Tadalafil, Oral

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

Generic and brand names: tadalafil, oral; Cialis

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.

Before taking this medicine, tell your health care 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
• 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 (an eye disorder that causes loss of vision)
• stomach ulcers.

Tell your health care 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.

Take your dosage of this medicine exactly as your health care 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. Talk with your health care provider about how often you can take this medicine.

Tell all of your health care providers that you take this medicine. If you need emergency medical care for a heart problem, it is very important you inform the health care provider when you last took this medicine.

Rarely, this medicine may cause a painful erection of the penis that will not return to normal within 4 hours. If this occurs, contact your health care 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 health care provider about this.

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.

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 health care provider if you have any side effects that continue or get worse.

Serious (report these to your health care 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.

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.

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 health care provider if you are taking:

• alcohol
• alpha blockers such as terazosin (Hytrin), tamsulosin (Flomax), doxazosin (Cardura), prazosin (Minipress), and alfuzosin (Uroxatral)
• cimetidine (Tagamet)
• antibiotics such as clarithromycin (Biaxin), dirithromycin (Dynabac), erythromycin (Erythrocin, E.E.S., E-Mycin, Ilotycin), doxycycline (Vibramycin, Vibra-Tabs), ciprofloxacin (Cipro), and troleandomycin (Tao)
• antifungals such as itraconazole (Sporanox) and ketoconazole (Nizoral)
• nitrates such as nitroglycerin (Nitrogard, Nitrostat, Nitrolingual, Nitrong, Nitroglyn, Nitro-Dur, Nitrol, Transderm Nitro), isosorbide dinitrate or mononitrate (Imdur, Isordil, Sorbitrate, Dilatrate-SR), and amyl nitrite inhalant
• other medicines to treat erectile dysfunction
• protease inhibitors such as ritonavir (Norvir), saquinavir (Fortovase, Invirase), indinavir sulfate (Crixivan), nelfinavir (Viracept), atazanavir (Reyataz), and amprenavir (Agenerase)
• rifampin (Rifadin, Rimactane)
• 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.

Keep a list of all your medicines (prescription, nonprescription, supplements, natural remedies, and vitamins) with you. Be sure that you tell all health care providers who treat you about all the products you are taking.

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 health care 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.