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What is Cialis? Cialis (tadalafil) relaxes muscles and increases blood flow to particular areas of the body. Cialis is used to treat erectile dysfunction (impotence) and symptoms of benign prostatic hypertrophy (enlarged prostate). Another brand of tadalafil is Adcirca, which is used to treat pulmonary arterial hypertension. Do not take Cialis while also taking Adcirca, unless your doctor tells you to. Important information Some medicines can cause unwanted or dangerous effects when used with Cialis. Tell your doctor about all your current medicines, especially riociguat (Adempas). Do not take Cialis if you are also using a nitrate drug for chest pain or heart problems, including nitroglycerin, isosorbide dinitrate, isosorbide mononitrate, and some recreational drugs such as "poppers". Taking Cialis with a nitrate medicine can cause a sudden and serious decrease in blood pressure. Slideshow: Setting The Record Straight: Erectile Dysfunction Setting The Record Straight: Erectile Dysfunction Contact your doctor or seek emergency medical attention if your erection is painful or lasts longer than 4 hours. A prolonged erection (priapism) can damage the penis. Stop using Cialis and get emergency medical help if you have sudden vision loss. Before taking this medicine You should not take Cialis if you are allergic to tadalafil, or: if you take other medicines to treat pulmonary arterial hypertension, such as riociguat (Adempas). Do not take Cialis if you are also using a nitrate drug for chest pain or heart problems. This includes nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate. Nitrates are also found in some recreational drugs such as amyl nitrate or nitrite ("poppers"). Taking Cialis with a nitrate medicine can cause a sudden and serious decrease in blood pressure. To make sure Cialis is safe for you, tell your doctor if you have any of these other conditions: heart disease or heart rhythm problems, coronary artery disease; a recent heart attack (within the past 90 days); a recent history (in the past 6 months) of a stroke, or congestive heart failure; angina (chest pain), high or low blood pressure; liver or kidney disease (or if you are on dialysis); a blood cell disorder such as sickle cell anemia, multiple myeloma, or leukemia; a bleeding disorder such as hemophilia; a stomach ulcer; retinitis pigmentosa (an inherited condition of the eye); a physical deformity of the penis (such as Peyronie's disease); or if you have been told you should not have sexual intercourse for health reasons. Cialis can decrease blood flow to the optic nerve of the eye, causing sudden vision loss. This has occurred in a small number of people taking Cialis, most of whom also had heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoke or are over 50 years old. tadalafil is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant. It is not known whether tadalafil passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby. How should I take Cialis? Cialis is usually taken only once per day. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended. Cialis can be taken with or without food. Do not break or split a tablet. Swallow it whole. For erectile dysfunction, take this medicine just before sexual activity but not more than once per day. Cialis can help achieve an erection when sexual stimulation occurs. An erection will not occur just by taking a pill. Follow your doctor's instructions. During sexual activity, if you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw, stop and call your doctor right away. You could be having a serious side effect of Cialis. Do not take Cialis for erectile dysfunction if you are taking Adcirca for pulmonary arterial hypertension. Store at room temperature away from moisture and heat. Cialis dosing information Usual Adult Dose for Erectile Dysfunction: Use as needed for ED: -Initial dose: 10 mg orally once a day, as needed, prior to sexual activity -Maintenance dose: 5 to 20 mg orally once a day, as needed, prior to sexual activity based on individual efficacy and tolerability Comment: Consider that this drug has shown to improve erectile dysfunction up to 36 hours following dosing, when used as needed. Once a day use for ED: -Initial dose: 2.5 mg orally once a day at approximately the same time, without regard to timing of sexual activity -Maintenance dose: 2.5 to 5 mg orally once a day based on individual efficacy and tolerability. Once daily use for ED and Benign Prostatic Hyperplasia (BPH): -5 mg orally once a day at approximately the same time, without regard to timing of sexual activity Use: Treatment of erectile dysfunction (ED) Usual Adult Dose for Benign Prostatic Hyperplasia: Once daily use for BPH: -5 mg orally once a day at approximately the same time Concomitant administration with finasteride: -5 mg orally once a day at approximately the same time, for up to 26 weeks Comments: The incremental benefit of this drug decreases from 4 weeks until 26 weeks. The incremental benefit of this drug beyond 26 weeks is unknown. Once daily use for ED and BPH: -5 mg orally once a day at approximately the same time, without regard to timing of sexual activity Use: Treatment of the signs and symptoms of benign prostatic hyperplasia (BPH) What happens if I miss a dose? If Cialis is used as needed, you are not likely to be on a dosing schedule. If you take Cialis every day and you miss a dose, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. What should I avoid while taking Cialis? Drinking alcohol with this medicine can cause side effects. Grapefruit and grapefruit juice may interact with tadalafil and lead to unwanted side effects. Avoid the use of grapefruit products while taking this medicine. Avoid using any other medicines to treat impotence, such as alprostadil or yohimbine, without first talking to your doctor. Cialis side effects Get emergency medical help if you have any of these signs of an allergic reaction to Cialis: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using Cialis and get emergency medical help if you have: erection is painful or lasts longer than 4 hours (prolonged erection can damage the penis); vision changes or sudden vision loss; or heart attack symptoms - chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating. Also call your doctor right away if you have: ringing in your ears, or sudden hearing loss; irregular heartbeat; swelling in your hands, ankles, or feet; shortness of breath; seizure (convulsions); or a light-headed feeling, like you might pass out. Common Cialis side effects may include: headache; sinus pain, sore throat; or muscle pain. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. See also: Side effects (in more detail) What other drugs will affect Cialis? Tell your doctor about all your current medicines and any you start or stop using, especially: an antibiotic or antifungal medicine; antiviral medicine to treat hepatitis C or HIV/AIDS; drugs to treat high blood pressure or a prostate disorder; or seizure medicine. This list is not complete. Other drugs may interact with tadalafil, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

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