What is Cialis?
Cialis (tadalafil) is a prescription-only oral medicine approved by the European Medicines Agency (EMA) for the treatment of erectile dysfunction (ED) in adult men. It is also approved for the treatment of signs and symptoms of benign prostatic hyperplasia (BPH), and as a combination therapy for men who have both ED and BPH.
Tadalafil belongs to the same class of medicines as sildenafil (Viagra) and vardenafil (Levitra) — phosphodiesterase type 5 (PDE5) inhibitors — but is distinguished by its markedly longer duration of action of up to 36 hours per dose.
How does Cialis work?
Like all PDE5 inhibitors, tadalafil works by blocking the enzyme phosphodiesterase type 5, which is responsible for breaking down cyclic guanosine monophosphate (cGMP) in penile smooth muscle tissue.
During sexual stimulation, nitric oxide is released in the erectile tissue of the penis. This triggers a biochemical cascade that produces cGMP, which relaxes vascular smooth muscle, increases blood flow into the corpora cavernosa, and produces an erection. In men with erectile dysfunction, PDE5 degrades cGMP too rapidly, impairing this process.
By inhibiting PDE5, tadalafil allows cGMP to remain at higher concentrations for longer, supporting normal erectile function in response to sexual stimulation.
Tadalafil does not produce an erection in the absence of sexual stimulation. The medicine supports — but does not replace — the physiological response to arousal.
For benign prostatic hyperplasia, tadalafil relaxes smooth muscle in the prostate, bladder, and bladder neck, reducing lower urinary tract symptoms such as difficulty urinating, weak stream, and urinary frequency.
Who is Cialis for?
Cialis is indicated for:
- Adult men with erectile dysfunction: Men who experience persistent difficulty achieving or maintaining an erection sufficient for satisfactory sexual activity.
- Adult men with benign prostatic hyperplasia (BPH): Men with symptoms of an enlarged prostate, including urinary hesitancy, weak urine flow, incomplete bladder emptying, and nocturia.
- Adult men with both ED and BPH: The 5 mg daily dose is specifically approved for this combined indication.
Cialis is not appropriate for all men. Se requiere una evaluación médica para determinar la idoneidad clínica. It is contraindicated in men who:
- Take nitrate medicines in any form
- Have severe cardiovascular disease
- Have severe hepatic impairment
- Have had a recent stroke or myocardial infarction
- Have hypotension (blood pressure below 90/50 mmHg)
Posología
Cialis is available in two distinct dosing regimens:
On-demand dosing (for sexual activity)
| Dosis | Detalles |
|---|---|
| 10 mg | Standard starting dose, taken 30 minutes before sexual activity |
| 20 mg | If 10 mg is well-tolerated but insufficiently effective |
On-demand doses are effective for up to 36 hours. Only one dose should be taken in a 24-hour period.
Daily dosing (continuous effect)
| Dosis | Uso habitual |
|---|---|
| 2.5 mg once daily | Starting dose for daily regimen |
| 5 mg once daily | For ED, BPH, or both; if 2.5 mg is insufficient |
Daily tadalafil maintains a stable concentration of the medicine in the bloodstream, removing the need to plan around dosing. It is suitable for men who have sexual activity more than twice per week or who prefer spontaneous activity.
Alimentos y bebidas: Unlike sildenafil, tadalafil absorption is not significantly affected by food or moderate alcohol consumption.
Efectos secundarios
Como todos los medicamentos, Cialis puede causar efectos secundarios.
Efectos secundarios frecuentes (pueden afectar a más de 1 de cada 10 personas)
- Headache
- Dyspepsia (indigestion, heartburn)
- Back pain
- Myalgia (muscle aches)
- Flushing (facial warmth and redness)
- Nasal congestion
Back pain and myalgia are more commonly reported with tadalafil than with sildenafil or vardenafil, and typically resolve within 48 hours without intervention.
Efectos secundarios poco frecuentes (pueden afectar hasta a 1 de cada 10 personas)
- Dizziness
- Blurred vision
- Nasal congestion or rhinitis
Efectos secundarios graves — busque atención médica inmediata
- Priapism: A persistent erection unrelated to sexual stimulation lasting more than 4 hours is a medical emergency. Immediate medical treatment is required to prevent permanent injury.
- Sudden vision loss: Rare cases of NAION have been reported. Discontinue immediately and seek urgent medical care.
- Sudden hearing loss: Stop treatment and contact a doctor immediately.
- Severe hypotension: Risk is substantially increased if tadalafil is combined with nitrates. This combination is contraindicated.
Consulte la información del producto aprobada por la EMA para obtener una lista completa de efectos secundarios.
Cialis vs alternatives
All four PDE5 inhibitors listed below are EMA-approved for erectile dysfunction. Esta tabla se proporciona únicamente con fines informativos. La idoneidad individual debe ser evaluada por un médico cualificado.
| Medicamento | Principio activo | Inicio de acción | Duración | Posología |
|---|---|---|---|---|
| Cialis | Tadalafil | 30–60 min | Up to 36 hours | On demand or daily |
| Viagra | Sildenafil Citrate | 30–60 min | 4–6 hours | On demand |
| Levitra | Vardenafil | 25–60 min | 4–5 hours | On demand |
| Generic Viagra | Sildenafil | 30–60 min | 4–6 hours | On demand |
Diferencias clave:
- Cialis vs Viagra: The most clinically significant difference is duration. Tadalafil remains effective for up to 36 hours versus 4–6 hours for sildenafil. Cialis is also less affected by food and is the only PDE5 inhibitor approved for BPH. Sildenafil is available at lower starting prices and has a longer post-market clinical history.
- Cialis vs Levitra: Both have similar onset profiles, but tadalafil’s markedly longer duration provides a larger window for spontaneous sexual activity. Levitra may have a slight edge in onset speed for some patients.
- Daily Cialis: This is a unique feature of tadalafil — no other PDE5 inhibitor is licensed for continuous daily use at a therapeutic dose in Europe. Daily dosing eliminates the need to time tablet-taking around sexual activity.
How to access Cialis online in Europe
Cialis es un medicamento sujeto a prescripción médica en todos los estados miembros de la UE. Se requiere una receta válida de un profesional médico autorizado para su dispensación legal.
Prescrivia opera como intermediario tecnológico: no prescribimos medicamentos, no empleamos médicos ni vendemos medicamentos. Nuestra plataforma conecta a los pacientes con médicos independientes registrados en la UE que pueden realizar evaluaciones de salud en línea confidenciales.
El proceso funciona de la siguiente manera:
- Complete una evaluación de salud: Responda preguntas de salud estructuradas que cubran su historial médico, medicamentos actuales, síntomas urinarios y factores de estilo de vida relevantes.
- Revisión médica: Un médico independiente registrado en la UE revisa su evaluación. If tadalafil is clinically appropriate — either on-demand or daily — they may issue a prescription. If it is not appropriate, the doctor will explain why.
- Prescripción y dispensación: Si se emite una receta, se envía a una farmacia asociada autorizada de la UE, que dispensa y envía el medicamento a usted.
Importante: Prescrivia no garantiza que se emita una receta. Todas las decisiones de prescripción son tomadas de forma independiente por profesionales médicos cualificados.
Información importante de seguridad
No utilice Cialis si usted:
- Take any form of nitrate medicine (including glyceryl trinitrate, isosorbide mononitrate, isosorbide dinitrate, or nitrate-containing recreational drugs)
- Have severe cardiovascular disease or have been told to avoid sexual activity for cardiac reasons
- Have severe liver impairment (Child-Pugh Class C)
- Have blood pressure below 90/50 mmHg
- Are allergic to tadalafil or any ingredient in Cialis
Informe a su médico antes de starting Cialis if you have:
- Any history of heart disease, heart attack, or stroke
- Severe kidney disease
- Retinitis pigmentosa or a history of NAION
- Peyronie’s disease or other penile abnormality
- Sickle cell anaemia, multiple myeloma, or leukaemia
- BPH treated with alpha-blockers (combination requires careful dose management)
Interacciones medicamentosas: Tadalafil has significant interactions with nitrates (absolutely contraindicated), alpha-blockers (risk of hypotension — dose adjustment required), antihypertensives, CYP3A4 inhibitors (including ritonavir, ketoconazole, and itraconazole), and rifampicin. Informe siempre de todos los medicamentos actuales al médico que realiza la evaluación.
Fuentes
La información médica de esta página se basa en las siguientes fuentes:
- European Medicines Agency (EMA). Cialis (tadalafil) — Summary of Product Characteristics. Disponible en: ema.europa.eu
- European Medicines Agency (EMA). Assessment report: Cialis. EMEA/H/C/000436.
- World Health Organization (WHO). Sexual health — Fact sheet. who.int
- Brock GB, et al. Efficacy and safety of tadalafil for the treatment of erectile dysfunction: results of integrated analyses. J Urol. 2002;168:1332-1336.
Este contenido se revisa periódicamente para reflejar las directrices clínicas actualizadas. Se proporciona únicamente con fines informativos y no constituye asesoramiento médico. Consulte siempre a un profesional sanitario cualificado para obtener asesoramiento relevante para sus circunstancias de salud individuales.
Frequently asked questions
- What is Cialis used for?
- Cialis (tadalafil) is approved by the European Medicines Agency (EMA) for two indications: erectile dysfunction (ED) in adult men, and the signs and symptoms of benign prostatic hyperplasia (BPH) — an enlarged prostate — in adult men. It is the only PDE5 inhibitor approved for both conditions.
- How long does Cialis last?
- Cialis has a significantly longer duration of action than other PDE5 inhibitors. A single on-demand dose (10 mg or 20 mg) can remain effective for up to 36 hours, giving patients a wider window for spontaneous sexual activity compared to sildenafil or vardenafil. This is why Cialis is sometimes called the 'weekend pill'.
- What is the difference between Cialis on demand and Cialis daily?
- On-demand Cialis (10 mg or 20 mg) is taken 30 minutes before anticipated sexual activity and provides up to 36 hours of effectiveness. Daily Cialis (2.5 mg or 5 mg) is taken once every day at the same time, maintaining continuous low-level tadalafil in the bloodstream. Daily dosing is suitable for men who prefer not to plan around tablet-taking or who have sexual activity more than twice a week.
- Can I get Cialis online in Europe?
- Puede acceder a Cialis a través de plataformas intermediarias en línea que le conectan con médicos independientes registrados en la UE. Tras completar una evaluación de salud confidencial, un médico evaluará si tadalafil es clínicamente apropiado para usted. Prescrivia no prescribe ni dispensa medicamentos — le conectamos con profesionales cualificados.
- Is Cialis affected by food or alcohol?
- Unlike sildenafil, tadalafil can be taken with or without food, including high-fat meals, without a clinically meaningful impact on its absorption or onset. Moderate alcohol consumption (up to 3 units) does not significantly reduce tadalafil's effectiveness, though excessive alcohol can worsen ED and increase the risk of side effects such as low blood pressure and dizziness.
Tratamientos
Prescrivia es únicamente una plataforma intermediaria. No prestamos servicios médicos, no prescribimos tratamientos ni dispensamos medicamentos. Todas las decisiones médicas son tomadas por médicos independientes registrados en la UE. Todos los medicamentos son dispensados por farmacias autorizadas de la UE. Esta plataforma facilita la conexión entre pacientes y profesionales sanitarios.