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Cialis (Tadalafil) in Pakistan | Best Uses, Dosage, Side Effects & More

Cialis (Tadalafil) in Pakistan | Best Uses, Dosage, Side Effects & More

What is Cialis? Cialis is the brand name of Tadalafil, a prescription medication used to treat two main conditions in men: erectile dysfunction (ED) and...
behtarsehat
Jun 29, 2025
Sexual Wellness
21 min read

What is Cialis?

Cialis is the brand name of Tadalafil, a prescription medication used to treat two main conditions in men: erectile dysfunction (ED) and benign prostatic hyperplasia (BPH). It belongs to a group of medicines known as PDE-5 inhibitors, which improve blood flow by relaxing blood vessels. In Pakistan, Cialis is commonly prescribed to married men looking for a reliable treatment for sexual performance and urinary problems caused by prostate enlargement.

Cialis Uses: FDA-Approved and Off-Label

Cialis (Tadalafil) is an FDA-approved prescription medicine for adult men. It is officially used to treat three conditions:

  1. Erectile Dysfunction (ED)
  2. Benign Prostatic Hyperplasia (BPH)
  3. Combined ED and BPH symptoms

Doctors may also prescribe Cialis off-label for other conditions based on clinical judgment. Off-label use means the medicine is being used for a purpose that’s not officially approved but is supported by medical research or practice.

Cialis for Erectile Dysfunction (ED)

ED is the inability to achieve or maintain an erection that’s firm enough for sex. It can be caused by:

Cialis works by improving blood flow to the penis during sexual stimulation. It doesn’t cause an erection on its own but helps the body respond naturally to arousal.

Effectiveness

Researchers evaluated Cialis by using the International Index of Erectile Function (IIEF) questionnaire to assess its effectiveness. Men taking Cialis showed a significant improvement in their IIEF scores, indicating better erections and increased sexual performance compared to those taking a placebo.

This was true for both.

Cialis for Benign Prostatic Hyperplasia (BPH)

Benign Prostatic Hyperplasia (BPH) is a non-cancerous increase in the size of the prostate gland, commonly seen in older men. As the prostate grows, it can press against the urethra and cause uncomfortable urinary symptoms like

Cialis helps relax the smooth muscle in the prostate and bladder, improving urinary flow and reducing BPH symptoms.

Effectiveness

In clinical studies, Cialis significantly improved BPH symptoms. Researchers measured changes using the International Prostate Symptom Score (IPSS), a questionnaire that tracks the severity of urinary problems. A lower score means fewer symptoms.

Patients who took Cialis reported a more significant drop in their IPSS scores than those who took a placebo, meaning Cialis helped reduce the number and intensity of urinary symptoms.

Cialis for ED and BPH Together

Cialis is also authorized for use in treating erectile dysfunction (ED) and benign prostatic hyperplasia (BPH) simultaneously. Though these conditions are not directly related, they often occur together in older men.

Some BPH medications like dutasteride may worsen sexual function, but Cialis helps relieve urinary symptoms and supports erectile function.

Effectiveness

Clinical studies showed that Cialis led to improvements in both IPSS scores for BPH and IIEF scores for ED in men experiencing both conditions.

  1. Patients saw better urine flow and fewer urinary symptoms
  2. They also experienced stronger, longer-lasting erections

Cialis offers a dual benefit and simplifies treatment for men dealing with both issues simultaneously.

Off-Label Use: Cialis for Ureteral Stones (Kidney Stones)

While not officially approved by the FDA for this use, doctors may prescribe Cialis off-label to assist in passing ureteral stones — kidney stones that have traveled into the ureter, the tube connecting the kidneys to the bladder.

Effectiveness

A clinical trial comparing Cialis to tamsulosin (Flomax) found that more people passed their stones with Cialis. This is likely because tadalafil relaxes the ureter muscles, making it easier for stones to pass.

Doctors may consider this treatment in cases where ureteral stones are small and other medical conditions are managed.

Cialis Dosage

The correct dosage of Cialis (Tadalafil) depends on several factors, including the condition being treated, the severity of symptoms, the patient’s age, and overall health. Doctors usually start with a low dose and adjust it based on response and tolerance. The goal is to prescribe the lowest effective dose.

Cialis comes in tablet form and is offered in four different strengths: 2.5 mg, 5 mg, 10 mg, and 20 mg. It should never be taken more than once in a 24-hour period unless specifically advised by a healthcare provider.

Dosage for Benign Prostatic Hyperplasia (BPH)

For managing urinary issues due to prostate enlargement, the usual recommended dose of Cialis is 5 mg once daily. It’s important to take it at the same time every day to maintain steady results.

In certain cases, doctors may prescribe Cialis together with finasteride (Proscar) to enhance the treatment of BPH symptoms. This combined approach is typically followed for up to 26 weeks under a doctor’s guidance.

Dosage for Erectile Dysfunction (ED)

There are two main approaches for using Cialis to treat ED:

1. Cialis as Needed

When used occasionally for ED, the typical starting dose is 10 mg taken 30 to 60 minutes before anticipated sexual activity.
This dose can be

The effects of Cialis can last for as long as 36 hours, but it should not be used more than once within 24 hours.

2. Cialis for Daily Use

For men who choose ongoing treatment, Cialis is taken once daily at a dose of either 2.5 mg or 5 mg. It should be taken at the same time each day, whether or not sexual activity is planned. This approach supports more natural and spontaneous intimacy.

Dosage for Both ED and BPH

When treating both erectile dysfunction and benign prostatic hyperplasia together, the standard dose is 5 mg taken once daily at a consistent time.

Higher Dosages

Cialis is approved in doses ranging from 2.5 mg to 20 mg, depending on the treatment plan. Doses higher than 20 mg per day have not been clinically studied and may cause serious side effects, including dangerously low blood pressure.

Patients should never increase their dosage on their own. Always consult a healthcare provider before making any changes to the treatment.

Missed Dose

If you forget your daily dose, take it as soon as you remember. If it is almost time for the next dose, skip the missed one. Do not take two doses on the same day. For better adherence, consider setting reminders or using a medication tracker.

Long-Term Use

Cialis may be used long term, especially for managing BPH. For ED, long-term use depends on the cause. If ED is caused by stress, an illness, or another treatable condition, Cialis may be stopped after the underlying issue is resolved. Treatment duration should always be discussed with a doctor.

A Guide to Cialis Variants: Black, Gold, Silver, and White Tablets Explained

Cialis is a trusted name in the treatment of erectile dysfunction (ED), known for its long-lasting effects and ability to boost sexual confidence. Over time, multiple Cialis variants have been introduced, each offering unique benefits tailored to different user needs. Whether you’re new to ED medication or looking for enhanced performance, this guide helps you choose the right version of Cialis.

Cialis Black – Maximum Power for Maximum Performance

Key Benefits:

Best For: Cialis Black tablets are Ideal for men who have already used ED medications and want a more powerful boost in performance.

Cialis Gold – Premium Experience, Long Duration

Key Benefits:

Best For: Cialis Gold Tablets are Perfect for men who prefer peace of mind during extended romantic periods or weekend plans.

Cialis Silver – Gentle Yet Effective

Key Benefits:

Best For: Cialis Silver Tablet is a Great option for beginners or those who want a lighter and more manageable ED treatment.

Cialis White – Everyday Confidence with Low Dose

Key Benefits:

Best For: Cialis White is best suited for men who want consistent support without taking a tablet before each encounter.

How Cialis Works | Mechanism of Action for ED and BPH

Cialis (Tadalafil) is a prescription medication used to treat erectile dysfunction (ED), benign prostatic hyperplasia (BPH), and cases where both conditions occur together. It belongs to a class of drugs known as phosphodiesterase type 5 (PDE5) inhibitors, which work by relaxing smooth muscles and increasing blood flow in specific areas of the body.

Erectile Dysfunction (ED): How Cialis Helps

An erection happens when blood flows into the penis and is held there, allowing a firm and lasting erection suitable for sexual activity. This process is controlled by a natural chemical in the body called cyclic guanosine monophosphate (cGMP). It helps by relaxing the smooth muscles in the penis, which improves blood flow and supports achieving and maintaining an erection.

In men with ED, this process is disrupted, either due to poor blood circulation, nerve issues, or psychological factors. An enzyme called PDE5 breaks down cGMP too early, leading to weak or no erections.

Cialis works by blocking the PDE5 enzyme, allowing more cGMP to build up. As a result:

Benign Prostatic Hyperplasia (BPH): How Cialis Helps

BPH is a condition where the prostate gland becomes enlarged, often due to age. This can press against the urethra and lead to urinary symptoms such as:

Although the exact way Cialis helps is not fully understood, it is believed to relax the muscles in the bladder and prostate, which can ease the pressure and improve urine flow.

How Long Does Cialis Take to Work?

Cialis usually starts to take effect about 30 minutes after the dose is taken. However, for some men, it may take up to 6 hours to feel full effects, depending on metabolism and other factors.

The drug reaches peak concentration in the body about 2 hours after ingestion. This is when its effects are usually strongest, making it suitable for both on-demand use and daily therapy.

Cialis Side Effects: What You Should Know Before Use

As with any medication, Cialis (Tadalafil) may cause side effects in some individuals. While most are mild and short-lived, a few can be severe and may need prompt medical care.

Seek Immediate Medical Attention If You Experience:

These may be signs of a severe allergic reaction or dangerous cardiovascular response, and you should stop using Cialis and contact a doctor immediately.

Common Side Effects of Cialis

Some side effects occur more frequently and often resolve on their own without the need for medical treatment. These include:

These symptoms usually ease within a few hours or days. Staying hydrated, getting adequate rest, or adjusting the dosage under medical supervision can help relieve the discomfort.

Important Note

The risk of side effects may increase:

Always follow your doctor’s dosage instructions and never self-medicate or exceed the recommended amount.

Cialis Compared to Other Medications: Viagra, Levitra (Vardenafil), and Adcirca

Many men ask how Cialis (Tadalafil) compares with other erectile dysfunction (ED) medications like Viagra (Sildenafil) and Vardenafil (Levitra). Although these medicines are used for similar purposes, they have differences in ingredients, how long they last, side effects, and cost.

Cialis vs Viagra

Active Ingredients:

Both drugs are part of the PDE5 inhibitor group, which enhances blood flow to the penis in response to sexual stimulation.

Uses:

Dosage and Use:

Duration of Action:

Common Side Effects:

Both can cause:

Viagra may also cause abnormal vision (blue tint). Cialis may cause pain in the arms or legs and heartburn.

Serious Side Effects (Both):

Effectiveness:

Studies show both medicines work well for ED. However, some research found:

Cost:

Both have generic versions:

Generics are more affordable than the brand-name versions.

Cialis vs Vardenafil (Levitra)

Active Ingredients:

Both are PDE5 inhibitors

Uses:

Dosage and Use:

Side Effects:

Common side effects (shared):

Serious side effects (both):

Effectiveness:

Both are effective for ED and work similarly in clinical studies.

Cost:

  1. Vardenafil (generic) is usually cheaper than Cialis
  2. Generic Cialis (Tadalafil) is widely available and more affordable than the brand version

Cialis vs Adcirca

Both Cialis and Adcirca contain the same active ingredient: Tadalafil, but they are approved for very different medical conditions.

Uses:

Dosage and Administration:

Important Note:

These medications are not interchangeable and should only be used as prescribed by a healthcare professional. Taking Adcirca instead of Cialis (or vice versa) without medical approval is unsafe and may not work for the intended condition.

Cialis Interactions with Medications, Foods, and Supplements

Before starting Cialis (Tadalafil), it’s important to understand how it may interact with other drugs, supplements, or even certain foods. Some interactions can increase the risk of side effects or reduce the effectiveness of the medication. Always discuss your complete medication list with your doctor or pharmacist.

1۔ Interactions with Medications

The following medications may interact with Cialis and should be discussed with your doctor before use:

Nitrates:

Avoid using Cialis with nitrate-based medications commonly prescribed for chest pain (angina), as this combination can lead to a serious and unsafe drop in blood pressure.

Common nitrates include:

If you’re given nitrates during a medical emergency, your doctor will monitor you closely, especially if it’s been less than 48 hours since your last Cialis dose.

Alpha-blockers

Alpha-blockers are used to manage BPH and high blood pressure, but they may also reduce blood pressure further, which can lead to dizziness or fainting. Taking them with Cialis increases the risk of dizziness or fainting due to low blood pressure.

Common alpha-blockers:

Your doctor might modify your Cialis dosage or advise against using it alongside certain medications, depending on your health condition.

Blood Pressure Medications

Cialis can slightly lower blood pressure. If you’re taking other antihypertensive drugs, combining them with Cialis may cause symptomatic hypotension (very low blood pressure).

Examples:

Antacids

Over-the-counter antacids can reduce your body’s ability to absorb Cialis properly, which may make it less effective.

Examples:

Take Cialis and antacids at different times as advised by your doctor.

CYP3A4 Inhibitors

Cialis is metabolized by the liver enzyme CYP3A4. Some drugs block this enzyme, leading to higher levels of Cialis in the body, which may raise the risk of side effects.

Examples:

CYP3A4 Inducers

On the other hand, enzyme inducers speed up how quickly Cialis is broken down. This may make Cialis less effective.

Examples:

In such cases, your doctor may consider a different ED treatment.

Guanylate Cyclase Stimulators

Medications used to treat pulmonary hypertension should not be combined with Cialis, as this can result in a dangerously low drop in blood pressure.

Example:

If you’re on these medications, your doctor will recommend an alternative to Cialis.

2. Interactions with Supplements and Herbal Products

Although no herbal supplements are officially known to interact with Cialis, it is still important to consult your doctor before using any of the following:

Some supplements may influence blood pressure or interfere with prescription medications.

3۔Cialis and Food Interactions

Here are some foods that interact with Cialis:

a. Alcohol

Cialis and alcohol both lower blood pressure. Drinking large amounts of alcohol while using Cialis can increase the risk of:

Limit alcohol use when taking Cialis to reduce the risk of side effects.

b. Grapefruit

Avoid grapefruit and grapefruit juice while using Cialis. Grapefruit blocks the CYP3A4 enzyme, which slows down the breakdown of Cialis. This leads to higher drug levels in your body, increasing the risk of:

Cialis Precautions: Who Should Be Careful?

Before starting Cialis (Tadalafil), make sure to share your full medical history with your doctor. Some health issues or risk factors could make this medication unsafe or raise the risk of serious side effects. Be mindful of the following conditions:

Heart Conditions

Cialis can affect your cardiovascular system, especially during sexual activity, which increases heart workload. If you’ve had a heart attack, irregular heartbeat, or heart failure, consult your doctor before taking Cialis. Stop using the medication and seek emergency help if you feel chest pain or palpitations during sex.

Pulmonary Hypertension

Do not use Cialis if you are being treated with riociguat (Adempas) for pulmonary arterial hypertension, as combining these medications can lead to a serious and unsafe drop in blood pressure.

Blood Pressure Issues

Cialis may cause either high or low blood pressure. If you already have blood pressure disorders, your doctor may monitor you more closely or adjust the dose.

Stroke History

If you have a history of stroke, using Cialis might not be suitable for you. Research has shown a possible connection between Cialis and a higher risk of stroke in people with heart-related conditions. It’s essential to undergo a detailed medical assessment before starting this medication.

Liver Disease

People with liver conditions (like hepatitis or cirrhosis) may not process Cialis properly. The medication can accumulate in the body and raise the risk of side effects. Your doctor may start you on a lower dose or suggest an alternative.

Kidney Problems

If you have chronic kidney disease or reduced kidney function, Cialis may not be eliminated from your system efficiently. This can lead to drug buildup and side effects. A reduced dose may be necessary.

Eye Conditions

Avoid Cialis if you have a history of sudden vision loss, especially from conditions like non-arteritic anterior ischemic optic neuropathy (NAION). It could worsen vision problems or increase your risk of permanent damage.

Retinitis Pigmentosa

This is a genetic eye disorder that can cause gradual vision loss. Cialis is not recommended for people with this condition due to a higher risk of eye-related side effects.

Stomach Ulcers

If you’ve had stomach or intestinal ulcers, Cialis might raise the risk of gastrointestinal bleeding. Consult your doctor before starting the medication.

Bleeding Disorders

Conditions such as hemophilia or a history of abnormal bleeding can worsen with Cialis use. Your healthcare provider may recommend an alternative treatment.

Deformed Penis or Peyronie’s Disease

People with Peyronie’s disease or any structural abnormalities of the penis are at a higher risk for complications such as priapism (a prolonged, painful erection). Caution is advised.

History of Prolonged Erections (Priapism)

Cialis may raise the risk of prolonged erections lasting more than 4 hours. If you have a history of priapism (a persistent, painful erection), be sure to inform your doctor. This condition is a medical emergency and requires prompt treatment to prevent long-term damage.

Blood Cell Disorders

Diseases like sickle cell anemia, leukemia, or multiple myeloma can also raise the risk of prolonged erections when taking Cialis. A low dose or close monitoring may be necessary.

Allergies

Avoid using Cialis if you are allergic to tadalafil or any of the other ingredients in the tablet. Allergic reactions may include symptoms such as rash, itching, swelling, or trouble breathing.

Conclusion:

Cialis (Tadalafil) has become a trusted option for men in Pakistan seeking treatment for erectile dysfunction (ED), benign prostatic hyperplasia (BPH), or both. Its long-lasting effect, flexibility in use (daily or on-demand), and dual benefits for sexual and urinary health make it a preferred choice over many other ED medications.

However, like any medicine, Cialis must be used responsibly. Always consult your doctor before starting, especially if you have heart issues, vision problems, or take other medications. With proper guidance and use, Cialis can significantly improve quality of life, confidence, and overall wellbeing in intimate relationships.

Common Questions About Cialis

These pills are a widely used medication for erectile dysfunction (ED) and benign prostatic hyperplasia (BPH). If you’re considering using Cialis or already taking it, you might have several questions about its safety, usage, and effects. Below are some of the most frequently asked questions to help you understand how Cialis works and what to expect.

Can women take Cialis?

It is intended only for use in men and is not approved for women. It is prescribed to treat erectile dysfunction (ED) and benign prostatic hyperplasia (BPH) in males. For women experiencing low sexual desire, other treatments such as Bremelanotide (Vyleesi) or Flibanserin (Addyi) may be considered. Always consult a healthcare professional to explore suitable treatment options.

Does Cialis work, and is it safe?

Yes, Cialis is FDA-approved and considered safe and effective for most men. However, people with heart conditions or those taking certain medications (like nitrates) should avoid it. Always share your medical history with your doctor before starting Cialis.

Can Cialis help maintain an erection even after ejaculation?

No, Cialis doesn’t maintain an erection after ejaculation. However, because it stays active in the body for up to 36 hours, it may help you achieve another erection later if sexual stimulation occurs again.

How long does Cialis stay in your system?

Cialis remains active in the body for over 48 hours, offering extended flexibility for sexual activity. Because of its long-lasting effects, it’s often referred to as the weekend pill.

Can Cialis be used after prostate surgery?

Yes, Cialis can be effective for treating ED after prostate surgery. Clinical studies have shown improved erectile function in men who took Cialis post-surgery compared to those who took a placebo.

Does Cialis increase penis size?

No, These pills does not increase penis size. However, it can improve blood flow, which may result in firmer and fuller erections, especially if previous erections were not complete.

Can Cialis treat premature ejaculation?

Cialis (Tadalafil) is not approved to treat premature ejaculation (PE). It is mainly used for erectile dysfunction (ED) and benign prostatic hyperplasia (BPH). However, in some cases, men with both ED and PE may experience improvement in ejaculation control indirectly because Cialis helps maintain an erection longer. But it is not a direct treatment for PE.

Better Options for PE Treatment:

  1. Dapoxetine (EverLong tablets) (a short-acting SSRI) is specifically approved for PE.
  2. Behavioral therapy, desensitizing sprays, and counseling are also helpful.

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