Stop using tadalafil and call your doctor at once if you have: heart attack symptoms–chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating; vision changes or sudden vision loss; ringing in your ears or sudden hearing loss; or an erection is painful or lasts longer than 4 hours prolonged erection can damage the penis. Most erectile dysfunction medications belong to the drug class known as PDE5 inhibitors , which help relax the muscles and increase blood flow to allow for a full erection. Insurance: If you plan to use insurance, make sure the online provider accepts it. In such a patient, who has taken CIALIS, where nitrate administration is deemed medically necessary for a life-threatening situation, at least 48 hours should have elapsed after the last dose of CIALIS before nitrate administration is considered. The dose may be increased to 20 mg or decreased to 5 mg, based on individual efficacy and tolerability.The recommended starting dose for Cialis intended for once daily use is mg, take at the same time each day, without regard to timing of sexual activity. This may be increased to 5mg/day based on need and tolerability. May be taken with or without food. Cialis is available as a generic, under the name tadalafil. 3. headache *. upset stomach. runny nose. back pain *. upper respiratory infection. heartburn *. muscle pain. For a list of side effects reported by people taking Cialis in clinical trials, including. Tadalafil (Cialis) is available both as brand-name and generic tablets. Common side effects of this medication include headache and indigestion. Tadalafil Missing: los angeles.