BPH is caused by an enlarged prostate. Most companies have an FAQ or shipping policy page you can reference to learn whether discreet packaging is available. According to the FDA, generic medications contain the same active ingredients as brand names, meaning there’s no difference in effectiveness or safety. In BPH, the medication relaxes the urinary tract and bladder muscles, allowing for more effortless urine flow. Contact your medical provider if you experience any side effects during treatment.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 . Side Effects. Headache, stomach upset, back pain, muscle pain, stuffy nose, flushing, or dizziness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly. To. It is available in both brand and generic versions. Cialis is not covered by most Medicare and insurance plans, but manufacturer and pharmacy coupons can help offset the cost. Prices Medicare Drug Info Side Effects Images. Cialis How to Take Cialis: 4 Tips to Get the Best Results and Avoid Side Effects Written by Joshua Murdock, PharmD, BCBBS.