We considered cost, medications available, and whether generic versions were offered to help reduce costs. Your doctor or other health care professional can recommend one for you based on these factors, other health conditions you have and any other medicines you take. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Finally, we checked customer reviews to better understand user experiences with each platform. You can take it in a small dose daily or in a larger dose as needed. ED medications can cause side effects, and it’s crucial to have access to a medical provider if needed.The recommended starting dose for Cialis intended for once daily use is mg, take at the same time each day, without regard to timing of sexual activity. This may be increased to 5mg/day based on need and tolerability. May be taken with or without food. Cialis is available as a generic, under the name tadalafil. 3. The most commonly reported side effects in patients treated with Cialis during the testing of the product were: headache. indigestion. back pain. muscle pain. flushing. stuffy nose. Patients who. CIALIS for Use as Needed. 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 .