Table of contents
Medically reviewed by
Dr Daniel Atkinson
GP Clinical lead
on August 02, 2022.
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Is Cialis going to give me side effects?

It’s impossible to predict who will get side effects from any medication, let alone what those side effects might be or their severity. What we can do is talk about the likelihood of side effects occurring and what can be done to manage them.

Firstly, Cialis daily side effects are rare, with the most common affecting just one in 10 of those who use it. These most common side effects are also usually mild and in many cases hardly noticeable. What’s more, they can often subside the more you use Cialis, as the body becomes used to the medication.

There are also some things you can do to minimize the risk of experiencing side effects. This includes drinking plenty of water. Not drinking alcohol with it can also lessen the risk of low blood pressure and dizziness.

If you’re concerned about side effects from Cialis, you can speak to the prescriber. They can talk through the risks with you and even adjust your dosage or recommend a different treatment if needed.

What can I do about a Cialis headache?

One of the more common side effects from Cialis is a headache. This is more likely to occur when taking Cialis for the first time and usually they only last a few minutes, so it’s very possible any headaches will subside the more you use the treatment.

There are a few things you can do to avoid headaches at the start of treatment, the most obvious being taking acetaminophen. It’s also important to avoid becoming dehydrated, so drinking plenty of water can help to minimize the risk.

If your headaches persist, or are noticeably severe in nature, stop using Cialis and speak with your prescribing clinician. With their help, you should be able to find another treatment to manage your erectile dysfunction without this side effect.

Is back pain on Cialis normal?

While most side effects for Cialis (Tadalafil) are just as common for other oral ED drugs, back pain is a little more common. That doesn’t mean you’ll definitely experience it and if you do, the symptoms tend to be mild, with less than 1% of users discontinuing use after reporting such symptoms .

If you do experience mild to moderate back pain, you can use your preferred pain relief medication. This can be acetaminophen, ibuprofen or a topical treatment. If the pain is severe, you should discontinue use and speak with your doctor, who will be able to investigate further and offer a different treatment.

What other side effects does Cialis cause?

There are other side effects that you should look out for when taking Cialis. Remember, this doesn’t mean that you will experience them but it’s good practice to be aware before you start taking any new medication.

  • Common Tadalafil side effects

  • Uncommon Tadalafil side effects

  • Rare Tadalafil side effects

Common side effects may affect up to 1 in 10 people.
Affects 1 to 10 in every 100 of patients

  • Headache
  • Back pain
  • Muscle aches
  • Pain in arms and legs
  • Facial flushing
  • Nasal congestion
  • Indigestion

Affects 1 to 10 in every 1,000 of patients

  • Dizziness
  • Stomach ache
  • Feeling sick
  • Being sick (vomiting)
  • Reflux
  • Blurred vision
  • Eye pain
  • Difficulty in breathing
  • Presence of blood in urine
  • Prolonged erection
  • Pounding heartbeat sensation
  • Fast heart rate
  • High blood pressure
  • Low blood pressure
  • Nose bleeds
  • Ringing in the ears
  • Swelling of the hands, feet or ankles
  • Feeling tired

Affects 1 to 10 in every 10,000 patients

  • Fainting
  • Seizures and passing memory loss
  • Swelling of the eyelids
  • Red eyes
  • Sudden decrease or loss of hearing
  • Hives (itchy red welts on the surface of the skin)
  • Penile bleeding
  • Presence of blood in semen
  • Increased sweating

How long do side effects from Cialis last?

When side effects occur when taking Cialis, most of them are mild in nature. They also tend to subside quickly, or as the body gets used to the medication. In other words, you’re unlikely to have any issues with them beyond a few hours, if you do experience any issues at all.

Cialis long term side effects are rare, but if you have concerns then you can always discuss them with your prescriber. The first option might be to lower the dosage, which can minimize or completely stop the issue. However, it could be that there is a more altogether suitable treatment for you, one where you don’t need to put up with any ongoing side effects.

There are plenty of ED treatment options available, so there’s every reason to be optimistic that another medication will be just as effective.

Do I need to do anything about Cialis side effects?

That depends entirely on how severe they are. If your side effects are severe, such as an allergic reaction, you’ll need to stop using Cialis and seek immediate medical attention.

On one hand, if you think the side effects are minimal and the treatment is worthwhile, you can continue using Cialis. On the other hand, if the discomfort is enough to be noticeable and ongoing, you might want to consider other options.

Whatever the case, you can always discuss any issues you have with your doctor. Sometimes even the mildest of side effects can be managed by lowering the dosage and there are tips to help minimize the likelihood of them occurring.

What interactions with Tadalafil do I need to know about?

It’s very important that you tell your prescribing clinician about any other treatments you’re taking. This includes any medication that is unrelated to erectile dysfunction, as well as any over the counter supplements.

Any medication from the group of drugs known as nitrates can interact with PDE5 inhibitors, such as Cialis, and should not be taken together.

Tadalafil interactions are relatively small in number, but some can pose serious health risks.

Drugs that may cause interactions with Tadalafil

  • Alpha blockers (used to treat high blood pressure or urinary symptoms associated with benign prostatic hyperplasia)
  • Other high blood pressure medication
  • Riociguat (a drug used for pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension, can also react with tadalafil and alter the drug’s hypotensive effects.)
  • Medicines such as ketoconazole tablets (to treat fungal infections) and protease inhibitors for treatment of AIDS or HIV infection
  • Phenobarbital, phenytoin and carbamazepine (anticonvulsant medicines)
  • Rifampicin, erythromycin, clarithromycin or itraconazole
  • Other treatments for erectile dysfunction
  • Nitrates

Taking Cialis with nitrates

Nitrates cannot be taken with Cialis, as they have the potential to interact in a way that can lead to serious health issues. Cialis lowers blood pressure without interacting with other medications, so when used with nitrates it can lead to a significant drop in blood pressure. If you take nitrates, including recreationally, you should tell your doctor.

It should also be noted that using Tadalafil with blood pressure conditions, whether high or low, could potentially cause some unwanted side effects. You should make sure your doctor is aware of any of these conditions before taking Cialis.

High blood pressure medicines and Cialis

High blood pressure, also known as hypertension, might make use of Cialis unsuitable. Some blood pressure treatments can also act as a contraindication. For example, Lisinopril and Cialis might be considered unsuitable, but this might depend on your specific health risks.

As long as your doctor has been fully informed about any medications you’re taking, they will be able to assess any risks and prescribe your treatment safely.

Can you mix Cialis and alcohol?

Alcohol consumption while using Cialis is unlikely to cause any issues within moderation, but it can lead to a drop in blood pressure and increase the likelihood of headaches if you drink too much.

What’s more, alcohol is a primary cause of erectile dysfunction, so at the very least it can worsen the very problems that you’re taking Cialis for. In other words, Tadalafil and alcohol can be mixed, but drinking large amounts of alcohol is not recommended.

How about Cialis and recreational drugs?

All drugs have the potential of interacting with other substances, so it’s not recommended that you take any illegal substances while using Cialis. You should also be aware that recreational drugs are often mixed with other ingredients, some of which can increase severe side effects when using Cialis.

Remember, Cialis is not an aphrodisiac and does not cause erections, it can only help you achieve and maintain them when you’re sexually aroused.

Man with grey hair and beard wearing baseball cap and smiling in the woods

Warnings and contraindications: When shouldn’t I take Cialis?

Cialis may be an unsafe option when you have certain conditions. In these cases, a different treatment will need to be considered. For the majority of men with ED, there are always different options, so don’t worry if it turns out that Cialis is unsuitable for you.

As with all treatments, the main Cialis contraindication is allergies to any of its ingredients. While rare, if you notice a swollen mouth, tongue, throat or face and problems breathing you should seek immediate medical attention.

If you’ve had a heart attack or serious heart disease, you will not be able to take Cialis. The same goes for any previous strokes. Low or severely high blood pressure will also make using Tadalafil unsuitable.

Lastly, the risk of NAION (non-arteritic anterior ischemic, optic neuropathy), sometimes referred to as stroke of the eye, can be increased when using Cialis. So if you’re prone to this condition, another treatment will need to be considered.

When will a doctor tell me to be cautious or use a low dose?

Some conditions do not automatically mean you cannot take Cialis, but your doctor might consider it an unnecessary risk. Sometimes a lower dose or having its use monitored will be enough.

Can I take Cialis after prostate surgery?

Cialis is often prescribed to men following a prostatectomy and can help to preserve erectile function after the operation. But all patients are different, so the dosage and type of treatment that is effective may vary from person to person.

If you are due to have prostate surgery it is likely that the consultant will also discuss penile rehabilitation following the procedure. Cialis can be an option for some men. If you’ve had prostate surgery in the past, make sure your doctor knows so they can assess and provide the best ED treatment options for you.

Do I need to be careful with Cialis if I have diabetes?

Using Tadalafil with diabetes is largely safe, but you should make sure your doctor is aware of the condition before they can prescribe a treatment. Diabetes is a common cause of erectile dysfunction and Cialis is one of a number of ED treatments that can be prescribed.

It’s possible that those living with diabetes will have an increased risk of side effects when taking Cialis, sometimes related to interactions between the different medications. In the case of nitrates, the risk of severe interactions are high. For this reason, Cialis can’t be prescribed alongside nitrate medications.

How can I make absolutely sure I’m safe taking Cialis?

The first way to ensure you’re safe taking Cialis is to be as honest as possible with your prescribing clinician. This means telling them about any medications you are currently, or have recently, taken and keeping them up to date about any changes to your health.

The second most important thing to do is follow the instructions properly, read the patient information leaflet before you start your course and follow the directions given to you by your doctor or pharmacist. This will help you to get the best out of your treatment with the minimum risk of side effects or any other health issues.

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How we source info:

When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognized analytics or data body. Read more in our editorial policy.

This page was medically reviewed by Dr Daniel Atkinson, GP Clinical lead on August 02, 2022. Next review due on August 02, 2024.

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