WHAT IS Cialis/Tadalafil?

• Cialis/Tadalafil relaxes muscles and increases blood flow to particular areas of the body.
• Cialis/Tadalafil is used to treat erectile dysfunction (impotence).
• Cialis/Tadalafil may also be used for purposes other than those listed in this medication guide.

WHAT HAPPENS IF I OVERDOSE?

• Seek emergency medical attention if you think you have used too much of this medicine.
• Symptoms of a Cialis/tadalafil overdose may include chest pain, nausea, irregular heartbeat, and feeling light-headed or fainting.

WHAT DRUG(S) MAY INTERACT WITH Cialis/Tadalafil?

Do not take Cialis/tadalafil if you are taking the following medications:

• nitroglycerin-type drugs for the heart or chest pain such as amyl nitrite, Isordil titradose/isosorbide dinitrate, Isordil titradose/isosorbide mononitrate, nitroglycerin, even if these are only taken occasionally

Cialis/Tadalafil may also interact with the following medications:

• Calan/verapamil
• bosentan
• certain drugs used for seizures such as Epitol/carbamazepine, Dilantin er/phenytoin, and phenobarbital
• medicines for fungal infections (Diflucan/fluconazole, Sporanox/itraconazole, Nizoral/ketoconazole, voriconazole)
• nicardipine
• grapefruit juice
• some drugs for treating depression, anxiety or other mood problems (examples: Rapiflux/fluoxetine, Luvox/fluvoxamine, nefazodone)
• rifabutin, rifampin or rifapentine
• certain antibiotics such as Biaxin/clarithromycin, Ilosone/erythromycin, troleandomycin
• quinidine
• mibefradil
• cisapride
• cimetidine
• Tiazac/Diltiazem cd/diltiazem
• certain medicines for the treatment of HIV infection or AIDS
• alpha blockers, such as Uroxatral/alfuzosin ( UroXatral ®), Cardura/doxazosin ( Cardura ®), Minipress/prazosin ( Minipress ®), or Hytrin/terazosin ( Hytrin ®), used to treat high blood pressure or an enlarged prostate.

WHAT HAPPENS IF I MISS A DOSE?

• Since Cialis/tadalafil is used as needed, you are not likely to be on a dosing schedule.

WHAT SHOULD I DISCUSS WITH MY DOCTOR BEFORE TAKING Cialis/Tadalafil?

• You may need a lower dose of this medication if you are older than 65. Follow your doctor's instructions.
• A small number of patients have had a sudden loss of eyesight after taking Cialis/tadalafil. This type of vision loss is caused by decreased blood flow to the optic nerve of the eye. It is not clear whether Cialis/tadalafil is the actual cause of such vision loss. Sudden vision loss with Cialis/tadalafil use has occurred most often in people with 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.
• Although Cialis/tadalafil is not for use in women, it is not known if Cialis/tadalafil passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
• If you have any of these conditions, you may not be able to use Cialis/tadalafil or you may need a dosage adjustment or special tests during treatment.
• Before taking Cialis/tadalafil, tell your doctor if you have:
  • a bleeding disorder such as hemophilia;
  • if you have been told you should not have sexual intercourse for health reasons.
  • angina (chest pain);
  • kidney disease (or if you are on dialysis);
  • heart disease or heart rhythm problems;
  • a recent history a heart attack (within the past 90 days);
  • high or low blood pressure;
  • a recent history of stroke or congestive heart failure (within the past 6 months);
  • liver disease;
  • retinitis pigmentosa (an inherited condition of the eye);
  • 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
  • a stomach ulcer;
• FDA pregnancy category B: Although Cialis/tadalafil is not for use in women, this medication is not expected to be harmful to an unborn baby. Do not use Cialis/tadalafil without telling your doctor if you are pregnant or plan to become pregnant during treatment.
• Do not take Cialis/tadalafil if you are also using a nitrate drug for chest pain or heart problems. This includes nitroglycerin (Nitrostat, Nitrolingual, Nitro-Dur, Nitro-Bid, and others), Isordil titradose/isosorbide dinitrate (Dilatrate-SR, Isordil titradose/Isordil , Sorbitrate tr/Sorbitrate ), and Isordil titradose/isosorbide mononitrate (Imdur, ISMO, Monoket ). Nitrates are also found in some recreational drugs such as amyl nitrate or nitrite ("poppers"). Taking Cialis/tadalafil with a nitrate medicine can cause a serious decrease in blood pressure, leading to fainting, stroke, or heart attack.

HOW SHOULD I TAKE Cialis/Tadalafil?

• Cialis/Tadalafil is usually taken only when needed, 30 - 60 minutes before sexual activity. The medication can help achieve an erection when sexual stimulation occurs. An erection will not occur just by taking a pill.
• Take each dose with a full glass of water.
• Avoid taking High-fat food before taking Viagra as it may cause the medicine to take more time to start working.
• Do not take Cialis/tadalafil more than once a day. Allow 24 hours to pass between doses.
• Store this medication at room temperature away from moisture and heat.

WHAT ARE THE POSSIBLE SIDE EFFECTS OF Cialis/Tadalafil?

• If you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw during sexual activity, stop and call your doctor right away. You could be having a serious side effect of Cialis/tadalafil.
• Stop using Cialis/tadalafil and call your doctor at once if you have any of these serious side effects:
  • swelling in your hands, ankles, or feet;
  • vision changes;
  • penis erection that is painful or lasts 4 hours or longer.
  • feeling light-headed, fainting; or
  • chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
  • shortness of breath;
  • irregular heartbeat;
• Stop using Cialis/tadalafil and get emergency medical help if you have sudden vision loss.
• Continue taking Cialis/tadalafil and talk with your doctor if you have any of these less serious side effects:
  • back pain.
  • headache;
  • warmth or redness in your face, neck, or chest;
  • upset stomach; or
  • stuffy nose;
• Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

WHAT SHOULD I AVOID WHILE TAKING Cialis/Tadalafil?

• Grapefruit and grapefruit juice may interact with Cialis/tadalafil. Discuss the use of grapefruit products with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.
• Avoid drinking alcohol, which can increase some of the side effects of Cialis/tadalafil.
• Do not use any other drug to treat impotence, such as alprostadil (Caverject, Muse, Edex) or yohimbine (Yocon, Yodoxin, others), unless your doctor tells you to.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.