It does not have to be taken around the time of sexual activity. This process helps increase blood flow to the penis and achieve an erection. A higher dose of tadalafil is needed if your body does not respond to the recommended dose. People with kidney or liver problems will need to either take a lower dose of Cialis or avoid the medication altogether, depending on the severity of the condition. This ensures the medication is always in the person’s system and allows for spontaneous sexual activity without planning dosing times.The maximum dose is 10 mg not more than once in every 48 hours. CrCl less than 30 mL/min or on hemodialysis: The maximum dose is 5 mg orally once every 72 hours. Once a day use for ED: CrCl 30 mL/min or greater: Data not available. CrCl less than 30 mL/min or on hemodialysis: Not recommended. Once a day use for BPH. Tadalafil’s effect on sexual ability may last up to 36 hours. The second way to treat ED is to take tadalafil regularly, once a day every day. If you take it this way, you may attempt sexual.  · It treats erection problems by increasing blood flow to the penis. It’s also used to treat symptoms of an enlarged prostate (benign prostatic hyperplasia or BPH). At $ for 30, 5MG Tablet, Cialis is an expensive prescription drug. You can lower the cost of Cialis to $ for 30, 20mg Tablet of generic Cialis.