Cialis 20 mg Dosage/Direction for Use

Do not split Tadalafil (Cialis) tablets; entire dose should be taken.
The recommended starting dose of Tadalafil (Cialis) for use as needed in most patients is 10 mg, taken prior to anticipated sexual activity.
The dose may be increased to 20 mg or decreased to 5 mg, based on individual efficacy and tolerability. The maximum recommended dosing frequency is once per day in most patients.
Tadalafil (Cialis) for use as needed was shown to improve erectile function compared to placebo up to 36 hours following dosing. Therefore, when advising patients on optimal use of Tadalafil (Cialis), this should be taken into consideration.
Use with Food: Tadalafil (Cialis) may be taken without regard to food.
Use in Specific Populations: Renal Impairment: 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 Precautions).
Hepatic Impairment: Mild or moderate (Child Pugh Class A or B): The dose should not exceed 10 mg once per day. The use of Tadalafil (Cialis) once per day has not been extensively evaluated in patients with hepatic impairment and therefore, caution is advised.
Severe (Child Pugh Class C): The use of Tadalafil (Cialis) is not recommended (see Precautions).
Pediatric Use: Tadalafil (Cialis) is not indicated for use in pediatric patients. Safety and efficacy in patients below the age of 18 years have not been established.
Geriatric Use: No dose adjustment is warranted based on age alone.
Concomitant Medications: Alpha-Blockers: When Tadalafil (Cialis) is coadministered with an alpha-blocker in patients being treated for ED, patients should be stable on alpha-blocker therapy prior to initiating treatment, and Tadalafil (Cialis) should be initiated at the lowest recommended dose (see Precautions, Adverse Reactions and Pharmacology: Pharmacodynamics under Actions).
CYP3A4 Inhibitors: For patients taking concomitant potent inhibitors of CYP3A4, such as ketoconazole or ritonavir, the maximum recommended dose of Tadalafil (Cialis) is 10 mg, not to exceed once every 72 hours (see Precautions, Adverse Reactions and Pharmacology: Pharmacodynamics under Actions).