Cialis®

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) in men. Cialis is also used to treat the signs and symptoms of benign prostatic hyperplasia (BPH), a condition in which the prostate gland becomes enlarged. Adcirca, another brand of tadalafil, is used to treat pulmonary arterial hypertension and improve exercise capacity in men and women. Cialis may also be used for purposes other than those listed in this medication guide.

Important information about Cialis

Do not take Cialis if you are allergic to tadalafil, or if you are also using a nitrate drug for chest pain or heart problems, including nitroglycerin(Nitro Dur, Nitrolingual, Nitrostat, Transderm Nitro, and others), isosorbide dinitrate (Dilatrate, Isordil, Isochron), isosorbide mononitrate (Imdur, ISMO, Monoket), or recreational drugs such as amyl nitrate or nitrite (“poppers”). If you become dizzy or nauseated during sexual activity, or if you have pain, numbness, or tingling in your chest, arms, neck, or jaw, stop and call your doctor right away. You could be suffering from a serious side effect of this medicine. Do not take Cialis more than once a day. Allow 24 hours to pass between doses. 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. 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. It is not clear whether Cialis is the actual cause of vision loss. Stop using Cialis and get emergency medical help if you have sudden vision loss.

Before taking Cialis

Do not take Cialis if you are allergic to tadalafil. Cialis should not be used together with nitrate medication, such as nitroglycerin (Nitro Dur, Nitrolingual, Nitrostat, Transderm Nitro, and others), isosorbide dinitrate (Dilatrate, Isordil, Isochron), isosorbide mononitrate (Imdur, ISMO, Monoket), or recreational drugs such as amyl nitrate or nitrite (“poppers”). Taking Cialis with a nitrate medicine for chest pain or heart problems can cause a sudden and serious decrease in blood pressure. If you have any of these other conditions, you may need a Cialis dose adjustment or special tests:

• heart disease or heart rhythm problems;
• 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 disease;
• 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. It is not clear whether Cialis is the actual cause of vision loss. Stop using Cialis and get emergency medical help if you have sudden vision loss. FDA pregnancy category B. Cialis is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether 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.

How should I take Cialis?

Take Cialis exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Cialis can be taken with or without food. Do not break or split a Cialis tablet. Swallow it whole. Cialis is usually taken only once per day. Follow your doctor’s instructions. For erectile dysfunction, take the 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. Do not take Cialis for erectile dysfunction if you are taking Adcirca for pulmonary arterial hypertension. Do not take Cialis more than once a day. Allow 24 hours to pass between doses. If you take the medication daily, take it at the same time each day. 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. Store Cialis at room temperature away from moisture and heat.

What happens if I miss a dose?

Since Cialis 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.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include chest pain, nausea, irregular heartbeat, and feeling light-headed or fainting.

What should I avoid while taking Cialis?

Drinking alcohol can increase certain side effects of Cialis. Grapefruit and grapefruit juice may interact with Cialis and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor. Avoid using other medicines to treat erectile dysfunction, such as sildenafil (Viagra) or vardenafil (Levitra) while you are taking Cialis.

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. If you become dizzy or nauseated during sexual activity, or if you 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. Stop using this medicine and call your doctor at once if you have any of these serious side effects:

• changes in vision or sudden vision loss;
• ringing in your ears, or sudden hearing loss;
• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
• irregular heartbeat;
• shortness of breath, swelling in your hands or feet;
• seizure (convulsions);
• feeling light-headed, fainting; or
• penis erection that is painful or lasts 4 hours or longer.

Less serious Cialis side effects may include:

• redness or warmth in your face, neck, or chest;
• cold symptoms such as stuffy nose, sneezing, or sore throat;
• headache;
• memory problems;
• diarrhea, upset stomach; or
• muscle pain, back pain.

Cialis Dosing Information

Usual Adult Dose of Cialis for Erectile Dysfunction: 10 mg orally taken prior to anticipated sexual activity. The maximum recommended dosing frequency is once per day in most patients. Alternatively, 2.5 mg orally once daily, without regard to timing of sexual activity. May increase to 5 mg orally once daily based on efficacy and tolerability.

What other drugs will affect Cialis?

Before taking Cialis, tell your doctor about all other medicines you use, especially:

• rifabutin (Mycobutin), rifampin (Rifadin, Rimactane, Rifater, Rifamate), or rifapentine (Priftin);
• an antibiotic such as clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole), or telithromycin (Ketek);
• antifungal medication such as itraconazole (Sporanox), ketoconazole (Nizoral), miconazole (Oravig), or voriconazole (Vfend);
• an antidepressant such as nefazodone;
• a barbiturate such as phenobarbital (Solfoton);
• drugs to treat high blood pressure or a prostate disorder, such as alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), terazosin (Hytrin), tamsulosin (Flomax);
• heart or blood pressure medication such as diltiazem (Cardizem, Dilacor, Tiazac), nicardipine (Cardene), quinidine (Quin-G), or verapamil (Calan, Covera, Isoptin, Verelan);
• HIV or AIDS medications such as darunavir (Prezista), efavirenz (Sustiva), etravirine (Intelence), nevirapine (Viramune), fosamprenavir (Lexiva), indinavir (Crixivan), ritonavir (Norvir, Kaletra), and others; or
• seizure medications such as carbamazepine (Carbatrol, Equetro, Tegretol), phenytoin (Dilantin), and others.

This list is not complete and other drugs may interact with Cialis. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

Your pharmacist has additional information about cialis written for health professionals that you may read.