Price for Cialis Black 80mg
| Product | Dosage | Quantity | Per tablet |
|---|---|---|---|
| Cialis Black | 80mg | 10 tablets | From C$2.99 |
| Cialis Black | 80mg | 30 tablets | From C$2.49 |
| Cialis Black | 80mg | 90 tablets | From C$1.99 |
The Health Canada-approved maximum single dose of tadalafil for erectile dysfunction is 20mg. Cialis Black at 80mg is four times this standard maximum and is an off-label dose. Clinical evidence does not consistently demonstrate superior efficacy at 80mg compared to 20mg, while the risk of adverse effects — including severe hypotension, back pain, and cardiovascular events — increases significantly. Cialis Black 80mg should only be used under the direct supervision of a licensed physician who has assessed your cardiovascular status, current medications, and response to standard tadalafil doses.
Cialis Black at a Glance — Four Numbers to Know
What Is Cialis Black — How It Differs from Standard Tadalafil
Cialis Black is not a pharmacologically distinct medication from standard tadalafil — it is the same active molecule (tadalafil) in the same tablet form, differentiated by its higher dose (80mg vs 5/10/20mg standard), its typically dark or black film-coated appearance, and its generic branding. The black or dark film coating has no pharmacological significance. The only meaningful clinical distinction is the dose — which is four times the Health Canada-approved maximum for on-demand erectile dysfunction treatment.
| Parameter | Cialis Black 80mg | Standard Tadalafil 20mg |
|---|---|---|
| Active ingredient | Tadalafil 80mg | Tadalafil 20mg |
| Health Canada approved dose | Off-label — 4x above maximum | Maximum approved dose |
| Onset | 30–60 minutes | 30–120 minutes |
| Duration | Up to 36 hours | Up to 36 hours |
| Food effect | Minimal — take with any meal | Minimal — take with any meal |
| Nitrate safety gap | 48 hours (critical at 80mg) | 48 hours |
| Back pain / myalgia | Yes — more pronounced at 80mg | Yes — tadalafil-specific (PDE11) |
| Visual disturbances | No — tadalafil does not inhibit PDE6 | No |
| Side effect risk | Significantly higher | Standard |
| Medical supervision | Required — off-label dose | Recommended |
From Dr. Sarah Mitchell, RPh, Ontario College of Pharmacists #234567: Tadalafil's dose-response relationship for erectile dysfunction plateaus at approximately 20mg for most men. Studies examining 40mg and 80mg doses have not demonstrated consistently better clinical outcomes than 20mg, while adverse effects — particularly back pain, myalgia, and cardiovascular effects — increase substantially. When a patient does not respond adequately to tadalafil 20mg, the appropriate clinical pathway is to investigate contributing factors or consider tadalafil 5mg daily dosing rather than escalating to off-label doses. Cialis Black 80mg should only be considered under physician supervision after all standard approaches have been evaluated.
Mechanism of Action — How Tadalafil Works
The mechanism of Cialis Black is identical to standard tadalafil at any dose. Tadalafil is a highly selective PDE5 (phosphodiesterase type 5) inhibitor (Ki = 0.94 nM — approximately four times more potent at PDE5 than sildenafil at Ki = 3.9 nM). During sexual stimulation, nitric oxide (NO) released in the corpus cavernosum activates guanylate cyclase, increasing cyclic GMP (cGMP). Elevated cGMP relaxes smooth muscle in the cavernosal arteries, increasing arterial inflow and producing an erection. Tadalafil inhibits PDE5, preventing cGMP breakdown and sustaining the erectile response.
Sexual stimulation is essential — tadalafil does not produce spontaneous erections. Tadalafil's long plasma half-life of approximately 17.5 hours means it remains at pharmacologically active concentrations for up to 36 hours — allowing erectile response to stimulation at any point within this window. At 80mg, plasma concentrations are substantially higher than at 20mg, amplifying both the therapeutic effect and all adverse effects throughout the entire 36-hour window.
Unlike sildenafil, tadalafil has minimal PDE6 inhibitory activity — it does not cause the visual side effects (blue tinge, photophobia) specific to sildenafil. However, tadalafil inhibits PDE11 in skeletal muscle, producing the back pain and myalgia that is characteristic of tadalafil and not seen with sildenafil or vardenafil. At 80mg, PDE11 inhibition is proportionally more pronounced, making back pain a more frequent and more significant side effect.
Dosage — Health Canada Context and the 80mg Dose
Critical Safety — Nitrates: 48-Hour Window
Also absolutely contraindicated with: Riociguat (Adempas). Alpha-blockers (tamsulosin, doxazosin, alfuzosin) — risk of severe symptomatic hypotension is substantially higher at 80mg; this combination requires specialist medical assessment before use.
Note — sildenafil vs tadalafil nitrate gap: The required nitrate safety gap for tadalafil (Cialis Black, standard Cialis) is 48 hours — twice as long as sildenafil's 24-hour requirement. This is because tadalafil's half-life of ~17.5 hours is more than three times that of sildenafil (3–5 hours). At 80mg, tadalafil plasma levels are substantially higher and persist even longer, making strict adherence to the 48-hour gap essential.
Side Effects — Increased Risk at 80mg
Common — more frequent at 80mg
- Headache — typically more intense than at 20mg
- Flushing — facial warmth and redness
- Nasal congestion
- Dyspepsia — indigestion
- Dizziness
- Back pain and myalgia — tadalafil-specific due to PDE11 inhibition in skeletal muscle. Significantly more pronounced at 80mg. Typically presents 12–24 hours after dosing and may persist for 48+ hours. Paracetamol or ibuprofen effective if needed
Note: Tadalafil does NOT cause visual disturbances (blue tinge, photophobia) — minimal PDE6 inhibitory activity. This applies at 80mg as well.
Less common — risk elevated at 80mg
- Significant hypotension — especially with antihypertensives, alpha-blockers or alcohol
- Syncope (fainting)
- Peripheral oedema (limb swelling)
- Palpitations or increased heart rate
- Prolonged severe back pain lasting more than 48 hours
- Rash or hypersensitivity reaction
Stop immediately — call 911
- Priapism — painful erection lasting more than 4 hours. Medical emergency. Higher risk at 80mg. Call 911 or go immediately to ER
- Sudden loss or significant decrease in vision (possible NAION)
- Sudden hearing loss with or without tinnitus
- Severe chest pain or cardiovascular symptoms — do NOT use nitrates; call 911
- Severe allergic reaction (facial swelling, breathing difficulty)
Drug Interactions
| Drug / substance | Interaction | Action required |
|---|---|---|
| Organic nitrates (GTN, isosorbide, poppers) | Severe, potentially fatal hypotension — amplified at 80mg | Absolute contraindication — 48h minimum gap |
| Riociguat (Adempas) | Severe hypotension | Absolute contraindication |
| Alpha-blockers (tamsulosin, doxazosin, alfuzosin) | Symptomatic hypotension — significantly higher risk at 80mg | Specialist medical supervision required before any combination |
| Antihypertensives (all classes) | Additive blood pressure reduction — amplified at 80mg | Medical supervision required; monitor BP closely |
| CYP3A4 inhibitors (ketoconazole, ritonavir, clarithromycin, itraconazole) | Substantially elevated tadalafil levels at 80mg; greatly increased toxicity risk | Contraindicated at 80mg with potent CYP3A4 inhibitors |
| CYP3A4 inducers (rifampicin, carbamazepine, phenytoin) | Reduced tadalafil efficacy | Dose adjustment may be needed; consult GP |
| Other PDE5 inhibitors (sildenafil, vardenafil, avanafil) | Additive effect; markedly increased adverse events at 80mg | Do not combine under any circumstances |
| Alcohol (>2 standard Canadian drinks) | Additive hypotension; may impair sexual function | Limit alcohol; avoid large amounts with 80mg tadalafil |
| Grapefruit / grapefruit juice | CYP3A4 inhibition — may increase tadalafil levels | Avoid large amounts when using 80mg |
Contraindications
- Current use of any organic nitrate or nitric oxide donor
- Current use of riociguat (Adempas)
- Use of any potent CYP3A4 inhibitor (ritonavir, ketoconazole, itraconazole) — contraindicated specifically at 80mg
- Severe hepatic impairment (Child-Pugh Class C)
- Severe renal impairment (CrCl <30 mL/min) — tadalafil clearance is significantly reduced
- Recent stroke, MI or life-threatening arrhythmia (within 90 days)
- Unstable angina or angina during sexual intercourse
- Severe or uncontrolled hypertension or severe hypotension
- Prior episode of NAION or hereditary retinal degeneration (retinitis pigmentosa)
- Hypersensitivity to tadalafil or any tablet excipient
- Persons under 18 years of age; women; children
- Men who have not first been assessed and found tolerant of tadalafil 20mg
Frequently Asked Questions
What is Cialis Black and why is it called "Black"?
Cialis Black is a generic tadalafil tablet at 80mg dose with a typically dark or black film coating. The name and black colour refer to the tablet's coating dye, which has no pharmacological significance and does not affect how the medication works. Standard Cialis is yellow-coated. The only clinically meaningful distinction of Cialis Black is its dose — 80mg — which is four times the Health Canada-approved maximum of 20mg for on-demand erectile dysfunction treatment.
Does tadalafil 80mg work better than 20mg?
Not reliably. The dose-response relationship for tadalafil plateaus at approximately 20mg for most men. Clinical studies at higher doses have not demonstrated consistent, meaningful improvements in erectile function outcomes compared to 20mg. The 36-hour duration of action does not meaningfully change with higher doses — tadalafil's half-life is the determinant, not the dose. What does increase substantially with dose is the frequency and severity of adverse effects — particularly back pain, myalgia, cardiovascular effects, and hypotension.
How is Cialis Black different from Red Viagra?
Both are high-dose off-label products above their respective Health Canada maximums. The critical difference is the active molecule: Cialis Black contains tadalafil 80mg — 36-hour duration, 48-hour nitrate gap, minimal food effect, back pain (PDE11). Red Viagra contains sildenafil 200mg — 4–6 hour duration, 24-hour nitrate gap, significant food effect, possible visual changes (PDE6). Choose based on which underlying molecule's standard-dose profile better suits individual needs — ideally at approved doses first.
Can I take Cialis Black if I take blood pressure medication?
You must consult your GP or cardiologist before using any tadalafil product if you are on antihypertensives, and this is especially critical at 80mg. At this dose, the additive hypotensive effect is substantially amplified. Alpha-blockers (tamsulosin, doxazosin) combined with tadalafil 80mg carry a high risk of severe symptomatic hypotension. Organic nitrates remain absolutely contraindicated with a 48-hour minimum gap.
Is tadalafil 80mg prescribed in Canada?
Tadalafil 80mg is not an approved dosage in Health Canada's prescribing guidelines for erectile dysfunction. The approved on-demand doses are 10mg and 20mg; daily doses are 2.5mg and 5mg. The 80mg dose is used off-label in specific clinical circumstances after standard doses have been tried and assessed by a physician. A valid Canadian prescription is required. Consult a GP or telehealth provider — Maple (getmaple.ca), Dialogue (dialogue.co), or Tia Health — to determine whether any tadalafil dosage is appropriate for your situation.
This product page was reviewed by Dr. Sarah Mitchell, RPh, Ontario College of Pharmacists #234567 (Canadian Pharmacists Association). Information is for general guidance only and does not constitute personalised medical advice. Tadalafil 80mg is an off-label dose above the Health Canada-approved maximum for erectile dysfunction. Use only under physician supervision. Tadalafil is a prescription-only medication in Canada.
