Do not take Tadalafil 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 Tadalafil with any of these medications may cause very low blood pressure, possibly resulting in dizziness, fainting, stroke, or heart attack.

Contact your doctor or seek emergency medical attention for any erection that lasts longer than 4 hours. A sustained erection can damage the penis.

Refrain from further sexual activity and notify your doctor it you develop dizziness, nausea, or angina (pain, tightness, discomfort, numbness, or tingling in the chest, arms, neck, or jaw) during sexual activity.

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

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Do not take Tadalafil if you are taking any of the following medicines:
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 Tadalafil with any of these medications may cause very low blood pressure, possibly resulting in dizziness, fainting, stroke, or heart attack.

Before taking Tadalafil , tell your doctor if you
have heart problems such as angina, heart failure, irregular heartbeats, or have had a heart attack;
have low blood pressure or high blood pressure that is not controlled;
have had a stroke;
have liver problems;
have kidney problems;
have ever had blood cell problems such as sickle cell anemia, multiple myeloma, or leukemia;
have a bleeding disorder;
have a stomach ulcer;
have retinitis pigmentosa (an inherited condition of the eye);
have a physical deformity of the penis such as Peyronie's disease;
had an erection that lasted longer than 4 hours.
You may not be able to take Tadalafil , or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Although Tadalafil is not indicated for use by women, it is in the FDA pregnancy category B. This means that Tadalafil is not expected to be harmful to an unborn baby. Tadalafil should not be taken by women.

It is not known whether Tadalafil passes into breast milk. Tadalafil should not be taken by women.

If you are over 65 years of age, you may be more likely to experience side effects from Tadalafil . Your doctor may prescribe a lower dose of this medication

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Take Tadalafil 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.

Tadalafil is usually taken when needed before sexual activity. The effects of Tadalafil may last for up to 36 hours or more. Your doctor will determine how often you can take Tadalafil . Do not take Tadalafil more often than is directed by your doctor. Tadalafil can help achieve an erection when sexual stimulation occurs. An erection will not occur just by taking a pill.

Tadalafil can be taken with or without food.

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 Tadalafil is taken.

If you develop dizziness, nausea, or angina (pain, tightness, discomfort, numbness, or tingling in the chest, arms, neck, or jaw) during sexual activity, refrain from further sexual activity and notify your doctor.

Contact your doctor or seek emergency medical attention for any erection that lasts longer than 4 hours. A sustained erection can damage the penis.

Grapefruit and grapefruit juice may interact with Tadalafil . 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.

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

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

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Seek emergency medical attention if an overdose is suspected.

Symptoms of a Tadalafil overdose are not known.

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Do not take any other drug used to treat impotence, such as sildenafil citrate (Viagra), vardenafil (Cialis), alprostadil (Caverject, Muse, Edex) or yohimbine (Yocon, Yodoxin, others), without first talking to your doctor.

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 Tadalafil is taken.

Grapefruit and grapefruit juice may interact with Tadalafil . 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.

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If you experience any of the following serious side effects, stop taking Tadalafil 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 Tadalafil and talk to your doctor if you experience :
headache;
indigestion;
back pain;
muscle aches;
flushing;
stuffy or runny nose; or
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.

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Do not take Tadalafil 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 Tadalafil with any of these medications may cause very low blood pressure, possibly resulting in dizziness, fainting, stroke, or heart attack.

Before taking Tadalafil , tell your doctor if you are taking any of the following medications:
any other drug used to treat impotence, such as sildenafil (Viagra), vardenafil (Cialis), 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 Tadalafil , 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 Tadalafil 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.

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

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