Vitamins for better erections

Some vitamin deficiencies might contribute to erectile dysfunction. Specifically, deficiencies in vitamins C and D have been found to be associated with erectile problems. Certain supplements have shown promise in improving ED, but they’re a roll of the dice, partly because supplements aren’t FDA-regulated and partly because there is a dearth of high-quality evidence regarding their effectiveness. If you’re experiencing ED, it’s a good idea to talk with a healthcare provider.

Table of Contents

Disclaimer

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

If you’ve been having less-than-stellar erections, chances are the first visit you made was to Dr. Google. There’s a lot of information out there about dietary supplements that claim to give you better erections, help you last longer, and make sex better. Here’s the truth: a lot of it is B.S. Let’s take a look at what the science says about vitamins and supplements that actually can improve erections.

Get $15 off your first month of ED treatment

If prescribed, get ED treatment delivered discreetly directly to your door.

Vitamins for ED

Erectile dysfunction (ED) is when you can’t get or keep an erection sufficient for satisfying sex. That might include erections that don’t last as long as you want or aren’t as firm as you’d like.

ED can be distressing, but it is very common—the most common sexual dysfunction there is. In fact, nearly one in five men experience ED by the age of 30, and about half of all men experience ED by the age of 50 (Feldman, 1994).

And since there are many different things that can contribute to ED, there are many different things you can try to treat it. Among them are various vitamins and supplements.

Read everything you need to know about erectile dysfunction here.

Vitamin D

One study found that men with vitamin D deficiency were 32% more likely to have trouble with erections than men without (Farag, 2016). More in-depth research has shown that the testicles have more receptors for vitamin D than other areas of the body, meaning the vitamin likely plays an important role there (Crafa, 2020).

Low vitamin D levels are pretty common. Between 2001–2006, one-third of the U.S. population had insufficient amounts of vitamin D, according to the Institute of Medicine (Looker, 2011). Your healthcare provider can test your vitamin D levels with a simple blood test.

To say for sure that vitamin D takes the “D” out of “ED,” we’d need more research. To date, there haven’t been any studies showing that treatment of vitamin D deficiency might restore erectile function. Still, if your levels are low, it’s a good idea to speak with your provider about supplementation.

According to the Institute of Medicine and the National Institutes of Health, the Recommended Dietary Allowance (RDA) is between 15 mcg (600 IU) and 20 mcg (800 IU) per day depending on your age. You can get the vitamin from foods you eat, but a supplement (like a pill, liquid drops, or vitamin D gummies) might be a better option if what you eat isn’t enough.

Vitamin C

We all know that vitamin C (ascorbic acid) is an important nutrient, but it may help your erections, too (Meldrum, 2010). Antioxidants like vitamin C boost a chemical in our bodies called nitric oxide (NO) and prevent its breakdown, which is actually very similar to how Viagra works (d’Uscio, 2003). Nitric oxide opens up our blood vessels and improves blood flow.

And while that might seem promising, there isn’t actually any research showing that vitamin C will get you hard. Still, if you have a deficiency, it probably won’t hurt. Vitamin C is found in citrus fruits, kale, cauliflower, berries, and more, so getting your daily dose has never been more delicious.

Vitamin C benefits: 9 you should know about

A single glass of orange juice will give you about twice what you need every day. But just because it’s nutritious doesn’t mean you should be downing extra. Your body doesn’t absorb it past a certain point, meaning you’ll just be peeing it out.

Speak with a provider to find out if you need to up your intake and explore ways to get the vitamin C you need.

Niacin (vitamin B3)

Vitamin B3 (a.k.a. niacin) is everywhere. It can be found in red meat, poultry, veggies, and fruits, meaning you likely get what you need already. But this handy vitamin can also be used to lower cholesterol in people with hyperlipidemia (high cholesterol), which is a known contributor to erectile dysfunction.

But here’s the kicker: when it comes to niacin, there actually is research showing it helps. People with high cholesterol and moderate to severe ED showed improvements in their ED after treatment with niacin (Ng, 2011).

Now, that doesn’t mean you should head out and pop a bunch of B3. What it does mean is that you should head to your healthcare provider to make sure your cholesterol is in check. Also, keep in mind that if it isn’t, you probably won’t get a prescription for niacin. That’s because, while it may help with high cholesterol, it isn’t the best treatment available.

You can also make sure you’re eating a balanced diet and getting your daily dose of niacin from your food. Foods that contain niacin include turkey, avocado, and peanuts.

Folic acid (vitamin B9)

Another B vitamin, vitamin B9, has also been linked to erections. Also known as folate, this vitamin plays a vital role in a range of different processes in the body, including the formation of new blood cells, as well as in sperm development in men. One small study showed a correlation between folate deficiency and erectile dysfunction (Yang, 2014).

Taking a B complex supplement could raise your B9 levels, or you can consume more foods high in folic acid, including spinach, milk, and orange juice. Your healthcare provider can perform a simple blood test to see if you’re low on B9.

Herbal supplements for ED

Some people prefer taking an herbal route to addressing their health concerns. While most herbal supplements don’t have much research behind them, we do have at least some evidence about how a few herbal supplements may impact erectile function.

Horny goat weed

Horny goat weed is a medicinal herb that has been used in traditional Chinese medicine for thousands of years to treat fatigue and low libido. Some anecdotal reports and animal tests suggest that horny goat weed might help address ED by improving erections. Horny goat weed contains icariin, a substance that works the same way Viagra works (Dell’Agli, 2008). But studies on icariin have been conducted on animals and in test tubes; horny goat weed may not work the same way in the human body.

What is horny goat weed? Does it work?

Yohimbe

Yohimbine, the active ingredient in Yohimbe bark, is a common ingredient in supplements sold as aphrodisiacs or male sexual enhancers. A 2015 review of studies found that seven clinical trials determined that yohimbine was superior to placebo for the treatment of ED (Ernst, 1998). But researchers noted that studies had not directly compared yohimbine to medications like Viagra, meaning it hasn’t been confirmed just how effective this herb is compared to the tried-and-true erectile dysfunction drugs available on the market.

Red ginseng

Red ginseng (aka Korean ginseng) has been touted for the treatment of erectile dysfunction for years. In one large meta-analysis that examined the results of 24 other studies involving 2,080 men with ED, researchers found that ginseng “significantly improved erectile function” and “may be an effective herbal treatment for ED,” although they cautioned that more studies would be needed before the herb could be recommended as a treatment (Borrelli, 2018).

Dehydroepiandrosterone (DHEA) is a hormone produced in the adrenal glands, which are small glands that sit on top of your kidneys. It’s a natural booster of hormones like testosterone and estrogen. Some studies have found that taking a DHEA supplement can boost testosterone levels, a measure associated with erectile function (Liu, 2013). Other studies found it doesn’t help (Brown, 1999).

Citrulline and arginine

Citrulline, an amino acid, may help increase blood flow, a lot like Viagra. The body can also convert it into arginine, another amino acid that may improve blood flow. Whether or not these supplements work as a treatment for erectile dysfunction is up for debate, though. It may break down too quickly for your body to use, and L-arginine deficiency doesn’t usually cause ED. But if you’re interested in trying it with very little risk, watermelon is one food that’s a rich natural source of citrulline.

Considerations for vitamins/herbal supplements for ED

A few things to keep in mind when you’re considering vitamins or supplements for the treatment of ED: Unlike prescription drugs, vitamins and supplements are not FDA-approved or regulated. So you can’t be absolutely sure of their potency or quality. Many of them also lack sufficient evidence regarding their effectiveness too.

Certain vitamins and supplements could affect other health conditions you have or interact dangerously with prescription medications you’re taking. You should always consult your healthcare provider before starting any vitamins or supplements.

8 natural remedies and treatments for erectile dysfunction

Other ED treatments

Oral medications for ED are highly effective. Several are available, including sildenafil (brand name Viagra; see Important Safety Information), tadalafil (brand name Cialis; see Important Safety Information), and vardenafil (brand name Levitra).

If low testosterone is responsible for your ED, testosterone replacement therapy (TRT) can boost your testosterone levels via injection, a wearable patch, or gel applied to the skin.

For some men with ED, using a device such as a penis pump, cock ring, or a surgically placed penis implant have been effective in restoring sexual function.

Your erections will be best when you’re healthy. Making simple lifestyle changes, such as getting regular exercise, eating a healthy diet, quitting smoking, and limiting your alcohol consumption, might be enough to improve ED.

If you’re experiencing ED, it’s a good idea to talk with a healthcare provider. They’ll help you find the solution that’s right for you—and potentially nip any other contributing health problems in the bud.

References

  1. Borrelli, F., Colalto, C., Delfino, D. V., Iriti, M., & Izzo, A. A. (2018). Herbal dietary supplements for erectile dysfunction: a systematic review and meta-analysis. Drugs, 78(6), 643–673. doi: 10.1007/s40265-018-0897-3. Retrieved from ​​https://pubmed.ncbi.nlm.nih.gov/29633089/
  2. Brown, G. A., Vukovich, M. D., Sharp, R. L., Reifenrath, T. A., Parsons, K. A., & King, D. S. (1999). Effect of oral DHEA on serum testosterone and adaptations to resistance training in young men. Journal of Applied Physiology, 87(6), 2274–2283. doi: 10.1152/jappl.1999.87.6.2274. Retrieved from https://pubmed.ncbi.nlm.nih.gov/10601178/
  3. Crafa, A., Cannarella, R., Condorelli, R. A., La Vignera, S., & Calogero, A. E. (2020). Is there an association between vitamin D deficiency and erectile dysfunction? A systematic review and meta-analysis. Nutrients, 12(5), 1411. doi: 10.3390/nu12051411 Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7284343/
  4. Cui, T., Kovell, R. C., Brooks, D. C., & Terlecki, R. P. (2015). A urologists guide to ingredients found in top-selling nutraceuticals for mens sexual health. The Journal of Sexual Medicine, 12(11), 2105–2117. doi: 10.1111/jsm.13013. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26531010/
  5. Dell’Agli, M., Galli, G. V., Cero, E. D., Belluti, F., Matera, R., Zironi, E., et al. (2008). Potent Inhibition of Human Phosphodiesterase-5 by Icariin Derivatives. Journal of Natural Products, 71(9), 1513–1517. doi: 10.1021/np800049y Retrieved from https://pubmed.ncbi.nlm.nih.gov/18778098/
  6. d’Uscio, L. V., Milstien, S., Richardson, D., Smith, L., & Katusic, Z. S. (2003). Long-term vitamin C treatment increases vascular tetrahydrobiopterin levels and nitric oxide synthase activity. Circulation Research, 92(1), 88–95. doi: 10.1161/01.res.0000049166.33035.62. Retrieved from https://pubmed.ncbi.nlm.nih.gov/12522125/
  7. Ernst, E., & Pittler, M. H. (1998). Yohimbine for erectile dysfunction: a systematic review and meta-analysis of randomized clinical trials. The Journal of Urology, 159(2), 433–436. doi: 10.1016/s0022-5347(01)63942-9. Retrieved from https://pubmed.ncbi.nlm.nih.gov/9649257/
  8. Farag, Y. M., Guallar, E., Zhao, D., Kalyani, R. R., Blaha, M. J., Feldman, D. I., et al. (2016). Vitamin D deficiency is independently associated with greater prevalence of erectile dysfunction: The National Health and Nutrition Examination Survey (NHANES) 2001–2004. Atherosclerosis, 252, 61–67. doi: 10.1016/j.atherosclerosis.2016.07.921. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5035618/
  9. Feldman, H. A., Goldstein, I., Hatzichristou, D. G., Krane, R. J., & McKinlay, J. B. (1994). Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. The Journal of Urology, 151(1), 54–61. doi: 10.1016/s0022-5347(17)34871-1. Retrieved from https://pubmed.ncbi.nlm.nih.gov/8254833/
  10. Looker, A. C. (2011, March). NCHS Data Brief: Vitamin D Status: United States, 2001–2006. Retrieved March 2020, from https://www.cdc.gov/nchs/data/databriefs/db59.pdf
  11. Liu, T. C., Lin, C. H., Huang, C. Y., Ivy, J. L., & Kuo, C. H. (2013). Effect of acute DHEA administration on free testosterone in middle-aged and young men following high-intensity interval training. European Journal of Applied Physiology, 113(7), 1783–1792. doi: 10.1007/s00421-013-2607-x. Retrieved from https://pubmed.ncbi.nlm.nih.gov/23417481/
  12. Meldrum, D. R., Gambone, J. C., Morris, M. A., & Ignarro, L. J. (2010). A multifaceted approach to maximize erectile function and vascular health. Fertility and Sterility, 94(7), 2514–2520. doi: 10.1016/j.fertnstert.2010.04.026. Retrieved from https://pubmed.ncbi.nlm.nih.gov/20522326/
  13. Ng, C. F., Lee, C. P., Ho, A. L., & Lee, V. W. (2011). Effect of niacin on erectile function in men suffering erectile dysfunction and dyslipidemia. The Journal of Sexual Medicine, 8(10), 2883–2893. doi: 10.1111/j.1743-6109.2011.02414.x. Retrieved from https://pubmed.ncbi.nlm.nih.gov/21810191/
  14. USDA FoodData Central Search Results: Brussels sprouts. (2020). Retrieved from https://fdc.nal.usda.gov/fdc-app.html#/food-details/170383/nutrients
  15. USDA FoodData Central Search Results: Orange juice. (2020). Retrieved from https://fdc.nal.usda.gov/fdc-app.html#/food-details/169098/nutrients
  16. Yang, J., Yan, W.-J., Yu, N., Yin, T.-L., & Zou, Y.-J. (2014). A new potential risk factor in patients with erectile dysfunction and premature ejaculation: folate deficiency. Asian Journal of Andrology, 16(6), 902. doi: 10.4103/1008-682x.135981. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4236337/

Erectile dysfunction and diabetes: are they linked?

Do blood pressure medications cause erectile dysfunction?

Erectile dysfunction pills and medications: Viagra, Cialis, and more

Can vitamin D boost testosterone?

Erectile dysfunction (ED) and mental health

8 natural remedies and treatments for erectile dysfunction

7 foods that help you stay erect

Autoimmune diseases and erectile dysfunction (ED)

Digital Health Clinic for Men

Digital Health Clinic for Women

Simple, Affordable Online Pharmacy

The Patient Company

Important Safety Information for Sildenafil (Viagra)

What are the most important things I need to know about VIAGRA® (sildenafil citrate) 25 mg, 50 mg, and 100 mg tablets and generic VIAGRA®?

Discuss your health with your doctor to ensure that you are healthy enough for sex. If you experience chest pain, dizziness, or nausea during sex, seek immediate emergency medical attention.

  • VIAGRA® and generic VIAGRA® can cause serious side effects. Serious, but rare, side effects include:
    • an erection that will not go away (priapism). If you have an erection that lasts more than 4 hours, seek emergency medical attention 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). Stop taking VIAGRA and call your healthcare provider right away if you have any sudden vision loss
    • 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 and contact a doctor right away

    Who should not take VIAGRA® or generic VIAGRA®?

    Do not take VIAGRA® or generic VIAGRA® 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®, or any of the ingredients in VIAGRA® or generic VIAGRA® tablets.
    • Are a women or a child

    When should I call my primary provider?

    Call your primary provider right away if you:

    • Have an erection that lasts longer than 4 hours
    • Experience a sudden loss of vision in one or both eyes
    • Experience a sudden decrease in or loss of hearing
    • Experience chest pain, dizziness, or nausea during sex
    • Take too much Viagra or sildenafil citrate

    If you are experiencing a medical emergency, call 911 or seek immediate medical attention.

    What are the most common side effects of VIAGRA® and generic VIAGRA®?

    The most common side effects 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

    What should I tell my Roman-affiliated provider before taking VIAGRA® and generic VIAGRA®?

    Before you take VIAGRA® or generic VIAGRA® , 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 other medical conditions

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

    VIAGRA may affect the way other medicines work, and other medicines may affect the way VIAGRA works, causing side effects.

    Especially tell your healthcare provider if you take any of the following:

    • 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
    • Other medicines or treatments for ED
    • VIAGRA® contains 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® should not be used with REVATIO® or with other PAH treatments containing sildenafil or any other PDE5 inhibitors (such as Adcirca [tadalafil])

    Withholding or providing inaccurate information about your health and medical history in order to obtain treatment may result in harm, including, in some cases, death.

    What is the FDA-approved use of VIAGRA® and generic VIAGRA®?

    VIAGRA® (sildenafil citrate) is prescription medicine used to treat erectile dysfunction (ED).

    Roman-affiliated doctors may prescribe VIAGRA® or generic VIAGRA® for the treatment of premature ejaculation (PE), if they believe in their medical judgment that it is an appropriate course of treatment. While this is not an FDA-approved use of the drug, the American Urological Association has included the use of sildenafil citrate in the treatment of PE in its Guideline on the Pharmacologic Management of Premature Ejaculation.

    You are encouraged to report negative side effects of prescription products to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

    Please see the full Prescribing Information for complete safety information.

    Product names referenced herein are trademarks of their respective owners.

    Important Safety Information for Tadalafil (Cialis)

    What Is The Most Important Information I Should Know About CIALIS® (tadalafil) and generic CIALIS®?

    • CIALIS® and generic CIALIS® can cause serious side effects. Serious, but rare, side effects include:
      • An erection that won’t go away (priapism). If you get an erection that lasts more than 4 hours, get medical help right away. Priapism must be treated as soon as possible or lasting damage can happen to your penis, including the inability to have erections.
      • Changes in vision. Color vision changes, such as seeing a blue tinge (shade) to objects or having difficulty telling the difference between the colors blue and green.
      • Sudden decrease or loss of vision. In rare instances, men taking PDE5 inhibitors (oral erectile dysfunction medicines, including CIALIS® and generic CIALIS®) reported a sudden decrease or loss of vision in one or both eyes. It is uncertain whether PDE5 inhibitors directly cause the vision loss. If you experience sudden decrease or loss of vision, stop taking PDE5 inhibitors, including CIALIS® and generic CIALIS®, and call a healthcare provider right away.
      • Sudden loss or decrease in hearing. Sudden loss or decrease in hearing, sometimes with ringing in the ears and dizziness, has been rarely reported in people taking PDE5 inhibitors, including CIALIS® and generic CIALIS®. It is not possible to determine whether these events are related directly to the PDE5 inhibitors, to other diseases or medications, to other factors, or to a combination of factors. If you experience these symptoms, stop taking CIALIS® and generic CIALIS® and contact a healthcare provider right away.
      • ED is a condition where the penis does not fill with enough blood to harden and expand when a man is sexually excited, or when he cannot keep an erection. A man who has trouble getting or keeping an erection should see his healthcare provider for help if the condition bothers him.
      • CIALIS® and generic CIALIS® help increase blood flow to the penis and may help men with ED get and keep an erection satisfactory for sexual activity. Once a man has completed sexual activity, blood flow to his penis decreases, and his erection goes away. Some form of sexual stimulation is needed for an erection to happen with CIALIS® or generic CIALIS®.
      • CIALIS® and generic CIALIS® do not:
        • Cure ED
        • Increase a man’s sexual desire
        • Protect a man or his partner from sexually transmitted diseases, including HIV. Speak to your healthcare provider about ways to guard against sexually transmitted diseases.
        • Serve as a male form of birth control
        • Take CIALIS® or generic CIALIS® exactly as your healthcare provider prescribes it. Your healthcare provider will prescribe the dose that is right for you. Do not change your dose or the way you take CIALIS® or generic CIALIS® without talking to your healthcare provider.

        Who Should Not Take CIALIS® or generic CIALIS®?

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

        • Have severe liver disease. Tell your doctor if you have mild to moderate liver disease as you may need dosage reductions.
        • Have severe kidney disease. Tell your doctor if you have mild to moderate kidney disease as you may need dosage reductions
        • Take any medicines called “nitrates”
        • Use recreational drugs called “poppers” like amyl nitrite and butyl nitrite
        • Take any medicines called guanylate cyclase stimulators, such as riociguat
        • Are allergic to CIALIS®, tadalafil or ADCIRCA®, or any of its ingredients

        When should I call my primary provider?

        Call your primary provider right away if you:

        • Have an erection that lasts longer than 4 hours
        • Experience a sudden loss of vision in one or both of your eyes
        • Experience a sudden decrease or loss hearing
        • Take too much CIALIS® or generic CIALIS®
        • Have an allergic reaction to CIALIS® or generic CIALIS®
        • Symptoms of an allergic reaction may include:
        • Rash
        • Hives
        • Swelling of the lips, tongue, or throat
        • Difficulty breathing or swallowing

        Call your healthcare provider or get help right away if you have any of the symptoms of an allergic reaction listed above.

        If you are experiencing a medical emergency, call 911 or seek immediate medical attention.

        What Should I Tell My Roman-affiliated Provider Before Taking CIALIS® and generic CIALIS®?

        Tell your Roman-affiliated provider about all your medical problems, including if you:

        • Have heart problems such as angina, heart failure, irregular heartbeats, or have had a heart attack. Ask your healthcare provider if it is safe for you to have sexual activity. You should not take CIALIS® and generic CIALIS® if your healthcare provider has told you not to have sexual activity because of your health problems.
        • Have pulmonary hypertension
        • Have low blood pressure or have high blood pressure that is not controlled
        • Have had a stroke
        • Have liver problems
        • Have kidney problems or require dialysis
        • Have retinitis pigmentosa, a rare genetic (runs in families) eye disease
        • Have ever had severe vision loss, including a condition called NAION
        • Have stomach or intestinal ulcers
        • Have a bleeding problem
        • Have a deformed penis shape or Peyronie’s disease
        • Have had an erection that lasted more than 4 hours
        • Have blood cell problems such as sickle cell anemia, multiple myeloma, or leukemia

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

        Especially tell your healthcare provider if you take any of the following:

        • Medicines called nitrates
        • Medicines called guanylate cyclase stimulators, such as riociguat (Adempas®), used to treat pulmonary hypertension
        • Medicines called alpha blockers. These include Hytrin® (terazosin HCl), Flomax® (tamsulosin HCl), Cardura® (doxazosin mesylate), Minipress® (prazosin HCl), Uroxatral® (alfuzosin HCl), 4 Jalyn® (dutasteride and tamsulosin HCl) or Rapaflo® (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. If CIALIS® or generic CIALIS® is taken with certain alpha blockers, your blood pressure could suddenly drop. You could get dizzy or faint.
        • Other medicines to treat high blood pressure (hypertension)
        • Medicines called HIV protease inhibitors, such as ritonavir (Norvir® , Kaletra® )
        • Oral antifungals such as ketoconazole (Nizoral® ), itraconazole (Sporanox® )
        • Antibiotics such as clarithromycin (Biaxin® ), telithromycin (Ketek® ), erythromycin (several brand names exist. Please consult your healthcare provider to determine if you are taking this medicine).
        • Other medicines or treatments for ED.
        • Tadalafil is also marketed as ADCIRCA® for the treatment of pulmonary arterial hypertension. Do not take both CIALIS® or generic CIALIS® and ADCIRCA®. Do not take sildenafil citrate (Revatio®, Viagra®) with CIALIS® or generic CIALIS®.

        Withholding or providing inaccurate information about your health and medical history in order to obtain treatment may result in harm, including, in some cases, death.

        What are the most common side effects of CIALIS® or generic CIALIS®?

        The most common side effects with CIALIS® and generic CIALIS® are:

        • Headache
        • Indigestion
        • Back pain
        • Muscle aches
        • Flushing
        • Stuffy or runny nose

        What is the FDA-approved Use of CIALIS® and generic CIALIS®?

        CIALIS® and generic CIALIS® are prescription medicines used to treat erectile dysfunction (ED), symptoms of benign prostatic hyperplasia (BPH), or both.

        Roman-affiliated doctors may prescribe CIALIS® for the treatment of premature ejaculation (PE), if they believe in their medical judgment that it is an appropriate course of treatment.

        You are encouraged to report negative side effects of prescription products to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

        Please see the full Prescribing Information for complete safety information.