Tadalafil (Cialis) is used to treat erectile dysfunction (ED, impotence; inability to achieve or maintain an erection) and the signs and symptoms of benign prostatic hyperplasia (BPH; an enlarged prostate), which include painful urination, frequent and urgent urination, and difficulty urinating (hesitation, dribbling, weak stream, and incomplete bladder emptying) in adult men. With tadalafil (Adcirca), persons with pulmonary arterial hypertension can exercise more easily (PAH; high blood pressure in the vessels carrying blood to the lungs, causing shortness of breath, dizziness, and tiredness). A group of drugs known as phosphodiesterase (PDE) inhibitors includes tadalafil. By boosting blood flow to the penis during sexual stimulation, it helps treat erectile dysfunction.

Tadalafil does not cure erectile dysfunction or raise sexual desire, so you should be aware of this if you’re taking it to treat it. Tadalafil does not stop sexually transmitted diseases like the human immunodeficiency virus or pregnancy from happening (HIV).

Tadalafil is available as an oral tablet. Taking it with or without food is acceptable.

If you are taking tadalafil to treat erectile dysfunction, abide by this paragraph’s instructions and those given by your doctor. Tadalafil can be taken daily or as needed, depending on the situation. The dose regimen is best for you should be discussed with your doctor. When necessary, tadalafil is occasionally taken, typically at least 30 minutes before sexual activity, and not more frequently than once per 24 hours. The ideal time for you to take tadalafil prior to sexual activity will be determined by your doctor. In certain cases, tadalafil is taken once daily, every day, regardless of when a person engages in sexual activity. Between doses, you are free to try sexual activity whenever you like. If you regularly take tadalafil, take it at roughly the same time each day. Your doctor could advise you to take tadalafil less frequently or might give you a lower dose to use once daily if you have certain medical conditions or are taking certain drugs. Ask your doctor or pharmacist to explain any instructions on your prescription label that you are unsure about following. Tadalafil should be used as prescribed. Never take it in larger or less amounts or more frequently than directed by your doctor.

Follow your doctor’s advice and the recommendations in this section if you’re taking tadalafil to treat PAH or BPH. Tadalafil needs to be taken once per day. Do not divide the pills into smaller doses to be taken during the day; instead, take the entire daily dose at once each day. Tadalafil should be taken every day at roughly the same time. If you already take medication for BPH, your doctor might advise you to cease using it at least one day before beginning tadalafil therapy. Pay close attention to your doctor’s instructions, and ask him or her to explain any points you don’t understand.

If you are taking tadalafil to treat erectile dysfunction, your doctor will likely start you on an average dose and then adjust it based on how you react to the drug. If tadalafil is not working as well as it should or if you experience any negative effects, let your doctor know.

If you are taking tadalafil to treat PAH, you should be aware that it only manages the condition. Tadalafil should still be used even if you feel fine. Without first seeing your doctor, never stop taking tadalafil.

For a copy of the manufacturer’s information for the patient, ask your pharmacist or doctor.

Ask your doctor or pharmacist for more details if you believe this drug should be used for something else.

Before taking tadalafil,

• If you have an allergy to tadalafil, any other drugs, or any of the substances in tadalafil tablets, inform your doctor and pharmacist right away. Get a list of the components from your pharmacist.
• Inform your physician if you are currently taking riociguat (Adempas) or nitrates such isosorbide dinitrate (Isordil), isosorbide mononitrate (Monoket), or nitroglycerin, or if you recently did (Minitran, Nitro-Dur, Nitromist, Nitrostat, others). Tablets, sublingual (under the tongue) pills, sprays, patches, pastes, and ointments are all forms of nitrates. If you are unsure whether any of your drugs include nitrates, consult your doctor. If you are taking nitrates, your doctor generally won’t advise you to use tadalafil.
• If you are taking nitrate-containing street drugs (often known as “poppers”) like amyl nitrate, butyl nitrate, or nitrite while taking tadalafil, let your doctor know. Tadalafil shouldn’t be taken if you are using nitrate-containing street drugs, your doctor will likely advise you.
• You should be aware that the brand names Adcirca and Cialis are both used to sell tadalafil. One of these products should be used to treat you at a time.
• Inform your doctor and pharmacist about any additional prescription and over-the-counter drugs, vitamins, and dietary supplements that you now take or intend to take. Make certain to bring up any of the following: alpha blockers including tamsulosin (Flomax, in Jalyn), tamsulosin (alfuzosin, Uroxatral), doxazosin (Cardura), dutasteride (Avodart, in Jalyn), prazosin (Minipress), silodosin (Rapaflo), and terazosin; amiodarone (Cordarone, Pacerone); specific antifungals, including fluconazole (Diflucan), griseofulvin (Grifulvin, Gris-PEG), itraconazole (Onmel, Sporanox), ketoconazole (Extina, Ketozole, Nizoral, Xolegel), and voriconazole (Vfend); aprepitant (Emend); bosentan (Tracleer); carbamazepine (Carbatrol,  Epitol, Tegretol, Teril, others);  HIV protease inhibitors such as indinavir (Crixivan), nelfinavir (Viracept), and ritonavir (Norvir, in Kaletra), lovastatin (Altocor, in Advicor); Erythromycin (E.E.S., E-Mycin, Erythrocin); nefazodone, nevirapine (Viramune), further ED drugs or treatments, additional PAH medications or therapies, phenobarbital, phenytoin (Dilantin, Phenytek), rifabutin (Mycobutin), rifampin (Rifadin, Rimactane, in Rifamate, in Rifater), and nevirapine (Viramune); verapamil, telithromycin (Ketek), and sertraline (Zoloft) (Calan, Covera,Verelan, in Tarka). Your physician might need to adjust the dosage of your drugs or keep a close eye on you for side effects.
• Inform your doctor about any herbal medications you are taking, especially if you use St. John’s wort.
• Inform your doctor if you smoke, if you’ve ever experienced an erection that lasted longer than four hours, or if you recently experienced diarrhoea, vomiting, a lack of fluid intake, or excessive perspiration that could have resulted in dehydration (loss of a significant amount of body fluids). Moreover, let your doctor know if you have ever experienced pulmonary veno-occlusive disease (PVOD; a blockage of lung veins); diabetes, high cholesterol, high or low blood pressure, irregular heartbeat, heart attack or heart failure, angina (chest discomfort), stroke, stomach ulcers, bleeding disease; any ailment that alters the morphology of the penis; problems with blood circulation; issues with blood cells such sickle cell anaemia (a disease of the red blood cells); multiple myeloma (cancer of the plasma cells); or leukaemia (cancer of the white blood cells); or heart, kidney, or liver disease. Additionally, let your doctor know if you or any members of your family have ever experienced sudden, severe vision loss or if you have retinitis pigmentosa, an inherited eye condition that impairs vision. This is especially important if you were told that the reason for your vision loss was a blockage of blood flow to the nerves that support your vision.
• If you are a woman using tadalafil to treat PAH, be sure to let your doctor know if you are currently breastfeeding or planning a pregnancy. Call your physician if you conceive while taking tadalafil.
• Inform the surgeon or dentist that you are taking tadalafil if you are having surgery, including dental surgery.
• If you plan to consume alcohol while taking tadalafil, discuss this with your doctor. Tadalafil side effects like dizziness, headache, a rapid heartbeat, and low blood pressure are more likely to occur if you consume a lot of alcohol (more than five glasses of wine or five shots of whisky) while taking it.
• If you’re using tadalafil to treat erectile dysfunction, let your doctor know if you’ve ever received a warning from a medical expert to avoid sexual activity or if you’ve ever felt any kind of pain in your chest while having sex. If you already have heart problems, sexual activity could put additional stress on your heart. Avoid sexual activity unless your doctor instructs you otherwise if you have chest discomfort, nausea, or dizziness during sexual activity. Call your doctor right away or seek emergency medical attention.
• Inform all of your medical professionals that you are taking tadalafil. The medical professionals who treat you will need to know when you last took tadalafil if you ever require emergency medical care for a heart condition.

If you plan to consume grapefruits or grapefruit juice while taking this medication, consult your doctor.

Take the missing dose of tadalafil as soon as you remember if you regularly take it for erectile dysfunction. If the next dose is soon due, skip the missed one and carry on with your regular dosing plan. To make up for a missed dose, do not take a double dose or more than one dose per day.

Take the missing dose of tadalafil as soon as you remember if you are treating PAH or BPH with it. If the next dose is soon due, skip the missed one and carry on with your regular dosing plan. To make up for a missing dose, do not take a second one.

Tadalafil could have negative effects. If any of these symptoms are severe or do not go away, let your doctor know right once:

• Headache
• Bloating or heartburn
• Nausea
• Diarrhea
• Flushing
• Back, stomach, muscles, arms, or legs hurt
• Cough

Certain adverse effects can be very harmful. Call your doctor right away if you encounter any of these symptoms, or seek emergency care:

• Abrupt eyesight loss or deterioration (see below for more information)
• Fuzzy vision
• Alterations to colour vision (seeing a blue tinge on objects or having difficulty telling the difference between blue and green)
• Abrupt hearing loss or decline (see below for more information)
• Hearing ringing
• Longer than four-hour erection
• Dizziness
• Chest ache
• Hives
• Rash
• Breathing or swallowing challenges
• Edoema of the hands, feet, ankles, lower legs, cheeks, neck, tongue, lips, and eyes
• Blistering or skin shedding

After taking tadalafil or other drugs that are similar to tadalafil, some people abruptly lost some or all of their vision. In some cases, the eyesight loss was irreversible. It is unknown if the drug contributed to the visual loss. While taking tadalafil, if you suddenly lose your vision, call your doctor right away or seek emergency medical attention. Tadalafil and comparable drugs including sildenafil (Revatio, Viagra), vardenafil (Levitra), and others should not be taken again until you speak with your doctor.

When taking tadalafil or other drugs that are similar to tadalafil, some patients experienced an abrupt decline or loss of hearing. Usually, just one ear was affected by the hearing loss, and stopping the medicine did not always make things better. It is unknown if the drug contributed to the hearing loss. Call your doctor right away if you suddenly lose your hearing while taking tadalafil, sometimes with ringing in your ears or dizziness. Tadalafil and comparable drugs including sildenafil (Revatio, Viagra), vardenafil (Levitra), and others should not be taken again until you speak with your doctor.

Further negative effects of tadalafil are possible. If you experience any odd issues while taking this medication, contact your doctor right away.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online or by phone if you have a serious side event (1-800-332-1088).

Keep this medication tightly closed in the original container and out of the reach of children. Keep it away from excessive heat and moisture at room temperature (not in the bathroom).

Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilising a medicine take-back programme is the easiest approach to get rid of your medication. To find out about take-back programmes in your area, speak with your pharmacist or the garbage/recycling department in your city. If you do not have access to a take-back programme, see the FDA’s Safe Disposal of Medications website at http://goo.gl/c4Rm4p for additional information.

Although many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning. http://www.upandaway.org

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Moreover, information can be found online at https://www.poisonhelp.org/help. Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

Keep all of your doctor’s appointments.

No one else should take your medication. Any queries you may have regarding medication refills should be directed to your pharmacist.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.