I have to take 10mg or 20mg of cialis. all I could find in pharmacies was 5mg. can I take 2 5mg pills instead of one

have low blood pressure or have high blood pressure that is not controlled have retinitis pigmentosa, a rare genetic (runs in families) eye disease have ever had severe vision loss, including a condition called NAION 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 (see “What Is The Most Important Information I Should Know About CIALIS?”) These include Hytrin® (terazosin HCl), Flomax® (tamsulosin HCl), Cardura® (doxazosin mesylate), Minipress® (prazosin HCl) or Uroxatral® (alfuzosin HCl). other medicines to treat high blood pressure (hypertension) medicines called HIV protease inhibitors, such as ritonavir (Norvir®, Kaletra®) cialis chewable CIALIS is also marketed as ADCIRCA for the treatment of pulmonary arterial hypertension. Take CIALIS exactly as your healthcare provider prescribes it.

17.3 Concomitant Use with Drugs Which Lower Blood Pressure

The makers of these brands are not affiliated with and do not endorse Eli Lilly and Company or its products.Literature revised July 28, 2009 Read this important information before you start taking CIALIS and each time you get a refill. If you do not understand the information, or have questions, talk with your healthcare provider or pharmacist. What Is The Most Important Information I Should Know About CIALIS? CIALIS can cause your blood pressure to drop suddenly to an unsafe level if it is taken with certain other medicines. You could get dizzy, faint, or have a heart attack or stroke.

Alternatives for benign prostatic hyperplasia (BPH)

Do not take CIALIS if you take any medicines called “nitrates.” Nitrates are commonly used to treat angina. Angina is a symptom of heart disease and can cause pain in your chest, jaw, or down your arm. Medicines called nitrates include nitroglycerin that is found in tablets, sprays, ointments, pastes, or patches. Some recreational drugs called “poppers” also contain nitrates, such as amyl nitrite and butyl nitrite. Ask your healthcare provider or pharmacist if you are not sure if any of your medicines are nitrates. Your healthcare provider will prescribe the dose that is right for you. Some men can only take a low dose of CIALIS or may have to take it less often, because of medical conditions or medicines they take. Do not change your dose or the way you take CIALIS without talking to your healthcare provider. Your healthcare provider may lower or raise your dose, depending on how your body reacts to CIALIS and your health condition. CIALIS may be taken with or without meals. If you take too much CIALIS, call your healthcare provider or emergency room right away.

There are two ways to take CIALIS: Do not take CIALIS more than one time each day. Take one CIALIS tablet before you expect to have sexual activity. Your healthcare provider may change your dose of CIALIS depending on how you respond to the medicine, and on your health condition. Do not take CIALIS more than one time each day. Take one CIALIS tablet every day at about the same time of day. You may attempt sexual activity at any time between doses. If you miss a dose, you may take it when you remember but do not take more than one dose per day.

More about Cialis (tadalafil)

If you experience sudden decrease or loss of vision, stop taking PDE5 inhibitors, including CIALIS, and call a healthcare provider right away.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. 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 contact a healthcare provider right away.These are not all the possible side effects of CIALIS. For more information, ask your healthcare provider or pharmacist.How Should I Store CIALIS?Store CIALIS at room temperature between 59° and 86°F (15° and 30°C).Keep CIALIS and all medicines out of the reach of children.General Information About CIALIS:Medicines are sometimes prescribed for conditions other than those described in patient information leaflets. Do not use CIALIS for a condition for which it was not prescribed.

1. They Look Different

Do not give CIALIS to other people, even if they have the same symptoms that you have. It may harm them.This is a summary of the most important information about CIALIS. If you would like more information, talk with your healthcare provider. You can ask your healthcare provider or pharmacist for information about CIALIS that is written for health providers. *The brands listed are trademarks of their respective owners and are not trademarks of Eli Lilly and Company. What Should I Avoid While Taking CIALIS?

12.2 Pharmacodynamics

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 CIALIS is only for men over the age of 18 who have ED, including men with diabetes or who have undergone prostatectomy CIALIS is not for women or children. CIALIS must be used only under a healthcare provider's care. use recreational drugs called “poppers” like amyl nitrite and butyl nitrite.

CIALIS for Once Daily Use for Erectile Dysfunction and Benign Prostatic Hyperplasia

(See “What Is The Most Important Information I Should Know About CIALIS?”) What Should I Tell My Healthcare Provider Before Taking CIALIS? Before taking CIALIS, tell your healthcare provider about all your medical problems, including if you: are allergic to CIALIS or ADCIRCA any of its ingredients. See the end of this leaflet for a complete list of ingredients in CIALIS. have heart problems such as angina, heart failure, irregular heartbeats, or have had a heart attack. You should not take CIALIS if your healthcare provider has told you not to have sexual activity because of your health problems. 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.

8.7 Renal Insufficiency

Tell all of your healthcare providers that you take CIALIS. If you need emergency medical care for a heart problem, it will be important for your healthcare provider to know when you last took CIALIS. After taking a single tablet, some of the active ingredient of CIALIS remains in your body for more than 2 days. The active ingredient can remain longer if you have problems with your kidneys or liver, or you are taking certain other medications (see “Can Other Medicines Affect CIALIS?”). Stop sexual activity and get medical help right away if you get symptoms such as chest pain, dizziness, or nausea during sex.

How does tadalafil work (mechanism of action)?

Sexual activity can put an extra strain on your heart, especially if your heart is already weak from a heart attack or heart disease. See also “What Are The Possible Side Effects Of CIALIS?” CIALIS is a prescription medicine taken by mouth for the treatment of erectile dysfunction (ED) in men. 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. 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. What Are The Possible Side Effects Of CIALIS? See “What Is The Most Important Information I Should Know About 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 (priapism). Priapism must be treated as soon as possible or lasting damage can happen to your penis, including the inability to have erections. Color vision changes, such as seeing a blue tinge (shade) to objects or having difficulty telling the difference between the colors blue and green. In rare instances, men taking PDE5 inhibitors (oral erectile dysfunction medicines, including CIALIS) reported a sudden decrease or loss of vision in one or both eyes. If you experience sudden decrease or loss of vision, stop taking PDE5 inhibitors, including CIALIS, and call a healthcare provider right away. 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.

If you experience these symptoms, stop taking CIALIS and contact a healthcare provider right away. These are not all the possible side effects of CIALIS. For more information, ask your healthcare provider or pharmacist. Store CIALIS at room temperature between 59° and 86°F (15° and 30°C). Keep CIALIS and all medicines out of the reach of children. Medicines are sometimes prescribed for conditions other than those described in patient information leaflets.

• The 10mg strength is suitable for a moderate frequency of activity.
• The 20mg strength is for achieving maximum efficacy per dose.
• Neither 10mg nor 20mg should be taken with recreational drugs.
• Both may worsen symptoms of retinitis pigmentosa (rare eye condition).
• Starting with a lower dose minimizes initial side effect severity.
• 20mg is the go-to dose for the "36-hour" window of opportunity.
• 10mg daily dosing may lead to fewer "peak" side effects over time.
• Consult a doctor before switching between 10mg and 20mg regimens.

This is a summary of the most important information about CIALIS.

• Cialis 10mg is sometimes called "Cialis for daily use."
• Cialis 20mg is often called "Cialis for weekend use."
• Both doses have been shown to improve erectile function scores.
• 20mg may not be suitable for men with hypotension.
• 10mg daily can be taken in the morning or evening consistently.
• Missing a daily 10mg dose is less critical than timing a 20mg dose.
• Both can interact with alpha-blockers used for BPH or blood pressure.
• Liver enzyme inhibitors may require a lower dose than 10mg.

For more information you can also visit or call 1-877-CIALIS1 (1-877-242-5471). CIALIS® (tadalafil) is a registered trademark of Eli Lilly and Company. The makers of these brands are not affiliated with and do not endorse Eli Lilly and Company or its products. Take Cialis at least two hours before sex for the best results. Avoid heavy meals and limit alcohol before taking Cialis.

• Bioavailability of tadalafil is not affected by the 10mg vs 20mg dose.
• Excretion is primarily via feces for both dosage strengths.
• 10mg daily may be covered differently by insurance than 20mg packs.
• 20mg tablets are physically larger due to higher drug content.
• Both are Schedule 4 prescription drugs in many countries.
• PDE5 inhibition from both doses also relaxes other smooth muscles.
• Men with cardiovascular disease need stress testing before use.
• The medication does not cure ED; it treats the symptom.

Always follow your healthcare provider's prescribed dosage and don't change it without their advice. To get the most out of Cialis (tadalafil) for erectile dysfunction, it's crucial to use the right dosage and timing.