Cialis side effects

[raven]

I've been experimenting with Indian made tadalafil that I ordered on the internet. it has been working great, but Im plagued with some bad side effects. Mainly pain in my body(especially my lower back), loose bowels, foggy head, acid reflux...It's gotten to the point where I don't want to take it anymore, but I'm having trouble performing for the Mrs. Is this maybe a bad batch? any thoughts, or any other ideas for me? this my first experience with any of the different types of ED drugs. I'm a patient of defy and plan on discussing this at my next appointment.

 

[MarcoFL]

I've been experimenting with Indian made tadalafil that I ordered on the internet. it has been working great, but Im plagued with some bad side effects. Mainly pain in my body(especially my lower back), loose bowels, foggy head, acid reflux...It's gotten to the point where I don't want to take it anymore, but I'm having trouble performing for the Mrs. Is this maybe a bad batch? any thoughts, or any other ideas for me? this my first experience with any of the different types of ED drugs. I'm a patient of defy and plan on discussing this at my next appointment.

Have Defy order safe supply from Empower and know what you are putting in your body. It is fairly cheap from Empower. NOT worth the risk!

 

[Vince]

I only buy my tadalafil from India pharmacies, great results. I did have lower back issues and heartburn. Thankfully overtime all issues have slowly going away.

 

[Mountain Man]

I only buy my tadalafil from India pharmacies, great results. I did have lower back issues and heartburn. Thankfully overtime all issues have slowly going away.

Me as well. Indian pharmacies are as good as any generic. I use Ceebis made by Cooper, a UK company. If you have sienna effects from Ceebis, I’m sure you’re going to get it from any tadalafil, regardless of who makes it.

 

[raven]

I would have to agree mountain man. I seem to be sensitive just just about all pharmaceuticals. if there a noted side effect, i seem to get it. I thank you men for yours replies. gonna discuss this further my next appointment with defy. thanks again.

 

[Prime]

Have Defy order safe supply from Empower and know what you are putting in your body. It is fairly cheap from Empower. NOT worth the risk!

I ordered some Cialis from Empower through Defy, I don’t quite understand why they won’t send generic Cialis instead of having Empower compound it.
I also don’t understand why I can’t deal directly with Empower once I have the script from Defy...

 

[Tommy Wall]

Raven lower back pain and heartburn are common start off effects. Give it 2 weeks and you’ll see it will become less or even gone. For me it can make me feel sluggish and I feel during the nights that my heart beats a bit slower and harder. I believe it’s due to that my blood pressure goes to low. The same happens if I take l-citruline together with my BP medication in the morning or even if I take L- histidine mixed with citruline. Tired and sluggish for 4-5 hours after the intake. I feel that L- histidine and even niacin alone are also a powerful vasculators. I noticed that I become a shower instead of a grower lol. Just measure your BP so doesn’t goes to low and dose accordingly and you will be fine.

 

[raven]

Thank you tommy. I'll give it a try

 

[raven]

Raven lower back pain and heartburn are common start off effects. Give it 2 weeks and you’ll see it will become less or even gone. For me it can make me feel sluggish and I feel during the nights that my heart beats a bit slower and harder. I believe it’s due to that my blood pressure goes to low. The same happens if I take l-citruline together with my BP medication in the morning or even if I take L- histidine mixed with citruline. Tired and sluggish for 4-5 hours after the intake. I feel that L- histidine and even niacin alone are also a powerful vasculators. I noticed that I become a shower instead of a grower lol. Just measure your BP so doesn’t goes to low and dose accordingly and you will be fine.

was this at a dose of 5mg?

 

[SilverSurfer]

I take my daily dose right before bed. I don’t notice any side effects anymore this way. The low back ache went away after about a month.

 

[MarcoFL]

Does anyone have any increased heart rate from daily use?

 

[Simon7]

I take 5mg tadalafil daily and had back pain and leg muscle pain that disappeared after 2 weeks. You can try taking probiotics to help with loose stools. If things don't improve over time you can try other pde5 inhibitors who have different side effects.

 

[Nashtide]

I dealt with the unwanted side effects by starting with a very low dose and slowly increasing the dose over a few months. I forget the exact protocol, but I started really low like 2mg eod for a month then moved to 2mg ed. Then gradually increased dose until I was at 5mg ed. I experienced no sides this way. The first time I jumped in and started taking 5mg ed, I had back pain and strange silent migraines.

 

[Nelson Vergel]

Why Tadalafil Causes Side Effects: The Mechanisms​

1. PDE5 Is Everywhere, Not Just the Penis​

The core issue: PDE5 inhibitors prolong the action of cGMP by inhibiting its degradation by PDE5, which is found throughout the body. Wikipedia When you block PDE5 systemically, you get vasodilation in tissues you didn't intend to target.

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2. Headaches & Flushing — Cranial and Cutaneous Vasodilation​

The same NO/cGMP pathway that relaxes penile smooth muscle also acts on blood vessels in the scalp, face, and skin. Elevated cGMP dilates these vessels, causing:

• Throbbing headaches (meningeal vessel dilation)
• Facial flushing and warmth
• Nasal congestion (dilation of nasal mucosal vasculature)

These are among the most common complaints and are purely on-target effects in unintended vascular beds.

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3. Hypotension & Dizziness — Systemic Vasodilation​

Tadalafil has mild systemic vasodilatory properties that may result in transient decreases in blood pressure. FDA This becomes clinically significant in several scenarios:

• With nitrates: PDE5 inhibitors have been shown to potentiate the hypotensive effects of organic nitrates Medscape Reference — potentially fatally, since both work through the NO/cGMP axis.
• With alpha-blockers: Caution is necessary when tadalafil is used with α-blockers or other antihypertensive agents due to the risk of additive blood pressure-lowering effects. NCBI
• With alcohol: Both alcohol and tadalafil are mild systemic vasodilators. More patients had clinically significant decreases in blood pressure on the combination than with alcohol alone, and some subjects reported postural dizziness and orthostatic hypotension. FDA

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4. Back Pain & Myalgia — PDE11 Inhibition (Tadalafil-Specific)​

This is what makes tadalafil unique among PDE5 inhibitors. Tadalafil also inhibits PDE11, which is present in the prostate Wikipedia — and in skeletal muscle. The inhibition of PDE11A in muscle tissue is believed to be the direct cause of the back pain and muscle aches that are characteristic of tadalafil but rare with sildenafil or vardenafil. Tadalafil is 14-fold more potent for PDE5 than for PDE11A1 and 40-fold more potent for PDE5 than for other isoforms FDA, but at clinical doses, PDE11 inhibition in muscle is real enough to produce symptoms in a meaningful subset of users.

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5. Why Tadalafil's Side Effects Last Longer​

Tadalafil has a half-life of ~17.5 hours vs. 4–5 hours for sildenafil. This is why the weekend pill works for 36+ hours — but it also means side effects (headache, flushing, back pain) persist much longer. At steady state with daily low-dose dosing (5 mg), exposure accumulates to approximately 1.6x a single dose.

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6. CYP3A4 Interactions Amplify Everything​

Tadalafil is metabolized by CYP3A4, so inhibitors like ketoconazole, itraconazole, and ritonavir can increase tadalafil exposure, while inducers like rifampin can decrease its effectiveness. NCBI Men taking HIV antiretrovirals, certain antifungals, or even large amounts of grapefruit juice can experience dramatically amplified side effects because plasma levels spike beyond the therapeutic range.

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7. Why Side Effects Often Diminish Over Time​

Tadalafil-related side effects decreased in frequency with continued administration, and less than 3% of patients left studies because of side effects. Rbmojournal This is likely due to adaptive downregulation of vasodilatory responses and vascular smooth muscle accommodation to sustained cGMP elevation.

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Bottom Line for Clinicians and Patients​

Most tadalafil side effects are mechanistically predictable on-target effects in non-genital vascular beds (headache, flushing, hypotension) or in cross-reactive enzymes (PDE11 → muscle pain). Dose selection matters enormously — daily 5 mg produces a much flatter pharmacokinetic curve than 20 mg on demand, reducing peak-related side effects while maintaining therapeutic benefit.