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Cialis should not be taken if you have any of the following: heart disease or severe high blood pressure coronary artery diseases such as angina (chest pain) or stroke caused in part by the narrowing of one or more arteries history of chest pain called unstable angina, sudden numbness/weakness with muscle spasm on one side, and short duration without warning symptoms uncontrolled congestive heart failure due to left ventricular impairment (unable to pump enough fluid), reduced ejection fraction (the amount pumped out of the heart to the rest of the body), or a history of arrhythmias uncontrolled high blood pressure (hypertension) severe liver problems and certain hereditary degenerative eye diseases such as retinitis pigmentosa low levels of the male hormone testosterone due to surgery (penectomy), injury, disease, or other causes Cialis can also cause an erection to last for more than four hours. Generic tadalafil is available at much lower cost, from 67p per tablet. 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