Your healthcare provider can help you determine the right dosage for you. This medicine works best when you take it on an empty stomach an hour before sex. There are two different ways to take tadalafil, either daily or on an as needed basis. The four main medicines taken by mouth for erectile dysfunction are: Avanafil Stendra. 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. · But on average, its effects start to lessen 2 to 3 hours after you take a dose. The typical dose for once-daily Cialis for ED is milligrams (mg) to 5 mg. When used as needed for ED, the usual. Cialis is only available by prescription in the United States. Viagra: Additionally, a study from Trusted Source. found that combining L-arginine and sildenafil (Viagra) worked better for. Cialis lasts up to 36 hours in the body, while Viagra lasts 4–6 hours in the body. Both are taken 30 minutes before sex. Cialis can cause limb pain, while Viagra can cause vision change, rash.

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