6 Cialis Side Effects You Should Know About

Cialis (tadalafil) is a prescription medication that treats erectile dysfunction (ED) and symptoms of benign prostatic hyperplasia (BPH). It’s part of a group of medications called phosphodiesterase 5 (PDE5) inhibitors. Other brand names for tadalafil include Tadliq, Alyq, and Adcirca.

ED happens when men have trouble getting and keeping an erection. Cialis increases blood flow to the penis, making it easier to have an erection. It also treats symptoms of BPH in various ways. This includes increasing blood flow to the prostate and decreasing inflammation.

Usually, Cialis is well tolerated. Still, there are possible risks. Knowing what Cialis side effects to watch for can help you understand what warrants calling your prescriber or, in some cases, emergency care.

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Cialis side effects at a glance

Though Cialis is typically well tolerated, side effects can happen. Some of the side effects people report are listed below.

Common but usually mild side effects include:

• Headache

• Stomach upset

• Flushing

• Muscle aches

• Back pain

• Cold symptoms, including nasal congestion and cough

• Diarrhea

Rare but more serious side effects include:

• Vision problems

• Hearing loss

• Persistent or painful erections

• Low blood pressure when combined with other substances or medications that decrease blood pressure

Below, we’ll discuss six Cialis side effects and offer tips to help you manage them.

Good to know: Before starting Cialis, ask your prescriber or pharmacist if it interacts with your other medications. Cialis interactions can increase your risk of side effects.

1. Headache

Headaches are one of the most common Cialis side effects. This is likely because of how Cialis works. It improves blood flow and enhances the effects of a chemical called nitric oxide. These actions can trigger headaches, including migraines.

People taking higher doses of Cialis are more likely to experience headaches. If you experience headaches after taking Cialis, some tips to follow include:

• Avoiding alcohol: Headaches are more likely if you drink alcohol while taking Cialis. Even just 1 or 2 drinks can interfere with your body’s ability to maintain an erection. Alcohol can also interact with Cialis, making side effects like low blood pressure more likely.

• Staying well hydrated: Dehydration is an easily overlooked cause of headaches. If your pee is dark, it’s a sign to drink more water.

• Taking an over-the-counter (OTC) pain reliever: Medications like Tylenol (acetaminophen) or Advil (ibuprofen) are usually safe to take with Cialis. But check with your prescriber or pharmacist first.

If your headaches continue or feel severe, talk with your prescriber. They may recommend a lower Cialis dose. If you’re taking Cialis as needed, switching to daily Cialis may be another option — side effects are less likely with this dosing schedule.

2. Stomach upset

You might have an upset stomach after taking Cialis. This is because Cialis increases blood flow to other areas of the body besides the penis, including the stomach. This increased blood flow can cause stomach upset.

You might notice a sour feeling in your stomach. Acid reflux is also possible. If needed, some strategies to settle an upset stomach include:

• Taking Cialis with food

• Eating smaller, more frequent meals throughout the day

• Staying away from spicy and fried foods, which can worsen stomach problems

If stomach problems continue, let your prescriber know. They may suggest a lower Cialis dose or consider whether there’s something else going on.

3. Back pain

Back pain is another possible Cialis side effect. Less commonly, muscle pain and limb pain can happen.

Back and muscle pain may seem like odd side effects for ED medications. This may occur because Cialis blocks an enzyme (protein) that’s found in skeletal muscle, which can lead to back pain and muscle pain.

Back pain from Cialis is usually mild and improves over time. Using cold compresses might help. For ongoing muscle pain, applying heat might be a better option. If needed, try an OTC pain reliever like Advil. But OTC pain relievers aren’t safe for everyone, so check if you’re unsure.

4. Prolonged erection

In rare cases, Cialis can lead to a prolonged erection (priapism). This is when an erection lasts longer than 4 hours.

Priapism is a medical emergency. If it isn’t treated, serious consequences like painful erections or an inability to have an erection can happen. So call 911 or seek emergency care if you experience an erection lasting longer than 4 hours.

5. Vision problems

PDE5 inhibitors like Cialis have been linked to several types of vision problems. Researchers think blood flow changes in the eye can lead to vision-related side effects.

The most common visual side effects include sensitivity to light and blue-tinted or hazy vision. These changes usually go away if Cialis is stopped.

Serious eye problems are possible but rare. These include:

• Nonarteritic anterior ischemic optic neuropathy

• Retinal detachment

• Retinal vein occlusion

If you have an existing eye issue, make sure your healthcare professional knows before you start taking Cialis. This medication should be avoided if you have certain eye-related conditions.

If you experience any eye problems, especially vision loss, while taking Cialis, stop taking it immediately and seek medical care.

6. Hearing loss

Rare cases of hearing loss have been reported in people taking Cialis and other PDE5 inhibitors. Hearing loss usually occurs within the first few days of taking the medication.

You may experience partial or complete hearing loss. And only one ear may be affected. You may also feel dizzy and have a ringing-in-the-ear sensation. If you notice any of these symptoms, stop taking Cialis and seek emergency care.

When should you seek medical care for Cialis side effects?

For mild side effects like a headache or stomach upset, it’s OK to follow some of the tips noted above and see if your side effects improve. But let your prescriber know if they continue or feel severe. Something as simple as a dose change might make a difference.

Serious side effects are rare with Cialis. But it’s important to watch for symptoms so you can catch them early. Seek immediate medical care if you notice any of the following:

• Chest pain

• Trouble breathing

• Severe dizziness

• Vision loss

• Hearing loss

• An erection lasting more than 4 hours

Why trust our experts?

Written by:

Daphne Berryhill, RPh

Daphne Berryhill, RPh, has two decades of experience as a clinical pharmacist. She spent most of her career in the Chicago area practicing in-home infusion.

Edited by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Alex Brewer, PharmD, MBA

Alex Brewer, PharmD, MBA, is a licensed pharmacist specializing in chronic disease and health and wellness. Upon completing his residency, he worked in the managed care field, conducting medication therapy management and adherence counseling sessions with Medicaid, Medicare, and private insurance patients, before transitioning to a career in medical writing.

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