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Nitric oxide then activates the enzyme, guanylate cyclase, which causes the production of cyclic guanosine monophosphate (cGMP). It is the cGMP that is primarily responsible for the erection by affecting the amount of blood that the blood vessels deliver and remove from the penis. Cialis and Viagra inhibit an enzyme called phosphodiesterase-5 (PDE5) which destroys the cGMP. Thus, Cialis and Viagra prevent the destruction of cGMP and allows cGMP to accumulate and persist longer. The longer cGMP persists, the more prolonged the engorgement of the penis. Studies show that the drug begins to work 30 minutes to 6 hours after you take your first dose.
The recommended dose is one 5 mg tablet taken once a day at approximately the same time of the day. Your doctor may adjust the dose to 2.5 mg based on your response to CIALIS. Since benign prostatic hyperplasia and prostate cancer may have the same symptoms, your doctor will check you for prostate cancer before starting treatment with CIALIS for benign prostatic hyperplasia.
You can safely take two tadalafil 10mg tablets to give you 20mg. You should only do this if your doctor of pharmacist has prescribed you with tadalafil 20mg. The maximum dose of tadalafil that you should take is 20mg within a 24 hour period. Tadalafil is an Erectile Dysfunction (ED) treatment used by men who have difficulty in achieving and maintaining an erection.
Men who regularly require Cialis more than twice a week sometimes prefer to take a lower dose 2.5mg or 5mg tablet each day, at the same time of day. These low dose tablets are specifically for daily use and provide a continuous level of treatment. Although sildenafil and tadalafil are different drugs that both block PDE5, they do not complement each other. In fact, 
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