It’s available in 10 mg and 20 mg tablets. Most companies have an FAQ or shipping policy page you can reference to learn whether discreet packaging is available. Also tell your doctor if you have or have ever had pulmonary veno-occlusive disease PVOD; blockage of veins in the lungs ; any condition that affects the shape of the penis; diabetes; high cholesterol; high or low blood pressure; irregular heartbeat; a heart attack or heart failure; angina chest pain ; a stroke; ulcers in the stomach; a bleeding disorder; blood circulation problems; blood cell problems such as sickle cell anemia a disease of the red blood cells , multiple myeloma cancer of the plasma cells , or leukemia cancer of the white blood cells ; or heart, kidney, or liver disease. Tadalafil comes as a tablet to take by mouth. These are commonly prescribed for an enlarged prostate or male pattern baldness. Ask your doctor if you are not sure whether any of your medications contain nitrates.Side Effects. Headache, stomach upset, back pain, muscle pain, stuffy nose, flushing, or dizziness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly. To. CIALIS for Use as Needed. Creatinine clearance 30 to 50 mL/min: A starting dose of 5 mg not more than once per day is recommended, and the maximum dose is 10 mg not more than once in every 48 hours. Creatinine clearance less than 30 mL/min or on hemodialysis: The maximum dose is 5 mg not more than once in every 72 hours [see . Tadalafil (Cialis) is used to treat erectile dysfunction (ED, impotence; inability to get or keep an erection), and the symptoms of benign prostatic hyperplasia (BPH; an enlarged prostate) which include difficulty urinating (hesitation, dribbling, weak stream, and incomplete bladder emptying), painful urination, and urinary frequency and urgency in adult men.