Tadalafil, Oral tah-DA-la-fil

What are other names for this medicine?

Type of medicine: PDE-5 inhibitor; erectile dysfunction therapy

Generic and brand names: tadalafil, oral; Cialis

What is this medicine used for?

This medicine is taken by mouth to treat erectile dysfunction (when a man is unable to get and keep his penis erect for sexual intercourse). This condition is also called impotence. This medicine is prescribed for men only.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• a heart attack, coronary artery disease, or chest pain
• a stroke
• a deformed penis shape, including curved penis or birth defects of the penis
• bleeding problems such as hemophilia or conditions causing thickened blood or slower blood flow, such as leukemia; multiple myeloma (tumors of the bone marrow); polycythemia; sickle cell disease; or thrombocythemia
• diabetes
• heart disease or an irregular heartbeat
• high blood pressure or low blood pressure
• kidney problems
• liver problems
• priapism (erection lasting longer than 4 hours)
• retinitis pigmentosa or any eye disorder that causes loss of vision
• stomach ulcers

Tell your healthcare provider if you are using any other treatment for erectile dysfunction.

Do not take this medicine if you are taking alpha blockers or any nitrate products (such as nitroglycerin, isosorbide dinitrate, or isosorbide mononitrate) for the treatment of angina or chest pain or to lower blood pressure.

How do I take it?

Check the label on the medicine for directions about your specific dose. Take your dosage of this medicine exactly as your healthcare provider prescribes. Do not take more than prescribed. Do not take this medicine more than once a day.

You may take this medicine with or without food. High-fat meals may delay the effects of the medicine.

This medicine can improve erectile function for up to 36 hours after you take it. There must be some sexual stimulation in order for this medicine to work. Talk with your healthcare provider about how often you can take this medicine.

What if I overdose?

Symptoms of an acute overdose have not been reported.

What should I watch out for?

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine. If you need emergency medical care for a heart problem, it is very important you inform the healthcare provider when you last took this medicine.

Rarely, this medicine may cause a painful erection of the penis that does not return to normal within 4 hours. If this occurs, contact your healthcare provider or get medical care right away. It can lead to permanent erectile dysfunction if not treated.

This medicine may affect your vision. You may have trouble telling the difference between blue and green. Talk with your healthcare provider about this.

This medicine may cause sudden decrease or loss of hearing or ringing in the ears. If this occurs, contact your healthcare provider or get medical care right away.

This medicine may make you dizzy or drowsy. Do not drive or operate machinery unless you are fully alert.

The use of this medicine does not protect against sexually transmitted diseases.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away). If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; chest pain or tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): Erection that is painful or lasts longer than 4 hours; dizziness; fainting; rash; chest pain; fast or pounding heartbeat; trouble breathing; loss of vision; loss of hearing or ringing in the ears.

Other: Headache, nausea, flushing, stomach upset, stuffy nose, back pain, muscle aches, abnormal vision (eyes sensitive to light, blurred vision, change in color vision), pain or burning when urinating, diarrhea.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• alcohol
• alpha blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), tamsulosin (Flomax), and terazosin (Hytrin)
• antibiotics such as clarithromycin (Biaxin), erythromycin (Ery-Tabs, E.E.S.), isoniazid, and rifampin (Rifadin, Rimactane)
• antifungals such as itraconazole (Sporanox) and ketoconazole (Nizoral)
• anti-HIV medicines such as atazanavir (Reyataz), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir), and saquinavir (Invirase)
• antiseizure medicines such as carbamazepine (Tegretol), phenytoin (Dilantin), and phenobarbital (Luminal)
• bosentan (Tracleer)
• calcium channel blockers such as diltiazem (Cardizem, Tiazac), nicardipine (Cardene), and verapamil (Calan, Isoptin SR)
• cimetidine (Tagamet)
• medicines to treat high blood pressure
• nefazodone
• nitrates such as amyl nitrite inhalant, isosorbide dinitrate or mononitrate (Imdur, Isordil, Dilatrate-SR), and nitroglycerin (Nitrogard, Nitrostat, Nitrolingual, Nitrong, Nitroglyn, Nitro-Dur, Nitrol, Transderm Nitro)
• other medicines to treat erectile dysfunction, or sildenafil (Revatio)
• St. John's wort

Do not eat grapefruit or drink grapefruit juice while taking this medicine. Grapefruit affects the way this medicine works and may increase the risk of side effects.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.