Cialis (Tadalafil)

Vad är Cialis?

Cialis (tadalafil) is a prescription-only oral medicine approved by the Europeiska läkemedelsmyndigheten (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.

Hur fungerar 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.

Vem är 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. A medical assessment is required to determine clinical suitability. 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)

Dosering

Cialis is available in two distinct dosing regimens:

On-demand dosing (for sexual activity)

Dose	Details
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)

Dose	Typical Use
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.

Food and drink: Unlike sildenafil, tadalafil absorption is not significantly affected by food or moderate alcohol consumption.

Biverkningar

As with all medicines, Cialis may cause side effects.

Vanliga biverkningar (kan drabba fler än 1 av 10 personer)

• 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.

Mindre vanliga side effects (kan drabba upp till 1 av 10 personer)

• Dizziness
• Blurred vision
• Nasal congestion or rhinitis

Allvarliga biverkningar — sök omedelbar medicinsk hjälp

• 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.

Refer to the EMA-approved product information for a complete list of side effects.

Cialis jämfört med alternativ

All four PDE5 inhibitors listed below are EMA-approved for erectile dysfunction. This table is provided for informational purposes only. Individual suitability must be assessed by a qualified doctor.

Medicine	Active Ingredient	Onset	Duration	Dosing
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

Key differences:

• 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.

Hur får man tillgång till Cialis online i Europa

Cialis is a receptbelagt läkemedel (POM) in all EU-medlemsländer. A valid prescription from a licensed medical professional is required before it can be legally dispensed.

Prescrivia operates as a technology intermediary: we do not prescribe medicines, employ doctors, or sell medicines. Our platform connects patients with independent EU-registered doctors who can conduct confidential online health assessments.

The process works as follows:

1. Fyll i en hälsobedömning: Answer structured health questions covering your medical history, current medications, urinary symptoms, and relevant lifestyle factors.
2. Läkarbedömning: An independent EU-registered doctor reviews your assessment. 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.
3. Recept och leverans: If a prescription is issued, it is sent to a licensed EU pharmacy partner, which dispenses and ships the medicine to you.

Important: Prescrivia garanterar inte that a prescription will be issued. All prescribing decisions are made independently by qualified medical professionals.

Viktig säkerhetsinformation

Använd inte Cialis if you:

• 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

Berätta för din läkare before 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)

Läkemedelsinteraktioner: 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. Always disclose all current medications to the reviewing doctor.

Källor

Medical information on this page is based on the following sources:

• Europeiska läkemedelsmyndigheten (EMA). Cialis (tadalafil) — Summary of Product Characteristics. Available at: ema.europa.eu
• Europeiska läkemedelsmyndigheten (EMA). Assessment report: Cialis. EMEA/H/C/000436.
• Världshälsoorganisationen (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.

This content is reviewed periodically to reflect updated clinical guidance. It is provided for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for advice relevant to your individual health circumstances.