Key takeaways:
Cialis (tadalafil) is a prescription medication used to treat erectile dysfunction (ED) in men. It can help you achieve and maintain an erection for sexual intercourse.
Cialis offers two convenient dosage options. You can take it as needed, at least 30 minutes before sex. Or you can take a lower Cialis dose once daily, regardless of sexual activity.
If you have benign prostatic hyperplasia (BPH) and ED, once-daily Cialis can be an option to treat both conditions. But certain people, including those with severe kidney disease, shouldn’t take Cialis every day.
Cialis is widely available as a lower-cost generic. You can find it for as low as $18.90 at certain pharmacies with a free GoodRx discount. And with GoodRx Care Direct, you can get generic Cialis delivered directly to your door starting at $21 per month.
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Erectile dysfunction (ED) can happen to men of all ages, but it’s more common as you get older. For many people with ED, a phosphodiesterase-5 (PDE5) inhibitor can be an effective medication option for helping you achieve and maintain an erection. There are several options to choose from — each with their own specific characteristics.
Most PDE5 inhibitors are taken as needed before sex. But with Cialis (tadalafil), you have the option to take it either as needed before sex or every day. You and your prescriber may prefer one of these options for a few reasons. We explain the key differences below.
What is Cialis?
Cialis (tadalafil) is a prescription medication used to treat ED and urinary symptoms associated with benign prostatic hyperplasia (BPH). It comes as a tablet that you take by mouth.
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Like all PDE5 inhibitors, Cialis works to increase blood flow to the penis. This blood flow makes it easier for you to achieve and maintain an erection for sex. But keep in mind that sexual stimulation is required for Cialis to work.
What is the difference between Cialis daily vs. as needed?
Cialis can be taken two different ways for ED. The first is to take a dose as needed before sex. The other way is to take a lower dose every day, even if you’re not planning to have sex. There are benefits to both the daily and as-needed Cialis dosages.
If you’re wondering which option is best for you, here are a few differences to consider.
Feature | Daily Cialis | Cialis as needed |
|---|---|---|
Approved use(s) | ED and BPH | ED only |
Dosage | Lower dose taken every day | Higher dose taken as needed |
Planning required? | No; allows for spontaneous sex | Yes; must be taken at least 30 minutes before sex |
Onset and duration | Already working in background | Usually starts working within 30 minutes, with effects lasting up to 36 hours |
Side effects | May be less likely | May be more likely |
Special populations | Not recommended if you have severe kidney disease or are receiving dialysis | Better option for certain people with kidney disease |
Who can take it
You may be prescribed Cialis if you have ED, BPH, or both conditions simultaneously. If you’re treating ED, you may have the option to take Cialis as needed or daily. But if you’re treating BPH (with or without ED), it’s better to take it every day.
Daily Cialis isn’t recommended if you have severe kidney disease or are receiving dialysis. In these cases, you may still be able to take Cialis as needed, but not as often. You’ll usually need to wait 72 hours (3 days) between doses since it takes longer for your body to clear Cialis. Your healthcare team will give you specific instructions.
How long it takes to work
If you take Cialis as needed, it usually starts working within 30 minutes. Full effects may take up to 2 hours, but they can last up to 36 hours. This gives you a wide window of time for sexual activity, though some planning is still needed to time your dose appropriately. The advantage is that you don’t have to take a pill every day — just when you anticipate needing it.
If you take a lower dose of Cialis daily, the medication stays active in your system continuously. That means you don’t need to time your dose around sexual activity since it’s already working in the background. This can be a convenient option for people who prefer the flexibility of spontaneous sex without the need for planning.
Dosage
Your recommended Cialis dosage depends on several factors, including whether you take Cialis as needed or daily. It can also depend on your health history and current medications.
As-needed Cialis dosage: 5 mg to 20 mg by mouth at least 30 minutes before you plan to have sex. You shouldn’t take more than 1 Cialis dose per day, since its effects can last up to 36 hours. People with kidney problems may need to take it less frequently.
Daily Cialis dosage: 2.5 mg to 5 mg by mouth once daily, taken at the same time each day. If you have ED and BPH, or just BPH, the recommended dosage is 5 mg daily.
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What to expect: Do you get headaches after taking Cialis? Learn more about Cialis side effects, why they happen, and what you can do to manage them.
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Side effects
Cialis can cause temporary side effects, which are usually more likely to happen with higher doses. Since the as-needed Cialis dosage is higher, you may be more likely to experience certain side effects with this option. Examples of possible side effects include:
Flushing
Stuffy nose
Upset stomach
Back pain
Are there long-term effects of taking Cialis daily?
Researchers have studied the effects of taking Cialis daily for up to 2 years, and no severe or long-term safety concerns have been found. In other words, taking Cialis daily doesn’t seem to have additional safety risks compared with taking it as needed.
Does Cialis lose effectiveness over time?
During the same study mentioned above, most men taking Cialis reported positive experiences with improved erections and ability to engage in sex over the course of 2 years. And while we don’t have longer-term studies, there isn’t evidence available to suggest that you build up tolerance to Cialis over time.
But it’s good to keep in mind that many underlying factors can cause or worsen ED. These factors can include health conditions, mental health factors, and other medications you take. If Cialis doesn’t seem to be working as well for you, your healthcare team can help figure out the cause.
How to decide between daily and as-needed Cialis
Still not sure which Cialis option best fits your lifestyle? Here are a few questions to consider when discussing your options with a healthcare professional.
Do you have other medical conditions? If you also have BPH, daily Cialis can be a good option for both ED and BPH. But if you have severe kidney disease, daily Cialis wouldn’t likely be an option for you.
How often do you have sex? If you’re having sex several times a week, daily Cialis may fit your lifestyle better. For occasional sex, taking Cialis as needed may be an appropriate option.
Are prescription costs adding up? A 30-day supply of daily Cialis may cost a little more than the cost of Cialis if you’re taking it only as needed.
Talk to a healthcare professional to help determine which option is best for you. Keep in mind that you shouldn’t switch how you’re taking Cialis without their approval or guidance.
How to save on Cialis
There are ways to save on Cialis, which is available as both a generic and brand-name medication.
Save with GoodRx: GoodRx can help you save over 80% off the average retail price of the generic version. Generic Cialis’ price at certain pharmacies is as low as $18.90 for 30 tablets with a free GoodRx discount. An equivalent dose of the brand-name product may cost as little as $294.59 with a free GoodRx discount.
Save with GoodRx Care Direct: Get generic Cialis delivered directly to your door starting at $21 per month.
Save with a patient assistance program: If you’re uninsured or underinsured, you may be eligible for Cialis’ patient assistance program, which offers the medication free of charge.
Frequently asked questions
Most people don’t develop a true tolerance to Cialis. That means it continues to work at the same dose over time. But if Cialis seems less effective for you than it used to be, this may be due to changes in your health, medications, or lifestyle. Talk to your prescriber if you notice a difference. They can adjust your treatment if needed.
There are a few things that you can do to help Cialis work better, including:
Limit alcohol, which can make it less effective and increase side effects.
Address underlying health issues, such as high blood pressure, diabetes, or low testosterone.
Manage stress and anxiety, which can affect sexual performance.
Follow your prescriber’s instructions, and give the medication time to work — it may take up to 2 hours to reach its full effect.
Most people don’t develop a true tolerance to Cialis. That means it continues to work at the same dose over time. But if Cialis seems less effective for you than it used to be, this may be due to changes in your health, medications, or lifestyle. Talk to your prescriber if you notice a difference. They can adjust your treatment if needed.
There are a few things that you can do to help Cialis work better, including:
Limit alcohol, which can make it less effective and increase side effects.
Address underlying health issues, such as high blood pressure, diabetes, or low testosterone.
Manage stress and anxiety, which can affect sexual performance.
Follow your prescriber’s instructions, and give the medication time to work — it may take up to 2 hours to reach its full effect.
The bottom line
Cialis (tadalafil) is a prescription medication that can help you achieve and maintain an erection if you have erectile dysfunction (ED). One unique aspect of Cialis is that you can take it in two different ways.
First, you have the option to take Cialis as needed, at least 30 minutes before sex. Alternatively, you can take Cialis once daily. This may be a good option if you have sex regularly or want the option of having spontaneous sex. A daily Cialis regimen may also be recommended if you’re treating both ED and benign prostatic hyperplasia (BPH), or if you’re only treating BPH.
Speak with a healthcare professional to determine which Cialis dosage option is best for you.
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References
Lilly Cares Foundation. (n.d.). Available medications.
NuCare Pharmaceuticals. (2025). Tadalafil- tadalafil tablet, film coated [package insert].
Porst, H., et al. (2008). Long-term safety and efficacy of tadalafil 5 mg dosed once daily in men with erectile dysfunction. The Journal of Sexual Medicine.
Zhou, Z., et al. (2019). Meta-analysis of the long-term efficacy and tolerance of tadalafil daily compared with tadalafil on-demand in treating men with erectile dysfunction. Sexual Medicine.
