Psychological factors like stress, depression, or anxiety can also contribute. All PDE5 inhibitors, including Viagra and Cialis, require a valid prescription regardless of the pharmacy or provider. Subsequently, the FDA approved both vardenafil [27] and tadalafil in Those with a history of blood pressure or heart issues, hormonal imbalances, mental health issues, and diabetes should consult their doctor before trying PDE5 inhibitors. Those with pre-existing conditions should always consult a healthcare provider before taking new medications or supplements.Updated on June 23, Key takeaways: Cialis (tadalafil) is a popular medication used to treat erectile dysfunction. It’s available in tablets ranging from mg to 20mg. It can cost more than $ for a month’s supply, depending . Brand names for tadalafil include Cialis. The cost for tadalafil oral tablet 5 mg is around $27 for a supply of 90 tablets, depending on the pharmacy you visit. Quoted prices are for . Getty Images/istockphoto. While working as a school district administrator, an Oklahoma man created and submitted bogus invoices as part of a $, scheme, authorities said. Now, Devin Darel.