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Cyclic guanosine monophosphate (GMP) is a chemical in your body that relaxes the muscles in the penis and increases blood flow into the penis. With ED, this activity isn’t working properly, so you can’t have or maintain an erection. An erection occurs when blood flows into the penis and remains there for a period of time. This happens because the blood vessels and muscles in the penis relax and open up, allowing more blood to flow into the area. Cialis can stay in your system for more than 2 days after a dose.

If you’re prescribed 20mg and find either that you’re experiencing too many side effects or are not seeing the results you want, speak with your clinician. They may suggest another type of ED pill or an alternative treatment. As 20mg is the Cialis max dose there is no "Cialis 30mg" or beyond and you should never take more than one tablet in any 24 hour period. You might feel the higher the dose the better, but if you get easy, strong erections on 10mg a higher dose isn’t going to beat that. Your clinician will evaluate whether the benefits outweigh the risk of side effects. Cialis 10mg and 20mg will stay active in your system for up to 36 hours.

To take effect, sildenafil can be taken as long as 4 hours prior to sexual activity and as short as 30 to 60 minutes beforehand. The cost of generic sildenafil makes this stand out as an ED medication option