What is Tadalafil (Cialis) ?

Tadalafil works by relaxing the muscles in blood vessels, enhancing blood flow to specific areas of the body.

Marketed under the brand name Cialis, tadalafil is prescribed for treating erectile dysfunction (impotence) and symptoms associated with benign prostatic hyperplasia (enlarged prostate). Another brand, Adcirca, is used to manage pulmonary arterial hypertension and improve exercise tolerance in both men and women.

Warnings

Avoid using tadalafil if you are currently taking nitrate medications for chest pain or heart conditions, such as nitroglycerin, isosorbide dinitrate, isosorbide mononitrate, or certain recreational drugs like "poppers." Combining tadalafil with these substances can lead to a severe drop in blood pressure.

Certain medications may interact adversely with tadalafil. Inform your healthcare provider about all your current medications, especially riociguat (Adempas).

Seek immediate medical attention if you experience a painful erection or one lasting over 4 hours, as this could result in permanent damage.

If you experience nausea, chest pain, or dizziness during sexual activity, contact your doctor immediately.

Discontinue tadalafil and seek emergency help if you suddenly lose vision.

Before Taking This Medicine

Do not use tadalafil if you are allergic to it.

Combining tadalafil with certain other medications can cause a significant and sudden drop in blood pressure. Avoid this medication if you are also using:

• Riociguat (for pulmonary arterial hypertension); or
• A nitrate drug (for chest pain or heart issues) such as nitroglycerin, isosorbide dinitrate, isosorbide mononitrate, or recreational drugs like amyl nitrate or nitrite "poppers."

Tadalafil may remain in your bloodstream for up to 2 days or more after use (longer with liver or kidney issues). Avoid nitrate use during this period.

To ensure tadalafil is safe for you, disclose any history of:

• Heart disease or irregular heartbeats;
• Heart attack or stroke;
• Angina (chest pain), high or low blood pressure;
• Pulmonary hypertension (unless treating with tadalafil);
• Pulmonary veno-occlusive disease (narrowing of veins from lungs to heart);
• Liver or kidney conditions (or if undergoing dialysis);
• Vision loss or retinitis pigmentosa (eye condition);
• Bleeding disorders;
• Blood cell disorders such as sickle cell anemia, multiple myeloma, or leukemia;
• Physical deformity of the penis (e.g., Peyronie’s disease), or prolonged erections;
• Stomach ulcers;
• Health conditions making sexual activity risky.

Sudden vision loss has been reported with tadalafil use, mostly among individuals with pre-existing eye problems or risk factors for vascular disorders (e.g., heart disease, diabetes, high blood pressure, high cholesterol, smoking, or being over 50). The direct link between the medication and vision loss is unclear. Sudden hearing loss has also been noted. Discontinue tadalafil and contact your doctor if you experience hearing loss, reduced hearing, or tinnitus.

Do not start or stop tadalafil during pregnancy without consulting your doctor. Pulmonary arterial hypertension (PAH) during pregnancy can lead to severe complications for both mother and baby. Inform your doctor immediately if you become pregnant.

Breastfeeding while using tadalafil may not be safe. Consult your doctor about potential risks.

Cialis is not intended for women.

Tadalafil is not approved for individuals under 18 years old.

How Should I Take Tadalafil?

Tadalafil is typically administered once daily. Follow all instructions on your prescription label and do not adjust your dosage without guidance.

You may take tadalafil with or without food.

Swallow Cialis tablets whole; do not break or split them.

For erectile dysfunction, take Cialis prior to sexual activity but no more than once a day. It can be effective for up to 36 hours before intercourse. Cialis helps achieve an erection when sexually stimulated. Merely taking the pill will not result in an erection. Adhere to your doctor’s recommendations.

Do not use Cialis for erectile dysfunction if you are also taking Adcirca for pulmonary arterial hypertension.

Store Cialis at room temperature away from moisture and heat.

What Happens If I Miss a Dose?

If you are using tadalafil on an as-needed basis, missing a dose is unlikely.

If you take tadalafil daily and miss a dose, take it as soon as you remember. Skip the missed dose if it's almost time for the next one. Do not double up on doses.

What Happens If I Overdose?

Seek emergency medical help or call the Poison Help line at 1-800-222-1222.

What to Avoid

Consuming alcohol with tadalafil can lead to a drop in blood pressure, resulting in dizziness or fainting.

Grapefruit and grapefruit juice may interact with tadalafil, causing unwanted side effects. Avoid these products while taking this medication.

Tadalafil Side Effects

Seek immediate medical attention if you experience an allergic reaction to tadalafil: hives; trouble breathing; swelling of the face, lips, tongue, or throat.

Stop taking tadalafil and get medical help if you experience:

• A light-headed feeling, as if you might faint;
• An erection that is painful or lasts longer than 4 hours (which can damage the penis);
• Vision changes or sudden vision loss;
• Ringing in the ears or sudden hearing loss;
• Symptoms of a heart attack, such as chest pain or pressure, pain spreading to the jaw or shoulder, nausea, sweating.

Common side effects may include:

• Headache;
• Flushing (warmth, redness, or tingling);
• Nausea or upset stomach;
• Stuffy nose;
• Muscle or back pain.

This list may not include all possible side effects. Contact your doctor for advice on side effects. Report side effects to the FDA at 1-800-FDA-1088.

What Other Drugs Will Affect Tadalafil?

Inform your doctor about all medications you are currently taking or plan to start or stop, especially:

• Medicines for erectile dysfunction or pulmonary arterial hypertension;
• Antibiotics or antifungal medications;
• Antiviral drugs for hepatitis C or HIV/AIDS;
• Medications for high blood pressure or prostate disorders;
• Seizure medications.

This is not a comprehensive list. Other drugs, including over-the-counter medications, vitamins, and herbal products, may interact with tadalafil.

Frequently Asked Questions

• Cialis vs Viagra - What's the difference between them?
• Cialis: 7 Important Things to Know

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More About Tadalafil

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• Dosage information
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• During pregnancy
• Support group
• Drug class: agents for pulmonary hypertension
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• Other brands: Cialis, Adcirca

Professional Resources

• Tadalafil (Erectile Dysfunction, Benign Prostatic Hyperplasia) monograph
• Tadalafil (Pulmonary Hypertension) (AHFS Monograph)
• Tadalafil (FDA)
• Other brands: Cialis, Adcirca, Tadliq, Alyq

Related Treatment Guides

• Benign Prostatic Hyperplasia
• Erectile Dysfunction
• Pulmonary Arterial Hypertension

Further Information

Keep all medicines out of children's reach, never share medications, and use tadalafil only as prescribed.

Always consult your healthcare provider to ensure the information on this page applies to your personal circumstances.