Whether you can take Tadalafil at the same time as your other medications will depend on which medications you are taking.

You are required to complete a short medical consultation questionnaire that asks for any medications that you are prescribed from your GP and will indicate the medications that can’t be taken alongside Tadalafil.

There are several medicines which should not be taken concurrently with Tadalafil. Medicines which can have potentially serious interactions with Tadalafil include :-

• Any alpha-blocker medicines e.g. doxazosin (Cardura), alfuzosin (Xatral), tamsulosin, terazosin, or Flomax, that you can buy in the pharmacy. (These medicines may be used to treat prostate problems or high blood pressure).

• Isosorbide mononitrate, isosorbide dinitrate, or use a GTN spray or tablets

for chest pain or use Rectogesic ointment?

• Nicorandil (Ikorel), used to treat angina

• Cimetidine, used to treat stomach or duodenal (peptic) ulcers

• Theophylline, used to treat asthma

• Antibiotics:- Clarithromycin, Erythromycin and Telithromycin

• Anti-fungals such as itraconazole and ketoconazole

• Seizure medication:- carbamazepine, oxcarbazepine, phenobarbital, phenytoin and primidone

• Heart or blood pressure medication:- disopyramide, amiodarone, quinidine and procainamide

• Anti-viral medication:- telaprevir, atazanavir, retonavir, indinavir, saquinavir and cobicistat

• Recreational drugs:- amyl nitrate (poppers)

If you are taking any prescribed medication from your GP then you can simply write those in the “Is there any other medical information that you think our doctor should know?” section on the medical questionnaire. Then, our doctor will know whether the Tadalafil is safe for you to take.

Read available consultation questionnaire information online for “Tadalafil 10mg/5ml May Be More Safe Than Sildenafil 20mg/Gravel.”What is Tadalafil 10mg/5ml? and Sildenafil and Tadalafil and Vardenafil and Cialis and Stendra and Levitra and Stereosporan Ointment are known as “side effects” with Tadalafil being one of the few being side effects from Tadalafil that do not go away, but that are more likely to go away, and that are more likely to be found with isosorbide mononitrate which is taken by mouth and is taken with Vardenafil by name and therefore will be referred to a doctor for could be a sign of a serious health condition. Tadalafil may also sometimes affect aautions and recommendations medication that can be used to treat certain conditions and its potential side effects.

Tadalafil 10mg/5ml can cause a few side effects as per your doctor’s or pharmacist or:

• Headache

• Dizziness

• Muscle pain

• Seizures

• Syncope, including people who have been taking Tadalafil for years and have a history of this condition.

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How to take a Cialis Tablet

You can take this medicine exactly as prescribed by your doctor. The recommended starting dose is 10mg, taken orally, with or without food. Cialis will only work if you take it regularly. Take it as soon as you remember about taking it, but it may take longer if you miss it. Most of the time it takes 1 hour or longer for it to work, and it must be taken regularly. Take this medicine as per the doctor's instructions and do not take it without telling your doctor if you have any pre-existing medical conditions. Do not take Cialis if you are taking any nitrates or amyl nitrate drugs.

This medicine is only used for you. Do not take this medicine if you have a stomach ulcer,

if you have:

If you have been told by your doctor to stop taking this medicine, you must ask your doctor again. In case you are not sure, ask your doctor or pharmacist. If you have to stop taking this medicine, you must ask your doctor again. Take this medicine as advised by your doctor. Do not change the dose or stop taking this medicine without talking to your doctor.

Missed Dose

You must take the medicine as your doctor tells you. If you miss a dose of Cialis, take it as soon as possible. If it is almost time for your next dose, skip the dose and go back to your regular dosing schedule. Do not take 2 doses at the same time.

Warning

Do not take this medicine if you are allergic to Tadalafil or any other ingredients in the medicine. This will not stop the treatment from working well. If you get any side effects, talk to your doctor.

If you miss a dose of Cialis, skip the dose and go back to your regular dosing schedule.

Storage Advice

Store at room temperature, away from light and moisture. Keep out of the reach of children.

Read the Patient Information Leaflet if available from your pharmacy before you start taking Cialis

Side Effects

The most common side effects are:

Headache Nausea Blurred vision Stuffy nose Diarrhea Dizziness

These effects may happen in some people. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Do not take Cialis if you are using the tablet:

• Before you take this medicine, you should ask your doctor or pharmacist.

• Do not take it when you are not sure whether it is safe to take it.

• Do not take it more than once a day.

• Do not take this medicine more than once in 24 hours.

• Do not stop taking it without consulting your doctor.

• Do not take this medicine more often than every 3 months unless directed by your doctor.

• Do not take this medicine more often than every 6 months unless directed by your doctor.

• Do not take this medicine more than 10 times a day.

• Do not stop using this medicine without talking to your doctor.

• Contact your doctor if your erection lasts longer than 4 hours.

If you have not told your doctor about any of the above, tell him or her afterward.

If you have not told your doctor before, tell your doctor.

If you miss a dose of Cialis, take it as soon as youpossibly can.

Cialis has been shown to cause some mild side effects. Talk to your health care provider if these do not go away within a few days. If you begin to experience more serious reactions, seek medical attention immediately.

Common side effects reported from Cialis use include:

• Headache
• Indigestion
• Heartburn
• Upset stomach
• Gas
• Nausea
• Flushing

More severe side effects include:

• Painful erections or erections that last longer than 4 hours
• Sudden loss of vision
• Sudden loss of hearing
• Ringing in the ears
• Chest pain
• Shortness of breath
• Painful urination
• Increased urination frequency
• Fainting
• Dizziness
• Skin rash
• Hives
• Facial swelling

If you experience any of these side effects, seek medical attention immediately. These are symptoms of a severe adverse reaction to this medication that require immediate treatment.

As with all prescription medications, inform your doctor of any medical conditions you currently manage. Tell them about any and all medications, prescription drugs, and supplements you are taking before starting treatment with Cialis. Cialis can interact with bodily substances, causing potentially serious adverse reactions.

Specifically, you should inform your health care provider of any alpha-blocker, antifungal, HIV protease inhibitor, or high blood pressure medication you are taking. Remember to mention any herbal products you use, especially St. John’s wort.

In addition, let your doctor know if you have recently had heart surgery or experience chest pain during sex. If you experience any changes in your heartbeat or chest pain during sex, contact your health care provider immediately.

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Common side effects associated with ringers:

As with all prescription medications, inform your doctor of any medical conditions you used to get started with Cialis.

As with all prescription medications, inform your doctor of any medical conditionsability of ringers.

If you experience changes in your heartbeat or chest pain during sex, contact your health care provider immediately.

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Common side effects associated with Cialis:

• Stomach pain
• Muscle aches
• Back pain

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Interactions

A. Top Drug-Drug Interactions:

1.Nitrates (e.g., nitroglycerin, isosorbide dinitrate): Cialis and nitrates both lower blood pressure. Taking them together can cause a significant and potentially life-threatening drop in blood pressure (hypotension), leading to dizziness, fainting, or even heart attack or stroke. It is contraindicated to use Cialis with nitrates or recreational "poppers" (amyl nitrites).

2.Alpha-blockers (e.g., prazosin, terazosin, tamsulosin): Both Cialis and alpha-blockers relax blood vessels, which can lead to excessive blood pressure reduction when used together. This may result in dizziness, fainting, or orthostatic hypotension (a sudden drop in blood pressure when standing). If needed, your doctor may adjust the dosage or recommend spacing the medications.

3.Other antihypertensive drugs (e.g., atenolol, propranolol, enalapril, lisinopril): Cialis can enhance the blood-pressure-lowering effects of these medications. While this interaction is usually less severe than with nitrates or alpha-blockers, it can still cause dizziness or fainting in sensitive individuals. Close monitoring of blood pressure is recommended.

Other Drug-Drug interactions:

• Ketoconazole, itraconazole (used to manage fungal infection)
• Protease inhibitors (used to manage HIV infection) Ex. ritonavir, lopinavir
• Phenobarbital, phenytoin, carbamazepine (medicines used for fits)
• Rifampicin, erythromycin, clarithromycin (medicines used for bacterial infections)
• Other medicines used to improve blood flow to the penis (Ex. sildenafil)

B. Drug-Food Interactions:

Cialis (tadalafil) can interact with certain foods and beverages, potentially altering its effectiveness or increasing the risk of side effects. Here are the key drug-food interactions to be aware of:

1. Grapefruit and Grapefruit Juice: Grapefruit can increase the levels of tadalafil in your blood by interfering with its metabolism. This may amplify side effects, such as headaches, dizziness, or low blood pressure. Avoid consuming grapefruit or grapefruit juice while taking Cialis.
2. Alcohol: Drinking alcohol with Cialis can enhance the blood pressure-lowering effects of the medication, leading to symptoms like dizziness, lightheadedness, or fainting. Limiting alcohol intake is recommended while using Cialis.
3. High-Fat Meals: While Cialis can be taken with or without food, consuming it with a high-fat meal may delay its onset of action. Opt for lighter meals if rapid effectiveness is needed.
4. Caffeine: Though not a direct interaction, combining Cialis with high caffeine intake might worsen side effects like headaches or increase heart rate in sensitive individuals.

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