Risk of heart attack or stroke
- Risk factors: Existing heart condition | Recent heart attack or stroke in past 6 months | High or low blood pressure
It’s not recommended for men to take Cialis (tadalafil) if they’ve had a heart attack, stroke, or symptoms of heart failure in the past 6 months, abnormal blood pressure, or if they have chest pain. The safety of Cialis (tadalafil) has not been studied in these situations. Talk to your doctor if you have any of these health conditions.
Low blood pressure
- Risk factors: Taking alpha blockers | Taking medications for high blood pressure or chest pain (angina) | Drinking alcohol
If you’re taking alpha blockers or medications for high blood pressure with Cialis (tadalafil), your blood pressure may drop too low. Make sure to check your blood pressure regularly if you’re taking these other medications. Be very careful getting up from a sitting or lying down position since this can make you feel dizzy and more likely to fall. Drinking alcohol can also cause low blood pressure. Avoid or lower your alcohol consumption when taking Cialis (tadalafil). You should never take Cialis (tadalafil) when taking nitrate medication for chest pain (angina) because it can cause your blood pressure to suddenly drop to unsafe levels.
- Risk factors: Peyronie’s disease | Cavernosal fibrosis | Sickle cell anemia
There have been reports of men having an erection lasting more than 4 hours while on Cialis (tadalafil). This is rare but if it’s not treated in time, it can cause permanent damage to your penis, including permanent impotence. Get medical help immediately if this happens.
If you suddenly notice changes in your vision in one or both eyes, go to the emergency room or call your doctor immediately. Although this is rare, Cialis (tadalafil) can cause permanent eye damage.
There have been reports of men having permanent hearing loss while taking Cialis (tadalafil). This may happen along with ringing in the ears (tinnitus) and dizziness. Go to the emergency room or call your doctor immediately if you notice changes in your hearing in one or both ears.
Interactions with other medications
- Risk factors: Age 65 years or older | Liver disease | Kidney disease | Taking medications such as nitrates, anti-hypertensives, alpha blockers, ketoconazole, or ritonavir
You may experience more side effects while taking Cialis (tadalafil) if you are also taking medications called nitrates for chest pain, blood pressure medications, certain medications for HIV, are elderly, or have liver or kidney disease. Talk to your doctor before starting Cialis (tadalafil) if any of these apply to you.