5 WARNINGS AND PRECAUTIONS

2.5 Use with Food
2.3 CIALIS for Once Daily Use for Benign Prostatic Hyperplasia
Drug Label Information
How much is generic Cialis?
2.7 Concomitant Medications
17.9 Alcohol
Key takeaways

Grünenthal announces that it agreed to acquire the commercial rights to Cialis® from Eli Lilly and Company in Mexico, Brazil and Colombia, further strengthening Grünenthal's footprint in Latin America. As part of the acquisition, Grünenthal will transfer the manufacturing of Cialis® to its production site in Chile. Since 2017, Grünenthal has invested more than €2 billion in successful M&A transactions, significantly strengthening its profitability. Aachen, Germany, 2 June 2025 – Grünenthal today announced the acquisition of the commercial rights to Cialis® (tadalafil) in Mexico, Brazil and Colombia from Eli Lilly and Company. Over the next few years, Grünenthal and Lilly will work together to transfer the manufacturing to Grünenthal's production site in Santiago, Chile, that will supply Cialis® for Mexico, Brazil and Colombia moving forward.

Tip	Explanation	Additional Advice
Consult a doctor beforehand	Especially if taking other medications or health conditions	Essential for safety
Follow recommended dosage	Avoid overdose, which can cause adverse effects	Check label instructions
Do not combine with nitrates	Can cause dangerous drops in blood pressure	Seek medical advice
Monitor for side effects	Report any severe reactions to a healthcare provider	Immediate consultation

The transaction is expected to close in the third quarter of 2025, subject to the satisfaction of customary closing conditions. Grünenthal will finance the transaction using available liquidity. The financial terms of the transaction are not disclosed. Cialis® is indicated for the oral treatment of erectile dysfunction and signs and symptoms of benign prostatic hyperplasia in adult men1. The acquisition will expand Grünenthal's Latin American Men's Health product portfolio. "Executing on our strategy of targeted acquisitions, Cialis® will expand our existing portfolio in the region and strengthen Grünenthal's Latin American business", says Gabriel Baertschi, CEO, Grünenthal. "In 2022, we acquired Nebido®, a long-acting treatment for testosterone deficiency, and with Cialis® we can continue to serve our existing customer base and foster our growth in key Latin American markets." Through the acquisition of Cialis®, Grünenthal continues executing its strategy of acquiring established medicines to expand its portfolio and increase its profitability.

Comparisons are often made between Cialis (tadalafil) and Viagra (sildenafil).
Cialis has a much longer duration of action (36 vs. 4-6 hours).
Viagra's effects can be more impaired by a high-fat meal.
Cialis daily dosing offers constant coverage, unlike Viagra.
Some patients report different side effect profiles between the drugs.
The choice depends on individual patient needs, lifestyle, and response.
A healthcare provider can help determine the most suitable option.

Since 2017, Grünenthal has invested over €2 billion in the acquisition of established medicines, including Nebido®, the European rights to Crestor® and Nexium®, as well as the global rights to Vimovo® (excluding the U.S. and Japan), Qutenza® and Zomig® (excluding Japan). In 2023, Grünenthal established Grünenthal Meds, a joint venture with Kyowa Kirin International, which manages a portfolio of 13 brands primarily focused on pain management and, in 2024, acquired the US company Valinor Pharma and the product Movantik®. 1 In Mexico Cialis® is indicated for the oral treatment of erectile dysfunction and symptoms of benign prostatic hyperplasia in adult men. About Grünenthal Grünenthal is a global leader in pain management and related diseases. As a science-based, fully integrated pharmaceutical company, we have a long track record of bringing innovative treatments and state-of-the-art technologies to patients worldwide. Our purpose is to change lives for the better – and innovation is our passion. We focus all our activities and efforts on working towards our vision of a World Free of Pain. Grünenthal is headquartered in Aachen, Germany, and has affiliates in 28 countries across Europe, Latin America, and the U.S. Our products are available in approx. In 2024, Grünenthal employed around 4,300 people and achieved revenues of €1.8 billion. Follow us on: LinkedIn: Grunenthal Group Instagram: grunenthal Click here for our Grünenthal Report 2024/2025 Grünenthal announces acquisition of the rights to Cialis® from Lilly in Mexico, Brazil & Colombia (pdf, 137.3 KB) Singapore, 5 February 2024 Zuellig Pharma, a leading healthcare solutions company in Asia, has announced that it has completed the acquisition of two brands, Cialis® (Tadalafil) and Alimta® (Pemetrexed), from Eli Lilly and Company (“Lilly”) for select ASEAN markets, including Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines and Thailand, via its wholly-owned subsidiary, Zanovex Pte. Zanovex will own the trademarks and marketing authorisations, and license manufacturing know-how for Alimta®, an established chemotherapy drug for the treatment of a certain type of non-small cell lung cancer and malignant pleural mesothelioma, and Cialis®, a leading men’s health product for the treatment of erectile dysfunction. ZP Therapeutics, the commercial division of Zuellig Pharma, will promote the two brands in the relevant markets.

Cost and insurance coverage vary widely by region and plan.
Brand-name Cialis was historically very expensive.
Most insurance plans now cover generic tadalafil with a copay.
Medicare Part D plans typically cover it for approved indications.
Prices can be compared using pharmacy discount cards or apps.
Some online services offer telemedicine prescriptions and delivery.
Always verify the legitimacy of any online pharmacy before purchasing.

Prior to the acquisition, ZP Therapeutics was responsible for the promotion and distribution of the brands as part of a broader, long-term strategic partnership with Lilly in Brunei, Indonesia, Malaysia, Philippines and Thailand. “This acquisition marks a major milestone in the evolution of Zuellig Pharma to becoming an integrated healthcare solutions company. It demonstrates the increasing strength of ZP Therapeutics, which has extensive in-market expertise and capabilities in driving growth of healthcare products in Asia.

2.5 Use with Food

International Pharmaceutical Students' Federation

A catalyst in improving patient journeys and healthcare outcomes through commercial excellence, robust in-market capabilities and strong ethical principles, ZP Therapeutics is a trusted partner for expanding patient access and providing innovations to the healthcare community. FDA is alerting consumers and health care professionals that counterfeit versions of Cialis 20 mg tablets were found in the mail on its way to a U.S. consumer. While this shipment was stopped, FDA is concerned about other possible mail shipments to consumers. FDA laboratory analysis showed the counterfeit versions contain multiple active ingredients, which if used could result in adverse effects or harm.

Frequently asked questions

Consumers should only buy prescription medicines from state-licensed pharmacies located in the U.S. FDA cannot confirm that the manufacturing, quality, storage, and handling of these products follow U.S. standards because these products are from an unknown source. Therefore, these products are considered unsafe and should not be used. FDA also recommends consumers talk to their health care professional about their condition and options for treatment if they received a counterfeit product. We look forward to further expanding our commercial presence in the region through meaningful strategic partnerships with the world’s leading biopharma companies as we remain focused on our purpose of making healthcare more accessible to communities in Asia,” said John Graham, Group CEO, Zuellig Pharma.

Product	Dosage	Quantity + Bonus	Price
Cialis Generic	2.5mg	10 Pills	28.51€ 27.15€
Cialis Professional	40mg	270 + 6 Pills	898.37€ 855.59€
Cialis Professional	20mg	90 + 2 Pills	241.49€ 229.99€
Cialis Generic	5mg	360 + 10 Pills	268.08€ 255.31€
Cialis Generic	40mg	270 + 10 Pills	382.19€ 363.99€
Cialis Original	20mg	76 + 4 Pills	319.19€ 303.99€
Cialis Generic	10mg	360 + 10 Pills	388.49€ 369.99€
Cialis Generic	40mg	360 + 10 Pills	477.87€ 455.11€
Cialis Professional	20mg	180 + 4 Pills	423.11€ 402.96€
Cialis Generic	20mg	120 + 8 Pills	188.15€ 179.19€
Cialis Original	20mg	34 + 2 Pills	183.99€ 175.23€
Cialis Super Active	20mg	20 + 4 Pills	92.35€ 87.95€
Cialis Generic	60mg	360 + 10 Pills	570.52€ 543.35€

Zuellig Pharma is a leading healthcare solutions company in Asia, and our mission is to make healthcare more accessible to the communities we serve. We provide world-class distribution, digital and commercial services to support the growing healthcare needs in this region. The company was started a hundred years ago and has grown to become a multibillion-dollar business covering 16 markets with over 12,000 employees. Our people serve cialis 20mg price more than 200,000 medical facilities and work with over 450 clients, including the top 20 pharmaceutical companies in the world. ZP Therapeutics, a division of Zuellig Pharma, is the commercialisation partner of choice for the healthcare industry with offices in 13 countries across Asia and over 2,500 associates. A catalyst in improving patient journeys and healthcare outcomes through commercial excellence, robust in-market capabilities and strong ethical principles, ZP Therapeutics is a trusted partner for expanding patient access and providing innovations to the healthcare community. FDA is alerting consumers and health care professionals that counterfeit versions of Cialis 20 mg tablets were found in the mail on its way to a U.S.

2.3 CIALIS for Once Daily Use for Benign Prostatic Hyperplasia

consumer. While this shipment was stopped, FDA is concerned about other possible mail shipments to consumers.

Year	Estimated Market Size (USD)	Growth Rate	Key Factors Influencing Market
2023	500 million	—	Increasing acceptance of herbal and natural aids
2024	620 million	24%	Growing awareness about sexual health products
2025	750 million	21%	Advances in supplement formulations
2026	900 million	20%	Expansion into new markets and online sales

FDA laboratory analysis showed the counterfeit versions contain multiple active ingredients, which if used could result in adverse effects or harm. Consumers should only buy prescription medicines from state-licensed pharmacies located in the U.S. FDA cannot confirm that the manufacturing, quality, storage, and handling of these products follow U.S.

Lifestyle factors can influence the effectiveness of Cialis.
Maintaining a healthy weight and exercising can improve ED.
Smoking cessation and reducing alcohol intake are beneficial.
Managing stress, anxiety, and underlying health conditions is important.
A high-fat meal may delay the onset of the "as-needed" dose slightly.
The daily dose is less affected by dietary timing.
Overall cardiovascular health is closely linked to erectile function.

standards because these products are from an unknown source. Therefore, these products are considered unsafe and should not be used. FDA also recommends consumers talk to their health care professional about their condition and options for treatment if they received a counterfeit product.

Drug Label Information

Customer Relationship Individual Leadership Award

Tadalafil and insulin sensitivity: why it matters for muscle gain

"Executing on our strategy of targeted acquisitions, Cialis® will expand our existing portfolio in the region and strengthen Grünenthal's Latin American business", says Gabriel Baertschi, CEO, Grünenthal. "In 2022, we acquired Nebido®, a long-acting treatment for testosterone deficiency, and with Cialis® we can continue to serve our existing customer base and foster our growth in key Latin American markets." Through the acquisition of Cialis®, Grünenthal continues executing its strategy of acquiring established medicines to expand its portfolio and increase its profitability. Since 2017, Grünenthal has invested over €2 billion in the acquisition of established medicines, including Nebido®, the European rights to Crestor® and Nexium®, as well as the global rights to Vimovo® (excluding the U.S. and Japan), Qutenza® and Zomig® (excluding Japan). In 2023, Grünenthal established Grünenthal Meds, a joint venture with Kyowa Kirin International, which manages a portfolio of 13 brands primarily focused on pain management and, in 2024, acquired the US company Valinor Pharma and the product Movantik®. FDA-approved Cialis tablets made by Eli Lilly contain the active ingredient, tadalafil, and are used for the treatment of erectile dysfunction and other approved indications.

How much is generic Cialis?

For starters, Tadalafil and Cialis have the same active ingredient: Tadalafil. In a lab test, you’d expect them to react the same way and produce indistinguishable results. Currently, Eli Lilly’s authentic product is considered safe and effective for its intended uses. There is no indication that the legitimate supply chain is at risk, therefore consumers can be confident that prescription medicines received through legitimate state-licensed pharmacies located in the U.S.

2.7 Concomitant Medications

are safe and effective. Counterfeit versions of Cialis can be identified by the following differences on the label of the bottle when compared to the authentic product. lists “AUSTR81137” on the front of the bottle; does not include an NDC number on the front of the bottle, such as “NDC 0002-4462-30” for the 20 mg tablets; does not include the tablet strength in a colored box; has different patterns and colors; it has yellow and darker green designs on the front label; has misspellings; it lists, “CLALIS is a product of: Eli lilly Australia PTY Limited” on the side of the bottle; lists the manufacturer location as “112 Wharf Road, WEST RYDE, NSW 2114” on the side of the bottle; and lists “Lot: AC 066018, Exp: 01SEP17” on the side of the bottle. Consumers should not use products that match one or more of the descriptions above. If you have additional information about these products, you may contact FDA at DrugSupplyChainIntegrity@fda.hhs.gov. To date, FDA is not aware of consumer adverse events related to the use of these counterfeit versions of Cialis. Health care professionals and consumers are encouraged to report adverse events related to the use of any suspect medications to FDA’s MedWatch Adverse Event Reporting program by: Completing and submitting the report online at MedWatch Online Voluntary Reporting Form Downloading and completing the form (PDF - 1.22MB), then submitting it via fax at 1-800-FDA-0178 Consumers who buy prescription medicines online should be careful. Some websites sell medicine that may not be safe to use and may put their health at risk.

17.9 Alcohol

1 In Mexico Cialis® is indicated for the oral treatment of erectile dysfunction and symptoms of benign prostatic hyperplasia in adult men. About Grünenthal Grünenthal is a global leader in pain management and related diseases. As a science-based, fully integrated pharmaceutical company, we have a long track record of bringing innovative treatments and state-of-the-art technologies to patients worldwide. Our purpose is to change lives for the better – and innovation is our passion. We focus all our activities and efforts on working towards our vision of a World Free of Pain.

2. They Have Different Price Points

Grünenthal is headquartered in Aachen, Germany, and has affiliates in 28 countries across Europe, Latin America, and the U.S. Our products are available in approx. In 2024, Grünenthal employed around 4,300 people and achieved revenues of €1.8 billion. Follow us on: LinkedIn: Grunenthal Group Instagram: grunenthal Click here for our Grünenthal Report 2024/2025 Grünenthal announces acquisition of the rights to Cialis® from Lilly in Mexico, Brazil & Colombia (pdf, 137.3 KB) Singapore, 5 February 2024 Zuellig Pharma, a leading healthcare solutions company in Asia, has announced that it has completed the acquisition of two brands, Cialis® (Tadalafil) and Alimta® (Pemetrexed), from Eli Lilly and Company (“Lilly”) for select ASEAN markets, including Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines and Thailand, via its wholly-owned subsidiary, Zanovex Pte. Zanovex will own the trademarks and marketing authorisations, and license manufacturing know-how for Alimta®, an established chemotherapy drug for the treatment of a certain type of non-small cell lung cancer and malignant pleural mesothelioma, and Cialis®, a leading men’s health product for the treatment of erectile dysfunction.

Transcelerate Outstanding Achievement Award

ZP Therapeutics, the commercial division of Zuellig Pharma, will promote the two brands in the relevant markets. Prior to the acquisition, ZP Therapeutics was responsible for the promotion and distribution of the brands as part of a broader, long-term strategic partnership with Lilly in Brunei, Indonesia, Malaysia, Philippines and Thailand. “This acquisition marks a major milestone in the evolution of Zuellig Pharma to becoming an integrated healthcare solutions company. It demonstrates the increasing strength of ZP Therapeutics, which has extensive in-market expertise and capabilities in driving growth of healthcare products in Asia. We look forward to further expanding our commercial presence in the region through meaningful strategic partnerships with the world’s leading biopharma companies as we remain focused on our purpose of making healthcare more accessible to communities in Asia,” said John Graham, Group CEO, Zuellig Pharma. Go to for more information about the risks, to learn the signs of websites that may sell counterfeit or otherwise unsafe medicines, and how to find legitimate licensed online pharmacies. FDA is committed to protecting public health by working to secure the drug supply chain against counterfeit and unapproved medications that enter the United States through fraudulent sources.

Important contraindications include concurrent use of nitrates (for chest pain).
Combining with nitrates can cause a dangerous drop in blood pressure.
It is not recommended for patients with severe heart or liver disease.
Men with retinitis pigmentosa or certain eye conditions should avoid it.
Alpha-blockers for BPH or blood pressure require careful dose timing.
Grapefruit juice may increase tadalafil levels and side effects.
A thorough cardiovascular assessment is needed before prescribing.

Picture of authentic bottle of Eli Lilly’s Cialis 20 mg Tablets sold in the U.S. Once you dig into the Cialis vs Tadalafil debate, you’ll discover that they have a great deal in common — and that their key differences are largely cosmetic and commercial in nature. For starters, Tadalafil and Cialis have the same active ingredient: Tadalafil.

Key takeaways

FDA-approved Cialis tablets made by Eli Lilly contain the active ingredient, tadalafil, and are used for the treatment of erectile dysfunction and other approved indications. Currently, Eli Lilly’s authentic product is considered safe and effective for its intended uses. There is no indication that the legitimate supply chain is at risk, therefore consumers can be confident that prescription medicines received through legitimate state-licensed pharmacies located in the U.S. are safe and effective. Counterfeit versions of Cialis can be identified by the following differences on the label of the bottle when compared to the authentic product.

1. They Look Different

lists “AUSTR81137” on the front of the bottle; does not include an NDC number on the front of the bottle, such as “NDC 0002-4462-30” for the 20 mg tablets; does not include the tablet strength in a colored box; has different patterns and colors; it has yellow and darker green designs on the front label; has misspellings; it lists, “CLALIS is a product of: Eli lilly Australia PTY Limited” on the side of the bottle; lists the manufacturer location as “112 Wharf Road, WEST RYDE, NSW 2114” on the side of the bottle; and lists “Lot: AC 066018, Exp: 01SEP17” on the side of the bottle. Consumers should not use products that match one or more of the descriptions above. If you have additional information about these products, you may contact FDA at DrugSupplyChainIntegrity@fda.hhs.gov. To date, FDA is not aware of consumer adverse events related to the use of these counterfeit versions of Cialis. Health care professionals and consumers are encouraged to report adverse events related to the use of any suspect medications to FDA’s MedWatch Adverse Event Reporting program by: Completing and submitting the report online at MedWatch Online Voluntary Reporting Form Downloading and completing the form (PDF - 1.22MB), then submitting it via fax at 1-800-FDA-0178 Consumers who buy prescription medicines online should be careful.

Does generic Cialis work the same as Cialis?

Some websites sell medicine that may not be safe to use and may put their health at risk. Go to for more information about the risks, to learn the signs of websites that may sell counterfeit or otherwise unsafe medicines, and how to find legitimate licensed online pharmacies. FDA is committed to protecting public health by working to secure the drug supply chain against counterfeit and unapproved medications that enter the United States through fraudulent sources. Picture of authentic bottle of Eli Lilly’s Cialis 20 mg Tablets sold in the U.S. Once you dig into the Cialis vs Tadalafil debate, you’ll discover that they have a great deal in common — and that their key differences are largely cosmetic and commercial in nature. In a lab test, you’d expect them to react the same way and produce indistinguishable results.