If you need emergency medical care for a heart problem, it will be important for your health care provider to know when you last took Cialis. What alternatives can I use for erectile dysfunction? Conclusion Purchasing Cialis online offers numerous advantages, from convenience to cost-effectiveness. Also tell your doctor if you have or have ever had pulmonary veno-occlusive disease PVOD; blockage of veins in the lungs ; any condition that affects the shape of the penis; diabetes; high cholesterol; high or low blood pressure; irregular heartbeat; a heart attack or heart failure; angina chest pain ; a stroke; ulcers in the stomach; a bleeding disorder; blood circulation problems; blood cell problems such as sickle cell anemia a disease of the red blood cells , multiple myeloma cancer of the plasma cells , or leukemia cancer of the white blood cells ; or heart, kidney, or liver disease. You should take tadalafil one time a day. Also tell your doctor if you or any of your family members have or have ever had an eye disease such as retinitis pigmentosa an inherited eye condition that causes loss of vision or if you have ever had sudden severe vision loss, especially if you were told that the vision loss was caused by a blockage of blood flow to the nerves that help you see.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. Tadalafil – STADA T20 – 20 Milligramm. Tadalafil, sold under the brand name Cialis among others, is a medication used to treat erectile dysfunction, benign prostatic hyperplasia, and pulmonary arterial hypertension. It is taken by mouth. Onset is typically within half an hour and the duration is up to 36 hours. Common side effects include headache, muscle pain, . 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.