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Potential Side Effects and Interactions. While Cialis is generally safe, like all medications, it can have side effects. Some common side effects include headaches, back pain, nasal congestion, or flushing. Rare but severe side effects might include an erection that doesn t go away, sudden vision loss, or hearing loss. Cialis form and strengths (2.5 mg, 5 mg, 10 mg, 20 mg) Cialis comes as oral tablets that are available in four strengths: 2.5 milligrams (mg), 5 mg, 10 mg, and 20 mg. Recommended dosage for Cialis cialis 20 mg review dosage Dosage and Administration. Cialis typically comes in 10 mg and 20 mg dosages for as-needed use. However, Cialis is available in 2.5 mg and 5 mg for daily use. Usual Adult Dose for Erectile Dysfunction. Use as needed for ED: Initial dose: 10 mg orally once a day, as needed, prior to sexual activity. Maintenance dose: 5 How should I take Cialis? Cialis is usually taken only once per day. Follow all directions on your prescription label. Do not take this medicine in larger or smaller