The 20 mg Cialis tablet is taken as needed

0120 mg as needed, once a day

As-needed Cialis for ED starts at 10 mg taken prior to anticipated sexual activity. The as-needed dose may be 20 mg based on individual efficacy and tolerability. A 5 mg as-needed tablet may be used when a lower dose is needed. In most patients the maximum dosing frequency is once per day.

02A successful erection at or before 30 minutes

As-needed Cialis improved the chance of a successful erection compared with placebo at 30 minutes after a 20 mg dose. In a stopwatch study of 223 men, the dose was 20 mg. The endpoint was a successful erection at or before 30 minutes after the dose. Placebo was the control arm. The stopwatch dose was 20 mg.

03Once-daily Cialis starts at 2.5 mg

Once-daily Cialis for ED starts at 2.5 mg taken at approximately the same time every day, without regard to timing of sexual activity. The daily dose may be increased to 5 mg based on individual efficacy and tolerability.

Plasma tadalafil accumulates about 1.6-fold with once-daily dosing. Steady state is reached by day 5.

04Erectile function versus placebo out to 36 hours

As-needed Cialis improved erectile function compared with placebo up to 36 hours after dosing. In two studies, men were assigned to attempt intercourse at 24 hours after the dose or at 36 hours after the dose.

Both assigned times still beat placebo. The endpoint was successful intercourse after a single as-needed dose. Mean terminal half-life in healthy subjects is 17.5 hours.

05Myocardial infarction in the prior 90 days

Cialis was not administered to men with myocardial infarction within the last 90 days in clinical trials. Until further information is available, Cialis is not recommended in that group.

The same not-recommended list includes unstable angina or angina during sexual intercourse, New York Heart Association Class 2 or greater heart failure in the last 6 months, uncontrolled arrhythmias, hypotension (blood pressure less than 90/50 mm Hg), uncontrolled hypertension, and stroke within the last 6 months.

06Creatinine clearance 30 to 50 mL/min

Once-daily Cialis for patients with creatinine clearance 30 to 50 milliliters per minute starts at 2.5 mg taken at approximately the same time every day, without regard to timing of sexual activity. The daily dose may be increased to 5 mg based on individual efficacy and tolerability. Plasma tadalafil accumulates about 1.6-fold with once-daily dosing. Steady state is reached by day 5.

07Potent CYP3A4 inhibitors

Once-daily Cialis for patients taking a potent CYP3A4 inhibitor such as ketoconazole or ritonavir is 2.5 mg taken at approximately the same time every day, without regard to timing of sexual activity. Itraconazole is on the same once-daily 2.5 mg line. Plasma tadalafil accumulates about 1.6-fold with once-daily dosing. Steady state is reached by day 5.

08BPH is 5 mg once daily

The recommended dose of Cialis for once daily use for BPH is 5 mg, taken at approximately the same time every day. When Cialis is used for ED and BPH, the dose is 5 mg once daily.

The combination of Cialis and alpha-blockers for BPH is not recommended. Efficacy of the combination has not been adequately studied, and both drugs can lower blood pressure. In a man already stable on an alpha-blocker who is treated for ED, Cialis should be started at the lowest recommended as-needed dose.

09Published listings for generic 20 mg tablets

GoodRx listed generic tadalafil 20 mg, thirty tablets, on 6 July 2026 at $1,618.15 average retail and $14.24 with a coupon. The chains on the board are CVS, Kroger, Walmart, and Wegmans. Each link is that chain's official pharmacy page.

Generic tadalafil 20 mg, thirty tablets, priced October 2026. GoodRx listed 20 mg x 30 at $1,618.15 average retail and $14.24 with a coupon on 06 July 2026. Daily 2.5 mg and 5 mg are separate products. The coupon figure belongs to GoodRx; each link goes to that chain's own pharmacy page.

10Food does not change absorption

The rate and extent of absorption of tadalafil are not influenced by food. Cialis may be taken with or without food.

A high-fat meal had no clinically relevant effect on rate or extent. Food-effect comparisons used 90 percent confidence intervals for Cmax and AUC mean ratios. The food-effect work used a 20 mg dose.

11At least 48 hours before a nitrate can be given

If a nitrate is needed in a life-threatening situation after Cialis, at least 48 hours should have elapsed after the last dose. The nitrate is given under close medical supervision with hemodynamic monitoring. The blood-pressure effect was still present at 24 hours. By most hemodynamic measures it was not detectable after 48 hours.

12An erection lasting more than 4 hours

An erection lasting more than 4 hours requires emergency care, whether or not it is painful. Priapism lasting longer than 6 hours can result in penile tissue damage and permanent loss of potency.

Use Cialis with caution in men with conditions that may predispose them to priapism: sickle cell anemia, multiple myeloma, leukemia, or penile deformity such as angulation, cavernosal fibrosis, or Peyronie's disease.