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On average, Cialis starts to work in about 30 minutes and can take up to 2 hours to take effect. Another reason not to double your dose is the long lasting effects of Cialis. While Cialis works for ED by affecting the PDE5 enzyme in the penis, it also affects other PDE enzymes in tissues and Alternatives to Levitra cells in other areas of the body. For example, PDE5 is found in tissues in the lungs, kidneys, liver, brain, and platelets. If you feel your current dosage isn’t working, there may be options to consider.

Nasal congestion was the only AE leading to discontinuation reported by more than&nbsp