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It is not possible to determine whether this event is related to the use of Levitra, to the patients underlying risk factors for developing NAION, to a combination of these factors, or to other factors. Cialis contains tadalafil as the main ingredient that belongs to a class of drugs called phophodiesterase inhibitors. Effects on Blood Pressure - Tadalafil 20 mg administered to healthy male subjects produced no significant difference compared to placebo in supine systolic and diastolic blood pressure difference in the mean maximal decrease of 1,6 0,8 mm Hg, respectively and in standing systolic and diastolic blood pressure difference in the mean maximal decrease of 0 2 4 6 mm Hg, respectively.