Refills: See if you can set up automatic refills or order as needed. Other conditions that may disqualify you from an ED prescription include a history of stroke, kidney or liver disease, cancer, diabetes, or a bleeding disorder. However, some states require a live video consultation. This increase in blood flow results in a firmer, longer-lasting erection. You could get dizzy, faint or have a heart attack or stroke.Cialis lasts up to 36 hours in the body, while Viagra lasts 4–6 hours in the body. Both are taken 30 minutes before sex. Cialis can cause limb pain, while Viagra can cause vision change, rash. How can I buy tadalafil? You need a prescription from a doctor to buy tadalafil. You can buy it from a store-based pharmacy or reputable online pharmacy with a prescription. Some people buy tadalafil online without a prescription. This isn’t a good idea, as you can’t be sure whether these pills contain the medicine or are counterfeit. 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 .

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