Talk to your doctor about eating grapefruit and drinking grapefruit juice while taking this medicine. A similar study reported a consistent result, with a risk estimate of 2. 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. CIALIS has not been administered to patients with bleeding disorders or significant active peptic ulceration. Such an event may be a sign of non-arteritic anterior ischemic optic neuropathy NAION , a rare condition and a cause of decreased vision, including permanent loss of vision, that has been reported rarely postmarketing in temporal association with the use of all PDE5 inhibitors.CIALIS is indicated for the treatment of ED and the signs and symptoms of BPH (ED/BPH). Limitation of Use If CIALIS is used with finasteride to initiate BPH treatment, such use is recommended for up to 26 weeks because the incremental benefit of CIALIS decreases from 4 weeks until 26 weeks, and the incremental benefit of CIALIS beyond. CIALIS for Use as Needed. Creatinine clearance 30 to 50 mL/min: A starting dose of 5 mg not more than once per day is recommended, and the maximum dose is 10 mg not more than once in every 48 hours. Creatinine clearance less than 30 mL/min or on hemodialysis: The maximum dose is 5 mg not more than once in every 72 hours [see . headache. indigestion. back pain. muscle pain. flushing. stuffy nose. Patients who get back pain and muscle aches usually get them 12 to 24 hours after taking Cialis and these usually go away by.