Cialis Lifecycle Management: Lilly's BPH Dilemma
Ask your healthcare provider if your heart is healthy enough for you to have sexual activity.
- Cialis’s indication for ED is supported by large-scale meta-analyses.
- Lilly recommends medical consultation before starting Cialis.
- Drug interactions include alpha-blockers and certain antifungals.
- Cialis should be used cautiously with other blood pressure medications.
- Common side effects include back pain and muscle aches.
- Rare side effects can include vision changes or hearing loss.
- Emergency medical help is needed if an erection lasts longer than 4 hours.
- Cialis improves blood flow by inhibiting phosphodiesterase type 5.
- Sexual stimulation is required for Cialis to be effective.
- Cialis is not addictive but should be used responsibly.
- The medication comes with usage instructions and warnings.
- Ongoing research explores new therapeutic uses for tadalafil.
You should not take Cialis if your healthcare provider has told you not to have sexual activity because of your health problems. Before taking Cialis, tell your healthcare provider about all your medical problems, particularly if you have or ever had: heart problems such as chest pain (angina), heart failure, irregular heartbeats, or have had a heart attack high or low blood pressure or have high blood pressure that is not controlled liver or kidney problems or require dialysis retinitis pigmentosa, a rare genetic (runs in families) eye disease severe vision loss, including a condition called NAION a deformed penis shape or Peyronie's disease an erection that lasted more than 4 hours blood cell problems such as sickle cell anemia, multiple myeloma, or leukemia Tell your healthcare provider about all the medicines you take especially if you take: medicines called "nitrates" which are often prescribed for chest pain alpha-blockers often prescribed for prostate problems medicines for HIV or some types of oral antifungal medications some types of antibiotics such as clarithromycin, telithromycin, erythromycin (several brand names exist, please contact your healthcare provider to determine if you are taking this medicine) other medicines or treatments for erectile dysfunction (ED) Cialis is also marketed as Adcirca for the treatment of pulmonary arterial hypertension. Do not take sildenafil citrate (Revatio®)* with Cialis. What Should I Avoid While Taking Cialis? Do not use other ED medicines or ED treatments while taking Cialis.
6. Adverse Reactions/Side Effects
Do not drink too much alcohol when taking Cialis (for example, 5 glasses of wine or 5 shots of whiskey). Drinking too much alcohol can increase your chances of getting a headache or getting dizzy, increasing your heart rate, or lowering your blood pressure. What Are The Possible Side Effects Of Cialis? The most common side effects with Cialis are: headache, indigestion, back pain, muscle aches, flushing, and stuffy or runny nose. Back pain and muscle aches usually go away within 2 days. Call your healthcare provider if you get any side effect that bothers you or one that does not go away. An erection that won't go away: If you get an erection lasting more than 4 hours, seek immediate medical help to avoid long-term injury. In rare instances, men taking prescription ED tablets, including Cialis, reported a sudden decrease or loss of vision or hearing (sometimes with ringing in the ears and dizziness). It's not possible to determine if these events are related directly to the ED tablets or to cialis pricing 20mg other factors. If you have a sudden decrease or loss of vision or hearing, stop taking any ED tablet, including Cialis and call a healthcare provider right away.
| Attribute | Description | Notes |
|---|---|---|
| Generic Name | Tadalafil | Main active ingredient |
| Brand Name | Cialis (by Lilly) | Commercial name |
| Dosage Forms | Tablets, oral | Available forms |
| Typical Dose | 5 mg, 10 mg, 20 mg | Varies per prescription |
| Onset of Action | 30-60 minutes | Time to effect |
| Duration of Effect | Up to 36 hours | Pharmacological window |
You are encouraged to report negative side effects of prescription drugs to the FDA. protect a man or his partner from sexually transmitted diseases, including HIV serve as a male form of birth control For additional information, talk to your doctor and see full Patient Information at and Prescribing Information at or visit for more information.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Cialis Generic | 10mg | 90 + 6 Pills | 146.17€ 139.21€ | |
| Cialis Generic | 5mg | 10 Pills | 29.39€ 27.99€ | |
| Cialis Professional | 20mg | 10 Pills | 48.29€ 45.99€ | |
| Cialis Professional | 40mg | 30 Pills | 148.94€ 141.85€ | |
| Cialis Generic | 5mg | 180 + 10 Pills | 159.65€ 152.05€ | |
| Cialis Generic | 5mg | 360 + 10 Pills | 268.08€ 255.31€ | |
| Cialis Black | 80mg | 30 + 2 Pills | 89.11€ 84.87€ | |
| Cialis Generic | 20mg | 20 Pills | 54.72€ 52.11€ | |
| Cialis Generic | 60mg | 60 + 4 Pills | 145.06€ 138.15€ | |
| Cialis Original | 20mg | 14 + 2 Pills | 95.75€ 91.19€ | |
| Cialis Generic | 2.5mg | 270 + 10 Pills | 199.64€ 190.13€ |
* The brand listed is a trademark of its respective owner and is not a trademark of Eli Lilly and Company.
- Tadalafil is chemically distinct from sildenafil, the active ingredient in Viagra.
- Cialis is often known as the "weekend pill" due to its long effect.
- The medication’s efficacy depends on adequate sexual arousal.
- Drug comparisons show Cialis’s side effect profile is favorable.
- Lilly’s patient assistance programs can reduce cost barriers.
- Daily low-dose Cialis may improve endothelial function in some patients.
- The drug is contraindicated with nitrates used for chest pain.
- Care should be taken when driving or performing tasks after taking Cialis.
- Cialis does not cause immediate permanent changes in sexual function.
- The medication's role in female sexual dysfunction remains unclear.
- Cialis has changed perceptions of male sexual health treatments.
- Safety reviews continue as new data emerge internationally.
The maker of this brand is not affiliated with and does not endorse Eli Lilly and Company or its products.
17. Patient Counseling Information
History of known serious hypersensitivity reaction to CIALIS or ADCIRCA® (4.2). Administration with guanylate cyclase (GC) stimulators, such as riociguat (4.3). Patients should not use CIALIS if sex is inadvisable due to cardiovascular status (5.1). Use of CIALIS with alpha-blockers, antihypertensives or substantial amounts of alcohol (≥5 units) may lead to hypotension (5.6, 5.9). CIALIS is not recommended in combination with alpha-blockers for the treatment of BPH because efficacy of the combination has not been adequately studied and because of the risk of blood pressure lowering.
1.3 Erectile Dysfunction and Benign Prostatic Hyperplasia
Caution is advised when CIALIS is used as a treatment for ED in men taking alpha-blockers. (2.7, 5.6, 7.1, 12.2) Patients should seek emergency treatment if an erection lasts >4 hours. Use CIALIS with caution in patients predisposed to priapism (5.3). Patients should stop CIALIS and seek medical care if a sudden loss of vision occurs in one or both eyes, which could be a sign of non-arteritic anterior ischemic optic neuropathy (NAION). CIALIS should be used with caution, and only when the anticipated benefits outweigh the risks, in patients with a history of NAION.
Related treatment guides
Patients with a "crowded" optic disc may also be at an increased risk of NAION (5.4, 6.2). Patients should stop CIALIS and seek prompt medical attention in the event of sudden decrease or loss of hearing (5.5). Prior to initiating treatment with CIALIS for BPH, consideration should be given to other urological conditions that may cause similar symptoms (5.14). Most common adverse reactions (≥2%) include headache, dyspepsia, back pain, myalgia, nasal congestion, flushing, and pain in limb (6.1). To report SUSPECTED ADVERSE REACTIONS, contact Eli Lilly and Company at 1-800-LillyRx (1-800-545-5979) or FDA at 1-800-FDA-1088 or CIALIS can potentiate the hypotensive effects of nitrates, alpha-blockers, antihypertensives or alcohol (7.1). About Eli Lilly and Company Lilly, a leading innovation-driven corporation, is developing a growing portfolio of pharmaceutical products by applying the latest research from its own worldwide laboratories and from collaborations with eminent scientific organizations. Headquartered in Indianapolis, Ind., Lilly provides answers – through medicines and information – for some of the world's most urgent medical needs.
5.3 Prolonged Erection
Relationship between lower urinary tract symptoms and erectile dysfunction: results from the Boston Area community Health Survey. Critical analysis of the relationship between sexual dysfunctions and lower urinary tract symptoms due to benign prostatic hyperplasia. Cialis® (tadalafil) Tablets Recommended for Approval for the Treatment of the Signs and Symptoms of Benign Prostatic Hyperplasia in the European Union Milestone reflects Eli Lilly and Company's commitment to bring new treatment options to millions of men who experience urological conditions INDIANAPOLIS, Sept. 21, 2012 -- Eli Lilly and Company (LLY) announced today it has received a positive opinion from the Committee for Medicinal Products for Human Use (CHMP) in the European Union (EU), recommending approval of Cialis 5 mg for once daily use for the treatment of the signs and symptoms of benign prostatic hyperplasia (BPH). Before taking Cialis, tell your healthcare provider about all your medical problems, particularly if you have or ever had: heart problems such as chest pain (angina), heart failure, irregular heartbeats, or have had a heart attack high or low blood pressure or have high blood pressure that is not controlled stroke liver or kidney problems or require dialysis retinitis pigmentosa, a rare genetic (runs in families) eye disease severe vision loss, including a condition called NAION stomach ulcers or a bleeding problem a deformed penis shape or Peyronie's disease an erection that lasted more than 4 hours blood cell problems such as sickle cell anemia, multiple myeloma, or leukemia Tell your healthcare provider about all the medicines you take especially if you take: medicines called "nitrates" which are often prescribed for chest pain alpha-blockers often prescribed for prostate problems blood pressure medications medicines for HIV or some types of oral antifungal medications some types of antibiotics such as clarithromycin, telithromycin, erythromycin (several brand names exist, please contact your healthcare provider to determine if you are taking this medicine) other medicines or treatments for erectile dysfunction (ED) Cialis is also marketed as Adcirca for the treatment of pulmonary arterial hypertension.
13.2 Animal Toxicology and/or Pharmacology
cure ED increase a man's sexual desire protect a man or his partner from sexually transmitted diseases, including HIV serve as a male form of birth control For additional information, talk to your doctor and see full Patient Information at and Prescribing Information at or visit for more information. Package insert / product label Generic name: tadalafil Dosage form: tablet, film coated Drug class: Impotence medications CIALIS® is a phosphodiesterase 5 (PDE5) inhibitor indicated for the treatment of: the signs and symptoms of benign cialis tadalafil 20mg prostatic hyperplasia (BPH) (1.2) ED and the signs and symptoms of BPH (ED/BPH) (1.3) If CIALIS is used with finasteride to initiate BPH treatment, such use is recommended for up to 26 weeks (1.4). CIALIS for use as needed: ED: Starting dose: 10 mg as needed prior to sexual activity. Increase to 20 mg or decrease to 5 mg based upon efficacy/tolerability. Improves erectile function compared to placebo up to 36 hours post dose.
5.10 Concomitant Use of Potent Inhibitors of Cytochrome P450 3A4 (CYP3A4)
Not to be taken more than once per day (2.1). ED: Starting dose: 10 mg as needed prior to sexual activity. CIALIS may be taken without regard to food (2.5). Administration of CIALIS to patients using any form of organic nitrate is contraindicated. CIALIS was shown to potentiate the hypotensive effect of nitrates (4.1). This press release contains forward-looking statements about the potential of Cialis for the treatment of benign prostatic hyperplasia and reflects Lilly's current beliefs. However, as with any pharmaceutical product under development, there are substantial risks and uncertainties in the process of development, commercialization, and regulatory review. There is no guarantee that the product will receive additional regulatory approvals. There is also no guarantee that the product will continue to be commercially successful. For further discussion of these and other risks and uncertainties, see Lilly's filings with the United States Securities and Exchange Commission. Lilly undertakes no duty to update forward-looking statements. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7). Relationship between lower urinary tract symptoms and erectile dysfunction: results from the Boston Area community Health Survey. Critical analysis of the relationship between sexual dysfunctions and lower urinary tract symptoms due to benign prostatic hyperplasia. Cialis® (tadalafil) Tablets Recommended for Approval for the Treatment of the Signs and Symptoms of Benign Prostatic Hyperplasia in the European Union Milestone reflects Eli Lilly and Company's commitment to bring new treatment options to millions of men who experience urological conditions INDIANAPOLIS, Sept.
- Cialis is sometimes combined with psychological counseling for ED.
- Lifestyle factors, such as diet and exercise, can impact Cialis outcomes.
- Lilly supports research into ED causes and therapies.
- Psychological stress may reduce Cialis effectiveness.
- Cialis’s long half-life allows for flexible timing of dosages.
- Sexual partners may also benefit from understanding ED treatment.
- Proper storage prevents Cialis degradation and loss of potency.
- Research indicates Cialis may help vascular function overall.
- Patient confidentiality is maintained during Cialis prescription.
- Cialis is not a recreational drug; misuse can have health risks.
- Regular health checks recommended for chronic Cialis users.
- Patient testimonials often highlight increased quality of life.
21, 2012 -- Eli Lilly and Company (LLY) announced today it has received a positive opinion from the Committee for Medicinal Products for Human Use (CHMP) in the European Union (EU), recommending approval of Cialis 5 mg for once daily use for the treatment of the signs and symptoms of benign prostatic hyperplasia (BPH). Before taking Cialis, tell your healthcare provider about all your medical problems, particularly if you have or ever had: heart problems such as chest pain (angina), heart failure, irregular heartbeats, or have had a heart attack high or low blood pressure or have high blood pressure that is not controlled stroke liver or kidney problems or require dialysis retinitis pigmentosa, a rare genetic (runs in families) eye disease severe vision loss, including a condition called NAION stomach ulcers or a bleeding problem a deformed penis shape or Peyronie's disease an erection that lasted more than 4 hours blood cell problems such as sickle cell anemia, multiple myeloma, or leukemia Tell your healthcare provider about all the medicines you take especially if you take: medicines called "nitrates" which are often prescribed for chest pain alpha-blockers often prescribed for prostate problems blood pressure medications medicines for HIV or some types of oral antifungal medications some types of antibiotics such as clarithromycin, telithromycin, erythromycin (several brand names exist, please contact your healthcare provider to determine if you are taking this medicine) other medicines or treatments for erectile dysfunction (ED) Cialis is also marketed as Adcirca for the treatment of pulmonary arterial hypertension. cure ED increase a man's sexual desire protect a man or his partner from sexually transmitted diseases, including HIV serve as a male form of birth control For additional information, talk to your doctor and see full Patient Information at and Prescribing Information at or visit for more information. Package insert / product label Generic name: tadalafil Dosage form: tablet, film coated Drug class: Impotence medications CIALIS® is a phosphodiesterase 5 (PDE5) inhibitor indicated for the treatment of: the signs and symptoms of benign cialis tadalafil 20mg prostatic hyperplasia (BPH) (1.2) ED and the signs and symptoms of BPH (ED/BPH) (1.3) If CIALIS is used with finasteride to initiate BPH treatment, such use is recommended for up to 26 weeks (1.4). CIALIS for use as needed: ED: Starting dose: 10 mg as needed prior to sexual activity. Increase to 20 mg or decrease to 5 mg based upon efficacy/tolerability. Improves erectile function compared to placebo up to 36 hours post dose. Not to be taken more than once per day (2.1). ED: Starting dose: 10 mg as needed prior to sexual activity. CIALIS may be taken without regard to food (2.5). Administration of CIALIS to patients using any form of organic nitrate is contraindicated. CIALIS was shown to potentiate the hypotensive effect of nitrates (4.1). History of known serious hypersensitivity reaction to CIALIS or ADCIRCA® (4.2).
| Use Case | Description | Notes |
|---|---|---|
| Erectile Dysfunction (ED) | Improves ability to achieve/maintain erection | Most common use |
| Pulmonary Arterial Hypertension | Reduces blood pressure in lungs | Prescribed under different dose |
| Benign Prostatic Hyperplasia | Relieves urinary symptoms | Off-label use |
| Raynaud's Phenomenon | Relaxes blood vessels | Experimental treatment |
Administration with guanylate cyclase (GC) stimulators, such as riociguat (4.3). Patients should not use CIALIS if sex is inadvisable due to cardiovascular status (5.1). Use of CIALIS with alpha-blockers, antihypertensives or substantial amounts of alcohol (≥5 units) may lead to hypotension (5.6, 5.9). CIALIS is not recommended in combination with alpha-blockers for the treatment of BPH because efficacy of the combination has not been adequately studied and because of the risk of blood pressure lowering. Caution is advised when CIALIS is used as a treatment for ED in men taking alpha-blockers. (2.7, 5.6, 7.1, 12.2) Patients should seek emergency treatment if an erection lasts >4 hours. Use CIALIS with caution in patients predisposed to priapism (5.3). Patients should stop CIALIS and seek medical care if a sudden loss of vision occurs in one or both eyes, which could be a sign of non-arteritic anterior ischemic optic neuropathy (NAION). CIALIS should be used with caution, and only when the anticipated benefits outweigh the risks, in patients with a history of NAION.
13.2 Animal Toxicology and/or Pharmacology
If you have a sudden decrease or loss of vision or hearing, stop taking any ED tablet, including Cialis and call a healthcare provider right away. You are encouraged to report negative side effects of prescription drugs to the FDA. protect a man or his partner from sexually transmitted diseases, including HIV serve as a male form of birth control For additional information, talk to your doctor and see full Patient Information at and Prescribing Information at or visit for more information. * The brand listed is a trademark of its respective owner and is not a trademark of Eli Lilly and Company. The maker of this brand is not affiliated with and does not endorse Eli Lilly and Company or its products.
5.13 Counseling Patients About Sexually Transmitted Diseases
About Eli Lilly and Company Lilly, a leading innovation-driven corporation, is developing a growing portfolio of pharmaceutical products by applying the latest research from its own worldwide laboratories and from collaborations with eminent scientific organizations. Headquartered in Indianapolis, Ind., Lilly provides answers – through medicines and information – for some of the world's most urgent medical needs. This press release contains forward-looking statements about the potential of Cialis for the treatment of benign prostatic hyperplasia and reflects Lilly's current beliefs. However, as with any pharmaceutical product under development, there are substantial risks and uncertainties in the process of development, commercialization, and regulatory review. There is no guarantee that the product will receive additional regulatory approvals.
How is tadalafil supplied (dosage forms)?
There is also no guarantee that the product will continue to be commercially successful. For further discussion of these and other risks and uncertainties, see Lilly's filings with the United States Securities and Exchange Commission. Lilly undertakes no duty to update forward-looking statements. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7). Patients with a "crowded" optic disc may also be at an increased risk of NAION (5.4, 6.2). Patients should stop CIALIS and seek prompt medical attention in the event of sudden decrease or loss of hearing (5.5). Prior to initiating treatment with CIALIS for BPH, consideration should be given to other urological conditions that may cause similar symptoms (5.14).
| Condition | Explanation | Notes |
|---|---|---|
| Menusen with nitrates | Risk of severe hypotension | Absolute contraindication |
| Severe liver impairment | Reduced metabolism leading to increased effects | Medical consultation needed |
| Retinitis pigmentosa | Potential risk of vision loss | Use with caution |
| Allergic reactions | Hypersensitivity to tadalafil or excipients | Discontinue if occurs |
Most common adverse reactions (≥2%) include headache, dyspepsia, back pain, myalgia, nasal congestion, flushing, and pain in limb (6.1). To report SUSPECTED ADVERSE REACTIONS, contact Eli Lilly and Company at 1-800-LillyRx (1-800-545-5979) or FDA at 1-800-FDA-1088 or CIALIS can potentiate the hypotensive effects of nitrates, alpha-blockers, antihypertensives or alcohol (7.1).
7.2 Potential for Other Drugs to Affect CIALIS
Ask your healthcare provider if your heart is healthy enough for you to have sexual activity. You should not take Cialis if your healthcare provider has told you not to have sexual activity because of your health problems. Before taking Cialis, tell your healthcare provider about all your medical problems, particularly if you have or ever had: heart problems such as chest pain (angina), heart failure, irregular heartbeats, or have had a heart attack high or low blood pressure or have high blood pressure that is not controlled liver or kidney problems or require dialysis retinitis pigmentosa, a rare genetic (runs in families) eye disease severe vision loss, including a condition called NAION a deformed penis shape or Peyronie's disease an erection that lasted more than 4 hours blood cell problems such as sickle cell anemia, multiple myeloma, or leukemia Tell your healthcare provider about all the medicines you take especially if you take: medicines called "nitrates" which are often prescribed for chest pain alpha-blockers often prescribed for prostate problems medicines for HIV or some types of oral antifungal medications some types of antibiotics such as clarithromycin, telithromycin, erythromycin (several brand names exist, please contact your healthcare provider to determine if you are taking this medicine) other medicines or treatments for erectile dysfunction (ED) Cialis is also marketed as Adcirca for the treatment of pulmonary arterial hypertension. Do not take sildenafil citrate (Revatio®)* with Cialis. What Should I Avoid While Taking Cialis?
Millions of orders
Do not use other ED medicines or ED treatments while taking Cialis. Do not drink too much alcohol when taking Cialis (for example, 5 glasses of wine or 5 shots of whiskey). Drinking too much alcohol can increase your chances of getting a headache or getting dizzy, increasing your heart rate, or lowering your blood pressure. What Are The Possible Side Effects Of Cialis? The most common side effects with Cialis are: headache, indigestion, back pain, muscle aches, flushing, and stuffy or runny nose.
Dosage Forms and Strengths
Back pain and muscle aches usually go away within 2 days. Call your healthcare provider if you get any side effect that bothers you or one that does not go away. An erection that won't go away: If you get an erection lasting more than 4 hours, seek immediate medical help to avoid long-term injury. In rare instances, men taking prescription ED tablets, including Cialis, reported a sudden decrease or loss of vision or hearing (sometimes with ringing in the ears and dizziness). It's not possible to determine if these events are related directly to the ED tablets or to cialis pricing 20mg other factors.