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CIALIS for Use as Needed for Erectile Dysfunction. 1  The recommended starting dose of CIALIS for use as needed in most patients is 10 mg, taken prior to anticipated sexual activity. 2  The dose may be increased to 20 mg or decreased to 5 mg, based on individual efficacy and tolerability.
Responses (2) Generally the recommended dose of Cialis is 5mg for ED, 2 X 20mg would be way way too much & would be considered an over dose. This could lead to serious side effects, please do talk to a doc who prescribed the med, he/she would give you better advice & maybe prescribed some med which works well with your system.