Both Cialis and Viagra are effective at these doses. Talk to a doc and get a prescription for Cialis or another ED treatment. Healthcare providers have experience talking about ED and providing treatment options without any judgment or shame. Brand-name versions of the drug approved for PAH include Adcirca. OTC Cialis substitutes come with health risks. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Valid at all major chains including Walgreens, CVS Pharmacy, Target, WalMart Pharmacy, Duane Reade and 65, pharmacies nationwide. No manufacturer promotions could be . How Cialis Works. Tadalafil and other PDE5 inhibitors primarily work by inducing muscle relaxation. Tadalafil stops the breakdown of a chemical responsible for relaxing muscles. In ED and PAH, the drug targets muscle cells in blood vessels. When the blood vessel muscle cells relax, this expands the vessel and increases blood flow; this . The History of Supplementation for Sexual Health. Many of the herbs contained in sexual wellness supplements have been used for centuries to address problems. These problems include reduced libido (sex drive) and erectile dysfunction (trouble getting or maintaining an erection). Ancient cultures believed that certain plants and foods functioned.