Tadalafil tablets (Cialis)

What is this medicine?

TADALAFIL (tah DA la fil) is used to treat erection problems in men. It is also used for enlargement of the prostate gland in men, a condition called benign prostatic hyperplasia or BPH. This medicine improves urine flow and reduces BPH symptoms. This medicine can also treat both erection problems and BPH when they occur together.

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. You may take this medicine with or without meals. When this medicine is used for erection problems, your doctor may prescribe it to be taken once daily or as needed. If you are taking the medicine as needed, you may be able to have sexual activity 30 minutes after taking it and for up to 36 hours after taking it. Whether you are taking the medicine as needed or once daily, you should not take more than one dose per day. If you are taking this medicine for symptoms of benign prostatic hyperplasia (BPH) or to treat both BPH and an erection problem, take the dose once daily at about the same time each day. Do not take your medicine more often than directed.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

• breathing problems

• changes in hearing

• changes in vision

• chest pain

• fast, irregular heartbeat

• prolonged or painful erection

• seizures

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• back pain

• dizziness

• flushing

• headache

• indigestion

• muscle aches

• nausea

• stuffy or runny nose

What may interact with this medicine?

Do not take this medicine with any of the following medications:

• nitrates like amyl nitrite, isosorbide dinitrate, isosorbide mononitrate, nitroglycerin

• other medicines for erectile dysfunction like avanafil, sildenafil, vardenafil

• other tadalafil products (Adcirca)

• riociguat

This medicine may also interact with the following medications:

• certain drugs for high blood pressure

• certain drugs for the treatment of HIV infection or AIDS

• certain drugs used for fungal or yeast infections, like fluconazole, itraconazole, ketoconazole, and voriconazole

• certain drugs used for seizures like carbamazepine, phenytoin, and phenobarbital

• grapefruit juice

• macrolide antibiotics like clarithromycin, erythromycin, troleandomycin

• medicines for prostate problems

• rifabutin, rifampin or rifapentine

What if I miss a dose?

If you are taking this medicine as needed for erection problems, this does not apply. If you miss a dose while taking this medicine once daily for an erection problem, benign prostatic hyperplasia, or both, take it as soon as you remember, but do not take more than one dose per day.

Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medicine after the expiration date.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• bleeding disorders

• eye or vision problems, including a rare inherited eye disease called retinitis pigmentosa

• anatomical deformation of the penis, Peyronie's disease, or history of priapism (painful and prolonged erection)

• heart disease, angina, a history of heart attack, irregular heart beats, or other heart problems

• high or low blood pressure

• history of blood diseases, like sickle cell anemia or leukemia

• history of stomach bleeding

• kidney disease

• liver disease

• stroke

• an unusual or allergic reaction to tadalafil, other medicines, foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

What should I watch for while using this medicine?

If you notice any changes in your vision while taking this drug, call your doctor or health care professional as soon as possible. Stop using this medicine and call your health care provider right away if you have a loss of sight in one or both eyes.

Contact your doctor or health care professional right away if the erection lasts longer than 4 hours or if it becomes painful. This may be a sign of serious problem and must be treated right away to prevent permanent damage.

If you experience symptoms of nausea, dizziness, chest pain or arm pain upon initiation of sexual activity after taking this medicine, you should refrain from further activity and call your doctor or health care professional as soon as possible.

Do not drink alcohol to excess (examples, 5 glasses of wine or 5 shots of whiskey) when taking this medicine. When taken in excess, alcohol can increase your chances of getting a headache or getting dizzy, increasing your heart rate or lowering your blood pressure.

Using this medicine does not protect you or your partner against HIV infection (the virus that causes AIDS) or other sexually transmitted diseases.