Penis deformation: As with other medications for erectile dysfunction, men with an anatomical deformation of the penis such as angulation, cavernosal fibrosis, or Peyronie’s disease should be closely monitored by their doctors if they take Cialis Tadalafil. Vision loss may be partial or complete. The decision of availability is completely up to the company marketing the product. What side effects can this medication cause? Heart conditions: Speak to your doctor before taking any medication for erectile dysfunction if you: have or have had heart disease have had a heart attack have had a stroke have angina chest pain as a result of poor blood flow to the heart muscle have experienced chest pain during sexual activity have uncontrolled irregular heart rhythm have very Low Blood Pressure have uncontrolled high blood pressure If you experience chest pains, dizziness, or nausea during sex, stop the exertion, and inform your doctor as soon as you can. Alcohol: Consumption of alcohol may decrease the ability to achieve an erection and may also temporarily decrease blood pressure, causing dizziness and fainting.Cialis is only available by prescription in the United States. Viagra: Additionally, a study from Trusted Source. found that combining L-arginine and sildenafil (Viagra) worked better for. Many providers sell Cialis online — learn about the safest and most discreet providers here. Cialis (tadalafil) is a prescription medication for those with erectile dysfunction. not available over-the-counter (OTC) Was this helpful? How does Cialis work? Cialis works by increasing blood flow to the penis to help a person get and .