If you drink a large amount of alcohol more than five glasses of wine or five shots of whiskey while you are taking tadalafil you are more likely to experience certain side effects of tadalafil such as dizziness, headache, fast heartbeat, and low blood pressure. 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. Though this growth is not cancerous, prostate cancer and BPH can co-occur. Tadalafil comes as a tablet to take by mouth. Egypt Egypt approved Viagra for sale in , but soon afterwards allowed local companies to produce generic versions of the drug, citing the interests of poor people who would not be able to afford Pfizer’s price. The results showed the combination to be even more effective than either medication alone.How Cialis Works. Tadalafil and other PDE5 inhibitors primarily work by inducing muscle relaxation. Tadalafil stops the breakdown of a chemical responsible for relaxing muscles. In ED and PAH, the drug targets muscle cells in blood vessels. When the blood vessel muscle cells relax, this expands the vessel and increases blood flow; this . AdFind the lowest available Sildenafil prices in your area. No sign-up required. Save now! Search & compare local Sildenafil prices. Save up to 80% on Sildenafil instantly! Cialis doesn’t work right away. For the as-needed dose, plan to take Cialis at least 30 minutes before sexual activity, but bear in mind it may take as long as 2 hours to take effect.