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. Tadalafil can be synthesized starting from D – tryptophan methyl ester and piperonal via a Pictet—Spengler reaction. Also tell your doctor if you or any of your family members have or have ever had an eye disease such as retinitis pigmentosa an inherited eye condition that causes loss of vision or if you have ever had sudden severe vision loss, especially if you were told that the vision loss was caused by a blockage of blood flow to the nerves that help you see. John’s wort. Your doctor will probably tell you not to take tadalafil if you are taking street drugs containing nitrates.headache *. upset stomach. runny nose. back pain *. upper respiratory infection. heartburn *. muscle pain. For a list of side effects reported by people taking Cialis in clinical trials, including. Compare prices and print coupons for Cialis (Tadalafil (Cialis)) and other drugs at CVS, Walgreens, and other pharmacies. Prices start at $ headache. indigestion. back pain. muscle pain. flushing. stuffy nose. Patients who get back pain and muscle aches usually get them 12 to 24 hours after taking Cialis and these usually go away by.

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