Cialis dosage: A complete guide for UK patients
- A clear overview of all available Cialis doses and their intended use
- The difference between daily and on-demand dosing
- Whether you can take 10 mg Cialis daily
- Dose adjustments for older patients and those with kidney or liver conditions
- What to do if your current dose is not working
- Cialis dosage overview
- Cialis 5mg daily: Who is it for and how does it work?
- Can you take 10mg Cialis daily?
- Cialis 10mg on-demand: What to expect
- Cialis 20mg on-demand: The maximum dose
- Daily Cialis vs on-demand: Which is better?
- Dose adjustments: Older patients and those with kidney or liver conditions
- What should you do if your Cialis dose is not working?
- Final thoughts
Cialis dosage overview
| Dose | Use | Frequency | Notes |
|---|---|---|---|
| 2.5 mg | Daily use (starting dose) | Once daily | For men who prefer continuous cover or have sex frequently |
| 5 mg | Daily use (maintenance) | Once daily | Most common daily dose; can be increased from 2.5 mg |
| 10 mg | On-demand | As needed, max once per 24 hours | Recommended starting dose for on-demand use |
| 20 mg | On-demand | As needed, max once per 24 hours | Maximum licensed dose; for men where 10 mg is insufficient |
All doses are taken orally and are available on prescription in the UK. For a full cost breakdown by dose, see our Cialis price guide. For guidance on how dosing compares between branded Cialis and generic tadalafil, see our tadalafil dosage guide.
Cialis 5mg daily: Who is it for and how does it work?
The 5 mg daily dose is designed for men who prefer not to plan sexual activity around a medication window, who have sex more than twice a week, or who find on-demand dosing inconvenient. By taking a low dose every day at the same time, a continuous therapeutic level of tadalafil is maintained in the bloodstream, meaning no separate dose is needed before sexual activity.
Treatment typically begins at 2.5 mg daily for the first two weeks to assess tolerability, before increasing to 5 mg if needed. The full effect of daily dosing is usually established within a few days of reaching a stable daily dose.
Good to know
Daily Cialis at 5 mg is also licensed for the treatment of benign prostatic hyperplasia (BPH) in the UK, making it a useful option for men with both ED and lower urinary tract symptoms.
Can you take 10mg Cialis daily?
The 10 mg dose is not licensed for daily use in the UK. The licensed daily doses are 2.5 mg and 5 mg, as specified in the Cialis Summary of Product Characteristics at medicines.org.uk. The 10 mg and 20 mg doses are formulated and licensed for on-demand use only.
A daily dose of 10 mg is considered an off-label prescription. While off-label prescribing is legally permitted in the UK when a prescriber deems it clinically appropriate, it is not standard practice for tadalafil, and the 5 mg daily dose is the appropriate licensed option for continuous use.
If you feel 5 mg daily is insufficient, discuss this with your prescriber rather than increasing the dose independently.
Cialis 10mg on-demand: What to expect
The 10 mg dose is the recommended starting point for on-demand Cialis. It should be taken approximately 30 minutes before anticipated sexual activity and remains effective for up to 36 hours, giving a substantially longer window than sildenafil's 4-6 hours.
Unlike Viagra, tadalafil is not significantly affected by food, so the 10 mg dose can be taken with or without a meal.
If 10 mg produces adequate results, there is no clinical reason to increase to 20 mg. Dose escalation should only be considered if results are insufficient after several attempts.
Cialis 20mg on-demand: The maximum dose
The 20 mg dose is the maximum licensed single dose of tadalafil and is prescribed when 10 mg has not produced sufficient results. The onset, duration, and food interaction are the same as the 10 mg dose, but the higher dose carries a somewhat higher incidence of side effects, particularly back pain, muscle aches, and flushing.
Warning!
Never take more than one 20 mg dose in a 24-hour period. Exceeding the maximum licensed dose does not improve efficacy and significantly increases the risk of side effects including severe hypotension. Always follow your prescriber's guidance on dose.
Daily Cialis vs on-demand: Which is better?
Neither approach is universally superior. The right choice depends on the frequency of sexual activity, lifestyle preferences, and individual tolerability.
| Daily Cialis (5 mg) | On-demand Cialis (10–20 mg) | |
|---|---|---|
| Spontaneity | No timing needed | Must be taken 30 min before activity |
| Best for | Frequent sex; performance anxiety | Occasional use |
| Food interaction | None | None |
| Side effects | Generally lower at 5 mg | More common at higher doses |
| Cost | Monthly ongoing cost | Pay only when needed |
Men who have sex more than twice a week, or who find the psychological pressure of timing medication adds to performance anxiety, often prefer daily dosing. Men who have sex less frequently and prefer not to take daily medication typically find on-demand dosing more practical.
Dose adjustments: Older patients and those with kidney or liver conditions
Older patients
The Cialis SmPC does not specify a lower starting dose for older men, unlike the Viagra SmPC which recommends 25 mg for men over 65. However, older men are more likely to have cardiovascular conditions and to be taking medications that interact with tadalafil. A prescriber should review the full medication list and health history before recommending a starting dose.
Kidney impairment
For men with mild to moderate kidney impairment, no dose adjustment is required for on-demand use, though the 20 mg dose should be used with caution. For daily use, a starting dose of 2.5 mg is recommended. Tadalafil is not recommended for men with severe kidney impairment.
Liver impairment
For men with mild to moderate liver impairment, the maximum recommended dose is 10 mg for on-demand use. Daily tadalafil is not recommended for men with any degree of hepatic impairment.
Good to know
If you have kidney or liver conditions, always disclose these to your prescriber before starting Cialis. Your prescriber will determine the most appropriate dose based on your individual health profile.
What should you do if your Cialis dose is not working?
If your current dose is consistently not producing adequate results, the following steps are worth considering before concluding that the treatment is not effective:
- Check timing: On-demand Cialis should be taken at least 30 minutes before activity
- Check consistency: Missing doses of daily Cialis disrupts the steady therapeutic level
- Consider dose adjustment: If you are on 10 mg on-demand with insufficient results, discuss increasing to 20 mg with your prescriber
- Review lifestyle factors: Alcohol, psychological factors, and underlying health conditions all affect how well tadalafil works
- Request a clinical review: If the maximum dose is not producing results, this warrants a prescriber assessment to investigate underlying causes or consider an alternative treatment
DoktorABC connects UK patients with licensed prescribers who can review dosing history and advise on the most appropriate next step.
Final thoughts
Choosing the right Cialis dose is a clinical decision based on your pattern of use, health profile, and tolerability. The licensed daily doses (2.5 mg and 5 mg) and on-demand doses (10 mg and 20 mg) each have a clear role, and switching between them is straightforward under prescriber guidance. Never increase your dose without clinical advice, and speak to your prescriber if your current dose is not meeting your needs.
FAQ
What doses does Cialis come in?
Cialis is available in 2.5 mg, 5 mg, 10 mg, and 20 mg. The 2.5 mg and 5 mg doses are for daily use; the 10 mg and 20 mg are for on-demand use.
What is the recommended starting dose of Cialis?
For on-demand use, 10 mg is the recommended starting dose. For daily use, treatment typically begins at 2.5 mg before increasing to 5 mg if needed.
Can I take 10mg Cialis daily?
The licensed daily doses are 2.5 mg and 5 mg only. Taking 10 mg daily would be off-label use and is not standard practice. Speak to your prescriber if you feel 5 mg daily is insufficient.
What is the maximum Cialis dose?
The maximum licensed single dose is 20 mg, taken no more than once per 24-hour period.
What are the benefits of daily Cialis?
Daily Cialis removes the need to time a dose around sexual activity, provides continuous therapeutic cover, and may reduce performance anxiety. It is most suitable for men who have sex frequently or who prefer not to plan around medication.
How long before sex should I take Cialis?
On-demand Cialis (10 mg or 20 mg) should be taken at least 30 minutes before sexual activity. Unlike Viagra, it is not significantly affected by food.
What should I do if Cialis is not working?
Check timing and consistency, consider whether a dose adjustment is appropriate, and speak to your prescriber for a clinical review. Do not increase your dose without medical guidance.
Where can I report a side effect from Cialis?
Via the MHRA Yellow Card scheme at yellowcard.mhra.gov.uk, through the Yellow Card app, or by asking your prescriber or pharmacist to report on your behalf.
The DoktorABC medical advisory board
Dr. Roland Ruiken
Medical advisor, Norway
Dr. Viktor Simunovic
Medical advisor, Croatia