Tadalafil is used to treat male sexual function problems (impotence or erectile dysfunction-ED).

- the inability to have an erection
- enlarged prostate with urination problem

In combination with sexual stimulation, tadalafil works by increasing blood flow to the penis to help a man get and keep an erection.Tadalafil is also used to treat the symptoms of an enlarged prostate (benign prostatic hyperplasia-BPH).

It helps to relieve symptoms of BPH such as difficulty in beginning the flow of urine, weak stream, and the need to urinate frequently or urgently (including during the middle of the night).

Tadalafil is thought to work by relaxing the smooth muscle in the prostate and bladder.This drug does not protect against sexually transmitted diseases (such as HIV, hepatitis B, gonorrhea, syphilis). Practice “safe sex” such as using latex condoms. Consult your doctor or pharmacist for more details.

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Cialis for benign prostatic hyperplasia (BPH)

Cialis is approved by the FDA to treat the symptoms of benign prostatic hyperplasia.

BPH is a condition that occurs in men as they age. It happens when the prostate gland slowly increases in size but isn’t cancerous. As the prostate gland gets bigger, it begins to push on your bladder. So eventually you may experience symptoms of BPH, including:

- needing to urinate often, especially at night
- straining to urinate
- producing a weak stream of urine
- being unable to urinate
- feeling that your bladder didn’t empty after urinating

Effectiveness of Cialis for Benign prostatic hyperplasia

Cialis was an effective medication to treat symptoms of BPH in clinical trials.

Researchers used a scale called the International Prostate Symptom Score (IPSS). IPSS is a questionnaire that was given to people to determine if their BPH symptoms improved. The symptoms included urinary urgency (sudden need to urinate), weak urine stream, and straining to urinate.

A higher score meant that symptoms of BPH were worse. The goal was to have a lower score, which indicates that people have had fewer and less severe symptoms of BPH.

The studies looked at people with BPH who took Cialis or a placebo (treatment with no active drug). Researchers found that people who took:

- Cialis had a decrease in their IPSS score of 4.8 to 5.6 points
- a placebo had a decrease in their IPSS score of 2.2 to 3.6 points

This means that the Cialis group noticed a larger decrease in the number and severity of BPH symptoms than the placebo group.

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How to use Cialis

Read the Patient Information Leaflet provided by your pharmacist before you start taking tadalafil and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth, with or without food, as directed by your doctor. Do not take tadalafil more often than once daily.

The manufacturer directs to swallow this medication whole. However, many similar drugs (immediate-release tablets) can be split/crushed. Follow your doctor’s directions on how to take this medication.

The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

To treat the symptoms of BPH, take this medication as directed by your doctor, usually once a day. If you are also taking finasteride with this medication to treat symptoms of BPH, talk with your doctor about how long you should continue taking this medication.

To treat erectile dysfunction-ED, there are 2 ways that tadalafil may be prescribed. Your doctor will determine which is the best way for you to take tadalafil. Follow your doctor’s directions exactly since your dosage depends on how you are taking it. The first way is to take it as needed, usually at least 30 minutes before sexual activity. Tadalafil’s effect on sexual ability may last up to 36 hours.

The second way to treat ED is to take tadalafil regularly, once a day every day. If you take it this way, you may attempt sexual activity at any time between your doses.

If you are taking tadalafil to treat both ED and BPH, take it as directed by your doctor, usually once a day. You may attempt sexual activity at any time between your doses.

If you are taking tadalafil once daily for BPH, or for ED, or for both, take it regularly to get the most benefit from it. To help you remember, take it at the same time each day.

Tell your doctor if your condition does not improve or if it worsens.

How quickly does Cialis work?

First, Cialis works relatively quickly but not as fast as Viagra. It can take 1 to 2 hours for the full effects of Cialis to kick in, though it only takes about an hour for Viagra to work fully.

Studies show the drug is absorbed quickly, and this is not affected by the timing of meals.

How long does Cialis last?

On the other hand, the effects of Cialis last noticeably longer than the effects of Viagra, normally up to 36 hours. That’s a full 1.5 days!

Don’t be alarmed, though: That doesn’t mean you’ll have an erection for 1.5 days straight. That would be an emergency, which we’ll talk about soon. But you may be able to achieve an erection with the help of Cialis throughout the 36-hour time period. This is one of the reasons some men prefer Cialis: It allows for more spontaneous sexual activity.

If your erection lasts longer than 4 hours, even if it’s not painful, consider it a medical emergency. Known as priapism, this condition can cause permanent damage to the tissue that allows you to become erect. People who are more likely to have a prolonged erection include those with:

Sickle cell anemia
Multiple myeloma
Leukemia
Some penile deformities

How does Cialis treat erectile dysfunction?

ED happens when there is not enough blood flow to the penis. This can be a result of a medical problem, medications, or emotional problems. Your healthcare provider can help determine the cause and whether medication might be right for you.

Much like Viagra, Cialis relaxes the smooth muscles and arteries inside the penis. At the same time, it also increases blood flow to the penis. When aroused, this combination of relaxation and increased blood flow allows the penis to fill with blood, which results in an erection. It’s important to remember that Cialis only works if you are sexually aroused.

If you’re using Cialis for the first time, here are a couple things to know up front.

Side Effects of Cialis

Headache, stomach upset, back pain, muscle pain, stuffy nose, flushing, or dizziness may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Sexual activity may put extra strain on your heart, especially if you have heart problems. If you have heart problems and experience any of these serious side effects while having sex, stop and get medical help right away: severe dizziness, fainting, chest/jaw/left arm pain, nausea.

Rarely, sudden decreased vision, including permanent blindness, in one or both eyes (NAION) may occur. If this serious problem occurs, stop taking tadalafil and get medical help right away. You have a slightly greater chance of developing NAION if you have heart disease, diabetes, high cholesterol, certain other eye problems (“crowded disk”), high blood pressure, if you are over 50, or if you smoke.

Rarely, a sudden decrease or loss of hearing, sometimes with ringing in the ears and dizziness, may occur. Stop taking tadalafil and get medical help right away if these effects occur.

In the rare event you have a painful or prolonged erection lasting 4 or more hours, stop using this drug and get medical help right away, or permanent problems could occur.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US –

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions of Taking Cialis

Before taking tadalafil, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart problems (such as heart attack or life-threatening irregular heartbeat in the past 6 months, chest pain/angina, heart failure), stroke in the past 6 months, kidney disease, liver disease, high or low blood pressure, dehydration, penis conditions (such as angulation, fibrosis/scarring, Peyronie’s disease), history of painful/prolonged erection (priapism), conditions that may increase the risk of priapism (such as sickle cell anemia, leukemia, multiple myeloma), eye problems (such as retinitis pigmentosa, sudden decreased vision, NAION), bleeding disorders, active stomach ulcers.

This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

This brand of the drug is not usually used in women. During pregnancy, tadalafil should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

Important warnings

- Heart disease warning. You shouldn’t use tadalafil if you have a heart condition and your doctor has advised against sexual activity. Call your doctor right away if you have symptoms during sex such as chest pain, dizziness, or nausea. Sexual activity can put an extra strain on your heart. This is especially true if your heart is already weak from a heart attack or heart disease.
- Priapism warning. Priapism is an erection that won’t go away. Without treatment, this condition could cause permanent damage to your penis. This damage includes impotence (not being able to have an erection). If you get an erection that lasts more than 4 hours, call your doctor right away.

How should I take Cialis?

Here are a few tips for taking Cialis safely and effectively:

1) Follow safe, recommended doses.

If you’d like to take Cialis for ED, you’ve got two options: You can take one of the higher-dose tablets on an as-needed basis (only when you want to have sex), or you can take a smaller-dose tablet every day.

A 10 mg tablet is usually recommended for as-needed use, though some men might find that a lower (5 mg) or higher (20 mg) dose works better.

According to studies, there is no difference in safety or efficacy between these two options.

2) You can make Cialis work faster.

If you take Cialis as needed, be sure to give yourself plenty of time (since it takes up to 1 to 2 hours to kick in). Otherwise, you can’t speed it up after you’ve taken it.

If that’s not working for you, you could consider taking a lower-dose tablet every day. This might be better if you prefer to be more spontaneous. If so, be sure to take it at the same time every day.

No matter which way you decide to take it, don’t take more than 1 dose per day.

3) Watch out for interactions with other medications.

ED medications combined with medications for high blood pressure can cause dangerously low blood pressure. Never take Cialis if you take nitroglycerin or another nitrate medication for angina or blood pressure. These include:

Nitroglycerin sprays, tablets, or patches
Isosorbide mononitrate (Imdur, Ismo, Monoket)
Isosorbide dinitrate (Dilatrate-SR, Isordil, Sorbitrate)

Taking certain medications or supplements can cause your body to eliminate Cialis from your system faster, such as:

Phenytoin
Fosphenytoin
Carbamazepine
Rifampin
Supplements like St. John’s Wort

If you are taking these medications, it’s important to continue taking them as prescribed, but taking them separately from Cialis may be helpful.

Who should not take CIALIS?

The following conditions are contraindicated with this drug. Check with your physician if you have any of the following Conditions:

multiple myeloma
leukemia
sickle cell anemia
increased risk of bleeding due to clotting disorder
an increased risk of bleeding
alcohol intoxication
pigmentary retinopathy
hearing loss
significant uncontrolled high blood pressure
a sudden worsening of heart related chest pain called angina
narrowing of the aortic heart valve
hypertrophic cardiomyopathy
life-threatening irregular heart rhythm
chronic heart failure
a stroke
low blood pressure
an ulcer from too much stomach acid
liver problems
severe renal impairment
mild to moderate kidney impairment
Peyronie’s disease
a bent penis with erection
fibrous tissue formation in the penis
seizures
a sudden vision loss due to loss of the blood supply to the front of the optic nerve
restrictive cardiomyopathy

Does Cialis interact with other drugs you are taking?

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

A product that may interact with this drug is: riociguat.

Tadalafil can cause a serious drop in your blood pressure when used with nitrates, which can lead to dizziness, fainting, and rarely heart attack or stroke. Do not use any of the following with tadalafil or within 48 hours of your last dose of tadalafil: certain drugs used to treat chest pain/angina (nitrates such as nitroglycerin, isosorbide), recreational drugs called “poppers” containing amyl or butyl nitrite.

If you re also taking an alpha blocker medication (such as doxazosin, tamsulosin) to treat an enlarged prostate/BPH or high blood pressure, your blood pressure may get too low which can lead to dizziness or fainting. Your doctor may start treatment with a lower dose of tadalafil or adjust your alpha blocker medication to minimize your risk of low blood pressure.

Other medications can affect the removal of tadalafil from your body, which may affect how tadalafil works. Examples include azole antifungals (such as itraconazole, ketoconazole), macrolide antibiotics (such as clarithromycin, erythromycin), HIV protease inhibitors (such as fosamprenavir, ritonavir), hepatitis C virus protease inhibitors (such as boceprevir, telaprevir), rifampin, among others.

Do not take this medication with any other product that contains tadalafil or other similar medications used to treat erectile dysfunction-ED or pulmonary hypertension (such as sildenafil, vardenafil).

Overdose of Taking Cialis

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

Notes of Taking Cialis

Do not share this medication with others.

Missed Dose of Taking Cialis

If you are taking this medication on a regular schedule and you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Storage of Taking Cialis

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Images of Cialis

Cialis 20 mg tablet

Color: yellow

Shape: almond

Imprint: C20

This medicine is a yellow, almond, film-coated, tablet imprinted with “C20”.

Cialis 10 mg tablet

Color: yellow

Shape: almond

Imprint: C 10

This medicine is a yellow, almond, film-coated, tablet imprinted with “C 10”.

Cialis 2.5 mg tablet

Color: yellow

Shape: almond

Imprint: C 2 1/2

This medicine is a yellow, almond, film-coated, tablet imprinted with “C 2 1/2”.

Cialis 5 mg tablet

Color: yellow

Shape: almond

Imprint: C 5

This medicine is a yellow, almond, film-coated, tablet imprinted with “C 5”.

Who Can Not Take Cialis ?

Tadalafil is not suitable for some people. To make sure it’s safe for you, tell your doctor if you:

- - have ever had an allergic reaction to tadalafil or any other medicine
  - are taking medicines called nitrates for chest pain (angina)
  - have a serious heart and liver problem
  - have recently had a stroke or a heart attack
  - have low blood pressure (hypotension) or uncontrolled high blood pressure (hypertension)
  - have ever lost your vision due to reduced blood flow to the eye
  - have sickle cell anaemia (an abnormality of red blood cells)
  - have leukaemia (cancer of blood cells)
  - have multiple myeloma (cancer of bone marrow)
  - have Peyronie’s disease (curved penis) or a similar problem with your penis
  - have a liver or kidney condition
  - have a heart condition – your doctor will advise you whether your heart can take the additional strain of having sex

Pregnancy, breastfeeding and fertility while taking tadalafil

Tadalafil is not often prescribed in pregnancy, but it may be recommended if you have pulmonary hypertension.

Pulmonary hypertension is an extremely serious condition in pregnancy. If you have this condition, it’s important to use reliable contraception (for example a contraceptive implant or a coil) and to talk to your doctor before trying for a baby. You heart condition will need to be assessed so that you can be given information on the risks of pregnancy to your health.

If you become pregnant while taking tadalafil, you will usually be recommended to continue to take it throughout pregnancy. This is because the risks from pulmonary hypertension are potentially life-threatening without treatment.

It’s important to let your doctors know that you are pregnant as early as possible. This is because you will need to be reviewed in a specialist pregnancy and heart clinic throughout your pregnancy. You will be considered a high-risk pregnancy and will have a lot of additional care.

Tadalafil and breastfeeding

If you are breastfeeding and have pulmonary hypertension, tadalafil is not usually prescribed, unless a specialist recommends it.

Tadalafil and fertility

There’s no evidence to suggest that taking tadalafil will reduce fertility in either women or men. However, speak to a pharmacist or doctor before taking it if you’re trying to get pregnant.

Taking Tadalafil With Other Medicines and Herbal Supplements

Cautions with other medicines

Some medicines do not mix well with tadalafil.

Tell your doctor or pharmacist if you’re taking these medicines before you start tadalafil:

- - nitrates for chest pain, such as glyceryl trinitrate (GTN)
  - riociguat for pulmonary hypertension

Mixing tadalafil with herbal remedies and supplements

There are lots of treatments that claim to be a “herbal Cialis”, but there is no such thing.

A herbal Cialis has never been approved as a treatment for erectile dysfunction. These treatments may also be fake or unsafe.

Some complementary therapies may have ingredients that could affect the way tadalafil works and cause side effects.

There’s not enough information to say whether complementary medicines, herbal remedies and supplements are safe to take with tadalafil. They’re not tested in the same way as pharmacy and prescription medicines. They’re generally not tested for the effect they have on other medicines.