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Why is this drug prescribed?

Cialis (relaxes muscles within the penis. This allows increased blood flow into the penis, necessary to achieve and maintain an erection.

Cialis is used to treat erectile dysfunction (impotence).

Cialis may also be used for purposes other than those listed in this medication guide.

How should you take this medication?

Take Cialis exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water.

Cialis is usually taken when needed before sexual activity. The effects of Cialis may last for up to 36 hours or more. Your doctor will determine how often you can take Cialis. Do not take Cialis more often than is directed by your doctor.

Cialis can help achieve an erection when sexual stimulation occurs. An erection will not occur just by taking a pill.

Cialis can be taken with or without food.

Cialis should not be taken with excessive amounts of alcohol (e.g. 5 or more drinks). Excessive alcohol may increase the risk of headache, dizziness, increased heart rate, or low blood pressure when Cialis is taken.

--If you miss a dose...

Cialis is used as needed, so you are not likely to miss a dose.

--Storage information...

Store this medication at room temperature away from moisture and heat.

What side effects may occur?

If you experience any of the following serious side effects, stop taking Cialis and seek emergency medical attention or contact your doctor immediately:

• an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
• chest pain or irregular heartbeats;
• dizziness, nausea, or angina (pain, tightness, discomfort, numbness, or tingling in the chest, arms, neck, or jaw);
• swelling of the ankles or legs;
• shortness of breath
• prolonged or severe dizziness; or
• a prolonged (lasting longer than 4 hours) or painful erection

Other, less serious side effects may be more likely to occur. Continue to take Cialis and talk to your doctor if you experience

• headache
• indigestion
• back pain
• muscle aches
• flushing
• stuffy and runny nose
• temporary blue tint in vision or difficulty telling the difference between the colors blue and green (uncommon).

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

Possible food and drug interactions when taking this medication

Do not take Cialis if you are taking any of the following medicines:

• A nitrate such as nitroglycerin (Nitrostat, Nitrolingual, Nitro-Dur, Nitro-Bid, Minitran, Deponit, Transderm-Nitro, others), isosorbide dinitrate (Dilatrate-SR, Isordil, Sorbitrate), isosorbide mononitrate (Imdur, ISMO, Monoket), and others;
• nitrates are also found in some recreational drugs such as amyl nitrate or nitrite ("poppers"); or
• an alpha blocker (other than tamsulosin (Flomax) 0.4 mg once a day) such as doxazosin (Cardura), guanadrel (Hylorel), prazosin (Minipress), terazosin (Hytrin), alfuzosin (Uroxatral), and others.

Taking Cialis  with any of these medications may cause very low blood pressure, possibly resulting in dizziness, fainting, stroke, or heart attack.

Before taking Cialis , tell your doctor if you are taking any of the following medications:

• any other drug used to treat impotence, such as sildenafil (Viagra), vardenafil (Levitra), alprostadil (Caverject, Muse, Edex) or yohimbine (Yocon, Yodoxin, others);
• the antibiotic erythromycin (E-Mycin, Eryc, Ery-Tab, others);
• an antifungal medication such as itraconazole (Sporanox) or ketoconazole (Nizoral); or

HIV medications such as indinavir (Crixivan), ritonavir (Norvir), and others.

You may not be able to take Cialis, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact with Cialis or affect your condition. Talk to your doctor or pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products. Do not take Cialis if you are taking any of the following medicines:

Special warnings while using this drug

Cialis (tadalafil) should not be taken with excessive amounts of alcohol (e.g. 5 or more drinks). Excessive alcohol may increase the risk of headache, dizziness, increased heart rate, or low blood pressure when Cialis is taken.

Grapefruit and grapefruit juice may interact with Cialis. The interaction could lead to potentially adverse effects. You should discuss the use of grapefruit and grapefruit juice with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

Overdosage

Seek emergency medical attention if an overdose is suspected.

Symptoms of a Cialis overdose are not known.