  • Vomiting
  • Bronchitis
  • Pharyngitis
  • runny nose
  • pneumonia in children

Tell your doctor if you have any side effect that bothers you or doesn’t go away.These are not all the possible side effects of REVATIO. For more information, ask your doctor or pharmacist.

  • Store tablets at controlled room temperature, between 20°C -25°C (68°F to 77°F).
  • Store constituted oral suspension below 30°C (86°F) or in a refrigerator between 2°C to 8°C (36°F to 46°F). Do not freeze oral suspension.
  • Throw away oral suspension after 60 days.
  • Keep all medicines away from children.

General information about sildenafil 20 mg tablets (Revatio)

Medicines are sometimes prescribed for purposes that are not in the patient leaflet. Do not use REVATIO for a condition for which it was not prescribed. Do not give REVATIO to other people, even if they have the same symptoms you have. It could harm them.

Active ingredients: sildenafil citrate

Inactive ingredients: microcrystalline cellulose, anhydrous dibasic calcium phosphate, croscarmellose sodium, magnesium stearate, hypromellose, titanium dioxide, lactose monohydrate, and triacetin

Important safety information

What Should You Know Before Taking Viagra

Contraindications

Do not take Viagra® or generic Viagra® if you:

  • take medicines called nitrates (such as nitroglycerin)
  • use street drugs called “poppers” such as amyl nitrate or amyl nitrite, and butyl nitrate
  • take any medicines called guanylate cyclase stimulators such as riociguat (Adempas)
  • are allergic to sildenafil, as contained in Viagra® and Revatio, or any of the ingredients in Viagra®. See the end of this leaflet for a complete list of ingredients in Viagra®.

What should I tell my healthcare provider before taking Viagra® or generic Viagra®?

To make sure Viagra® is safe for you, tell your healthcare provider if you have any of the following before you take Viagra® or generic Viagra®:

  • Have or have had heart problems such as a heart attack,irregular heartbeat, angina, chest pain, narrowing of the aortic valve, or heart failure
  • Have had heart surgery within the last 6 months
  • Have pulmonary hypertension
  • Have had a stroke
  • Have low blood pressure, or high blood pressure that is not controlled
  • Have a deformed penis shape
  • Have had an erection that lasted for more than 4 hours
  • Have problems with your blood cells such as sickle cell anemia, multiple myeloma, or leukemia
  • Have retinitis pigmentosa, a rare genetic (runs in families) eye disease
  • Have ever had severe vision loss, including an eye problem called NAION
  • Have bleeding problems
  • Have or have had stomach or intestinal ulcers
  • Have liver problems
  • Have kidney problems or are having kidney dialysis
  • Have any other medical conditions

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Drug Interactions

Tell your healthcare provider if you take any of the following because these drugs interact with Viagra® and generic Viagra®:

  • Medicines called nitrates
  • Medicines called guanylate cyclase stimulators such as Adempas® (riociguat)
  • Medicines called alpha-blockers such as Hytrin® (terazosin HCl), Flomax® (tamsulosin HCl), Cardura® (doxazosin mesylate), Minipress® (prazosin HCl), Uroxatral® (alfuzosin HCl), Jalyn® (dutasteride and tamsulosin HCl), or Rapaflo® (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients, the use of VIAGRA® or generic VIAGRA® with alpha-blockers can lead to a drop in blood pressure or to fainting
  • Medicines called HIV protease inhibitors, such as ritonavir (Norvir®), indinavir sulfate (Crixivan®), saquinavir (Fortovase® or Invirase®), or atazanavir sulfate (Reyataz®)
  • Oral antifungal medicines, such as ketoconazole (Nizoral®) and itraconazole (Sporanox®)
  • Antibiotics, such as clarithromycin (Biaxin®), telithromycin (Ketek®), or erythromycin
  • Other medicines that treat high blood pressure
  • Other medicines or treatments for ED
  • Viagra® and generic Viagra® contain sildenafil, which is the same medicine found in another drug called Revatio®. Revatio® is used to treat a rare disease called pulmonary arterial hypertension (PAH). Viagra® and generic Viagra® should not be used with Revatio® or with other PAH treatments containing sildenafil or any other PDE5 inhibitors (such as Adcirca [tadalafil])

Ask your healthcare provider or pharmacist for a list of these medicines, if you are not sure.

Viagra Side Effects

What are the possible side effects of Viagra® and generic Viagra®?

  • an erection that will not go away (priapism). If you have an erection that lasts more than 4 hours, get medical help right away. If it is not treated right away, priapism can permanently damage your penis.
  • sudden vision loss in one or both eyes. Sudden vision loss in one or both eyes can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropathy (NAION). It is uncertain whether PDE5 inhibitors directly cause the vision loss. Stop taking Viagra® and call your healthcare provider right away if you have sudden vision loss in one or both eyes.
  • sudden hearing decrease or hearing loss. Some people may also have ringing in their ears (tinnitus) or dizziness. If you have these symptoms, stop taking Viagra® or generic Viagra® and contact a doctor right away.

The most common side effects of Viagra® and generic Viagra® are:

  • headache
  • flushing
  • upset stomach
  • abnormal vision, such as changes in color vision (such as having a blue color tinge) and blurred vision
  • stuffy or runny nose
  • back pain
  • muscle pain
  • nausea
  • dizziness
  • Rash

In addition, heart attack, stroke, irregular heartbeats and death have happened rarely in men taking Viagra®. Most, but not all, of these men had heart problems before taking Viagra®. It is not known if Viagra® caused these problems.

Popular questions

Can I use Viagra with alcohol?

It is not recommended to mix alcohol with Viagra.

Can I take Viagra more than once per day?

No. Do not exceed one dose in a 24 hour period

Is Viagra affected by food?

You can use Viagra with or without food. However, fatty food has been shown to reduce the rate of absorption and strength. Viagra will have the strongest effect on an empty stomach. Also, it is worth noting grapefruit juice can possibly affect the absorption of Viagra.

Can I get a Viagra prescription online?

Yes, you can get a prescription through a Roman online visit for Erectile Dysfunction or an online visit for Premature Ejaculation, if determined appropriate by a U.S. licensed physician.

What is off-label usage of medication?

Roman-affiliated physicians have the discretion to prescribe 20mg Sildenafil for ED if they believe that it is an appropriate course of treatment for a particular patient. 20mg Sildenafil for ED is an off-label usage of the medication, and it is up to the medical judgment of the doctor to decide if such treatment is appropriate based on each patient’s unique medical history, symptoms, and preferences. The Roman Pharmacy Network is able to fill prescriptions for 20mg Sildenafil that are issued by a Roman-affiliated physician.

Important safety information

Disclaimer: The information provided on this page is not a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns about your health, please talk to a doctor.

What is Cialis?

Cialis® is a drug that is used to treat erectile dysfunction (ED). It comes in four doses, 2.5 mg, 5 mg, 10 mg, and 20 mg. Cialis® can be taken as needed in any of the four doses. The 2.5 mg and 5 mg doses are also approved for daily use for ED. Cialis® in the 2.5 mg and 5 mg doses is also FDA-approved for men suffering from urinary symptoms due to benign prostatic hyperplasia (BPH) with or without ED. Physicians on the Roman platform physicians do not currently treat BPH. If you feel you need Cialis for the treatment of BPH, please seek in-person care. For as needed dosing, the 10 mg dose is the most commonly used dose, although some people may benefit from higher or lower doses. Cialis® is part of a “family” of medicines used to treat ED called phosphodiesterase-5 inhibitors (PDE5i). Other drugs in this family include Viagra (sildenafil), Levitra (vardenafil), and Stendra (avanafil). All of these drugs have the same mechanism of action, but there are subtle differences that may lead the doctor to recommend one drug over the other based on your treatment goals.

Does Roman Offer Genuine Cialis?

Roman offers branded Cialis® and its generic, tadalafil, to treat ED. They are both FDA-approved to treat ED. They can be taken as needed (from 2.5 mg to 20 mg) or daily (in the 2.5 mg and 5 mg doses) to treat ED.

What is Cialis?

Cialis® is a drug that is used to treat erectile dysfunction (ED). It comes in four doses, 2.5 mg, 5 mg, 10 mg, and 20 mg. Cialis® can be taken as needed in any of the four doses. The 2.5 mg and 5 mg doses are also approved for daily use for ED. Cialis® in the 2.5 mg and 5 mg doses is also FDA-approved for men suffering from urinary symptoms due to benign prostatic hyperplasia (BPH) with or without ED. Physicians on the Roman platform physicians do not currently treat BPH. If you feel you need Cialis for the treatment of BPH, please seek in-person care. For as needed dosing, the 10 mg dose is the most commonly used dose, although some people may benefit from higher or lower doses. Cialis® is part of a “family” of medicines used to treat ED called phosphodiesterase-5 inhibitors (PDE5i). Other drugs in this family include Viagra (sildenafil), Levitra (vardenafil), and Stendra (avanafil). All of these drugs have the same mechanism of action, but there are subtle differences that may lead the doctor to recommend one drug over the other based on your treatment goals.

What is Tadalafil?

Tadalafil is the chemical name of the active ingredient in Cialis®. Cialis® was originally patented and sold by Eli Lilly. It is FDA-approved to treat ED and urinary symptoms due to BPH. After the patent expired in 2018, the FDA gave permission to other drug companies to manufacture a generic version of Cialis®. The FDA requires generic drugs to be bioequivalent to the brand name version. This means that they act the same way in the body and are expected to produce the same effects as the original brand name drug. Generic drugs are generally much cheaper than the original brand name drug, and most drugs prescribed in the US are generic.

Does Roman Offer Genuine Cialis?

Roman offers branded Cialis® and its generic, tadalafil, to treat ED. They are both FDA-approved to treat ED. They can be taken as needed (from 2.5 mg to 20 mg) or daily (in the 2.5 mg and 5 mg doses) to treat ED.

How Does Cialis Work?

In order to understand how Cialis® works to treat ED, it’s important to first understand the basics of how erections work. Erotic stimulation (by physical touch, erotic thoughts, smells, etc.) causes the local tissues to release nitric oxide (NO), which increases the amount of a chemical called cyclic guanosine monophosphate (cGMP). cGMP causes the muscles on the sides of the penis, the corpora cavernosa, to relax allowing blood to rush into the penis. At the same time veins that drain blood from the penis get compressed causing the increased blood to be trapped in the penis causing an erection. An enzyme called phosphodiesterase-5 breaks down cGMP leading the penis to return to its flaccid state. PDE5i, like Cialis®, block this enzyme leading to higher levels of cGMP and improving the ability to obtain and maintain an erection.

How Should I Take Cialis?

Cialis® should be taken at least 30–60 minutes before sex. Cialis is a long acting drug and will stay active in your body for up to 36 hours, which is sometimes why it’s nicknamed “the weekend pill.” Some people have better results when they take Cialis® at least 2 hours before sex. Cialis® absorption is not affected by food and can be taken with or without food.

What is Daily Cialis?

In addition to as needed dosing, Cialis® is also approved for daily use in the 2.5 mg and 5 mg doses. This creates a steady amount of medicine in the blood and completely eliminates the need to plan for sex. With daily Cialis®, treatment for ED becomes part of your daily routine. Most men who are eligible for ED treatment can take daily Cialis® with certain exceptions, including airline pilots, air traffic controllers, and people taking certain medicines (e.g., some HIV medicines, certain antibiotics and antifungals). You should speak with your doctor to determine if daily Cialis is an appropriate treatment option for you.

What Should You Know Before Taking Cialis

Who should not take Cialis® or generic Cialis®? Do not take Cialis® or generic Cialis® if you:

  • take medicines called nitrates (such as nitroglycerin)
  • use street drugs called “poppers” such as amyl nitrate or amyl nitrite, and butyl nitrate
  • take any medicines called guanylate cyclase stimulators such as riociguat (Adempas)
  • are allergic to Cialis® or any of the ingredients in Cialis®. See the end of this section for a complete list of ingredients in Cialis®.

What should I tell my healthcare provider before taking Cialis® or generic Cialis®?

To make sure Cialis® is safe for you, tell your healthcare provider if you have any of the following before you take Cialis® or generic Cialis®:

  • Have or have had heart problems such as a heart attack, irregular heartbeat, angina, chest pain, narrowing of the aortic valve, or heart failure
  • Have had heart surgery within the last 6 months
  • Have pulmonary hypertension
  • Have had a stroke
  • Have low blood pressure, or high blood pressure that is not controlled
  • Have a deformed penis shape
  • Have had an erection that lasted for more than 4 hours
  • Have problems with your blood cells such as sickle cell anemia, multiple myeloma, or leukemia
  • Have retinitis pigmentosa, a rare genetic (runs in families) eye disease
  • Have ever had severe vision loss, including an eye problem called NAION
  • Have bleeding problems
  • Have or have had stomach or intestinal ulcers
  • Have liver problems
  • Have kidney problems or are having kidney dialysis
  • Have any other medical conditions

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Cialis® and generic Cialis® may affect the way other medicines work, and other medicines may affect the way Cialis® and generic Cialis® works, causing side effects.

Tell your healthcare provider if you take any of the following because these drugs interact with Cialis® and generic Cialis®:

  • Medicines called nitrates
  • Medicines called guanylate cyclase stimulators such as Adempas® (riociguat)
  • Medicines called alpha-blockers such as Hytrin® (terazosin HCl), Flomax® (tamsulosin HCl), Cardura® (doxazosin mesylate), Minipress® (prazosin HCl), Uroxatral® (alfuzosin HCl), Jalyn® (dutasteride and tamsulosin HCl), or Rapaflo® (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients, the use of Cialis® or generic Cialis® with alpha-blockers can lead to a drop in blood pressure or to fainting
  • Medicines called HIV protease inhibitors, such as ritonavir (Norvir®), indinavir sulfate (Crixivan®), saquinavir (Fortovase® or Invirase®), or atazanavir sulfate (Reyataz®)
  • Oral antifungal medicines, such as ketoconazole (Nizoral®) and itraconazole (Sporanox®)
  • Antibiotics, such as clarithromycin (Biaxin®), telithromycin (Ketek®), or erythromycin
  • Other medicines that treat high blood pressure
  • Other medicines or treatments for ED
  • Adcirca® (tadalafil) is used to treat a rare disease called pulmonary arterial hypertension (PAH) and has the same active ingredient as Cialis®. Cialis® and generic Cialis® should not be used with Adcirca® or with other PAH treatments containing sildenafil or any other PDE5 inhibitors (such as Revatio® [sildenafil citrate])

Ask your healthcare provider or pharmacist for a list of these medicines, if you are not sure.

Cialis® Side Effects

What are the possible side effects of Cialis® and generic Cialis®?

Cialis® and generic Cialis® can cause serious side effects. Rarely reported side effects include:

  • an erection that will not go away (priapism). If you have an erection that lasts more than 4 hours, get medical help right away. If it is not treated right away, priapism can permanently damage your penis.
  • sudden vision loss in one or both eyes. Sudden vision loss in one or both eyes can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropathy (NAION). It is uncertain whether PDE5 inhibitors directly cause the vision loss. Stop taking Cialis® and call your healthcare provider right away if you have sudden vision loss in one or both eyes.
  • sudden hearing decrease or hearing loss. Some people may also have ringing in their ears (tinnitus) or dizziness. If you have these symptoms, stop taking Cialis® or generic Cialis® and contact a doctor right away.

The most common side effects of Cialis® and generic Cialis® are:

  • headache
  • flushing
  • upset stomach
  • abnormal vision, such as changes in color vision (such as having a blue color tinge) and blurred vision
  • stuffy or runny nose
  • back pain
  • muscle pain
  • nausea
  • dizziness
  • Rash

In addition, heart attack, stroke, irregular heartbeats and death have happened rarely in men taking Cialis®. Most, but not all, of these men had heart problems before taking Cialis®. It is not known if Cialis® caused these problems.

What Happens if I Overdose?

Taking more than the recommended amount of Cialis® or generic Cialis® greatly increases your risk of side effects, including severe ones that can be dangerous, such as severe low blood pressure or an erection that won’t go away even after 4 or more hours (priapism). Never take more than the amount prescribed to you by your doctor. If you have any severe side effects after taking more than the recommended amount, or even after taking the amount of medicine prescribed to you, seek out emergency medical attention immediately.

Popular questions

Can I use Cialis with alcohol?

Physicians should inform patients that substantial consumption of alcohol (e.g., 5 units or greater) in combination with CIALIS can increase the potential for side effects.

Can I take Cialis more than once per day?

No. Do not exceed one dose in a 24 hour period

Is Cialis affected by food?

You can eat normally. Except, it is worth noting grapefruit juice can possibly affect the absorption of Cialis (Tadalafil).