Tell your doctor if any of these symptoms are severe or do not go away: headache. Nitrates come as tablets, sublingual under the tongue tablets, sprays, patches, pastes, and ointments. Follow your doctor’s directions carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take all of the tablets for your daily dose at one time each day; do not divide the tablets to take as separate doses. Always discuss with your health care practitioner ALL of the medications you are taking prescription and over-the-counter that way, you can receive the best advice for your own situation. 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.The drug comes in low-dose versions that can be taken daily. This means you can have sex at any time, rather than needing to take a pill from time to time as needed like other ED brands. The starting dose for daily-use Cialis is milligrams (mg). If that doesn’t work, you can increase your daily dose up to 5 mg. Tadalafil (Cialis) is a medicine used to treat erectile dysfunction (ED, also called impotence) and problems with urination caused by an enlarged prostate (benign prostatic . 5 mg 10 mg 20 mg The cost for these different strengths depends on whether you have insurance, your individual plan coverage, and your treatment plan. For example, Cialis .