Physicians should discuss with patients the potential for CIALIS to augment the blood-pressure-lowering effect of alpha-blockers and antihypertensive medications. Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient. 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. Take tadalafil at around the same time every day. However, because sexual stimulation is required to initiate the local penile release of nitric oxide, tadalafil’s inhibition of PDE5 will have no effect without sexual stimulation. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.$ (save %) local_offer_outlined Avg retail price $ medication_outlined Availability Available See GoodRx coupons warning Are you . Show coupon to your pharmacist Present your printed or electronic coupon when you pick up your prescription. Get free coupon Learn more. But your blood pressure shouldn’t drop by too much. In clinical studies, people who took the 20 mg dose of tadalafil (Cialis) experienced an average drop in blood pressure by about 2 mm Hg. . MNT ‘s review. Lemonaid sells Cialis in these forms: Cialis: available in doses of 5, 10, and 20 mg, starting at $65 per tablet. Daily Cialis: 5 mg tablet with pricing starting from $50 per tablet.