Because patients with recent heart attacks or stroke, heart pains angina , heart failure, uncontrolled blood pressure or uncontrolled irregular heart beats, severe liver disease, and retinal eye problems were not studied with Cialis, Cialis is not recommended for these patients. Insurance can help you save even more on consultations and medications. The safety and effectiveness of Cialis when used with other treatments for impotence has not been studied. Most erectile dysfunction medications belong to the drug class known as PDE5 inhibitors , which help relax the muscles and increase blood flow to allow for a full erection. Cialis is not recommended for people taking any form of nitroglycerin because the combination may lower blood pressure to an unsafe level.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. headache. indigestion. back pain. muscle pain. flushing. stuffy nose. Patients who get back pain and muscle aches usually get them 12 to 24 hours after taking Cialis and these usually go away by. The 20mg dose can also be compounded at pharmacies and is generally cheaper but if you may obv have to consume/buy more pills for your dose. Cialis (20, 10, 5 and mg) .