What important information should you know about Cialis? Popular ED medications found online include: Viagra sildenafil : As the first FDA-approved PDE5 inhibitor for ED, sildenafil is taken 30 minutes to four hours before sexual intercourse to help achieve and maintain an erection. Alternatively, Cialis may be prescribed as an as-needed treatment for ED, to be taken before sexual activity. Side effects Side effects of oral ED medicines are often mild. Because patients with recent heart attacks or stroke, heart pains angina , heart failure, uncontrolled blood pressure or uncontrolled irregular heart beats, severe liver disease, and retinal eye problems were not studied with Cialis, Cialis is not recommended for these patients.tadalafil. erectile dysfunction (ED) benign prostatic hyperplasia, or BPH). Tadalafil (Cialis) is available both as brand-name and generic tablets. Common side effects of this medication include headache and indigestion. Tadalafil (Cialis) does interact with some medications. Cialis doesn’t work right away. For the as-needed dose, plan to take Cialis at least 30 minutes before sexual activity, but bear in mind it may take as long as 2 hours to take effect. headache. indigestion. back pain. muscle pain. flushing. stuffy nose. Patients who get back pain and muscle aches usually get them 12 to 24 hours after taking Cialis and these usually go away by.