Consider using another ED medication. International Journal of Clinical Practice. It works to treat erectile dysfunction by increasing blood flow to the penis during sexual stimulation. Mechanism of action[ edit ] Penile erection during sexual stimulation is caused by increased penile blood flow resulting from the relaxation of penile arteries and the smooth muscle of the corpus cavernosum. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Nitrates come as tablets, sublingual under the tongue tablets, sprays, patches, pastes, and ointments.CIALIS for Use as Needed. Creatinine clearance 30 to 50 mL/min: A starting dose of 5 mg not more than once per day is recommended, and the maximum dose is 10 mg not more than once in every 48 hours. Creatinine clearance less than 30 mL/min or on hemodialysis: The maximum dose is 5 mg not more than once in every 72 hours [see . Cialis is a member of the impotence agents drug class and is commonly used for Benign Prostatic Hyperplasia, and Erectile Dysfunction. The cost for Cialis oral tablet mg is . Tadalafil – STADA T20 – 20 Milligramm. Tadalafil, sold under the brand name Cialis among others, is a medication used to treat erectile dysfunction, benign prostatic hyperplasia, and pulmonary arterial hypertension. [4] [5] [7] It is taken by mouth. [7] Onset is typically within half an hour and the duration is up to 36 hours.