Tell your healthcare provider that you take Cialis. Both options require valid medical documentation, but some online services only require a health questionnaire to be filled out and reviewed for approval—meaning no face-to-face video interaction is needed. It’s best to check your chosen provider’s site for more information. However, because sexual stimulation is required to initiate the local penile release of nitric oxide, tadalafil’s inhibition of PDE5 will have no effect without sexual stimulation. We also looked at additional services, such as access to digital pharmacies and home delivery options.How Cialis Works. Tadalafil and other PDE5 inhibitors primarily work by inducing muscle relaxation. Tadalafil stops the breakdown of a chemical responsible for relaxing muscles. In ED and PAH, the drug targets muscle cells in blood vessels. When the blood vessel muscle cells relax, this expands the vessel and increases blood flow; this . Best Low Cost: GoodRx Fastest Delivery: Blink Health: Sesame Sign Up Now Key Specs Cost: Consultation prices vary based on the prescriber; $5 generic prescriptions Medical . Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended. Tadalafil can be taken with or without food. Do not break or split a Cialis tablet. Swallow it whole. For erectile dysfunction, take Cialis just before sexual activity but not more than once per day.