Some medicines can cause unwanted or dangerous effects when used with tadalafil. Tell your doctor about all your current medicines, especially riociguat (Adempas).
- 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.
- Get medical help at once if you have nausea, chest pain, or dizziness during sex.
- Stop using tadalafil and get emergency medical help if you have sudden vision loss.
- Before taking this medicine
- You should not take tadalafil if you are allergic to it.
Taking tadalafil with certain other medicines can cause a sudden and serious decrease in blood pressure. Do not take this medicine if you also use :
- Riociguat (to treat pulmonary arterial hypertension); or
- A nitrate drug (for chest pain or heart problems) such as nitroglycerin, isosorbide dinitrate, isosorbide mononitrate, or recreational drugs such as amyl nitrate or nitrite "poppers".
- Some tadalafil can remain in your bloodstream for 2 or more days after each dose you take (longer if you have liver or kidney disease). Avoid nitrate use during this time.
To make sure this medicine is safe for you, tell your doctor if you have ever had :
- Heart disease or heart rhythm problems;
- A heart attack or stroke;
- Angina (chest pain), high or low blood pressure;
- Pulmonary hypertension (unless you are taking tadalafil for this);
- A condition called pulmonary veno-occlusive disease (narrowing of the veins that carry blood from the lungs to the heart);
- Liver or kidney disease (or if you are on dialysis);
- Vision loss, or retinitis pigmentosa (an inherited condition of the eye);
- A bleeding disorder;
- A blood cell disorder such as sickle cell anemia, multiple myeloma, or leukemia;
- A physical deformity of the penis (such as Peyronie's disease), or an erection lasting longer than 4 hours;
- A stomach ulcer; or
- Health problems that make sexual activity unsafe.
- Sudden vision loss has occurred in a small number of people taking medicines like tadalafil (Viagra or others). Most of these people already had certain eye problems or risk factors for blood vessel disorders (heart disease, diabetes, high blood pressure, high cholesterol, coronary artery disease, smoking, or being over 50 years old). It is not clear whether the medicine was the actual cause of vision loss.
- 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 affect the nursing baby. Tell your doctor if you are breast-feeding.
- Tadalafil is not approved for use by anyone younger than 18 years old.
How should I take tadalafil?
- Tadalafil 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.
- Tadalafil can be taken with or without food.
- Do not break or split a Cialis tablet. Swallow it whole.
- For erectile dysfunction, take Cialis 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.
- 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.
- See also - Dosage Information (in more detail)
What happens if I miss a dose?
- If tadalafil is used as needed, you are not likely to be on a dosing schedule.
- If you take tadalafil 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.