What is Cialis (tadalafil)? CIALIS is a prescription medicine taken by mouth for the treatment of erectile dysfunction (ED) in men. ED is a condition where the penis does not harden and expand when a man is sexually excited, or when he cannot keep an erection. A man who has trouble getting or keeping an erection should see his doctor for help if the condition bothers him. CIALIS may help a man with ED get and keep an erection when he is sexually excited.

How does Cialis (tadalafil) work?
Cialis acts in the same way as Viagra, by blocking an enzyme called phosphodiesterase-5, or PDE-5. Cialis is more targeted than Viagra which results in fewer sides effects and lower dosage. Cialis helps the smooth muscles in the penis relax and widen, which allows for more blood to enter. As a result, you gain erections faster and easier with Cialis.

How well does Cialis (tadalafil) work?
Cialis is approved in authorized markets for the treatment of mild to severe ED at both 10 and 20 mg Cialis doses. When you buy Cialis, the labels in each of these markets indicate that the product should be taken prior to anticipated sexual activity and without regard to food. Just like Viagra, sexual stimulation is needed for Cialis to work. According to the European label, the efficacy of Cialis may persist up to 24 hours after the pill is taken. In Australia and United States the label indicates efficacy up to 36 hours after dosing.

Who can not use Cialis?
Cialis is not for everyone. Men taking any form of nitrates (often used to control anginal chest pain) should never take Cialis, as the combination may cause an unsafe drop in blood pressure. Men taking medicines called "alpha blockers" (sometimes prescribed for prostate problems or high blood pressure), with exception of Flomax® (tamsulosin HCl) 0.4 mg once-daily, should not take Cialis. This side effects from this combination could cause a significant drop in blood pressure.
learn more about Cialis - and see how it compares to Levitra and Viagra

CIALIS can cause your blood pressure to drop suddenly to an unsafe level if it is taken with certain other medicines. You could get dizzy, faint, or have a heart attack or stroke.

Who should not take CIALIS?

Do not take CIALIS if you:

take any medicines called nitrates. Nitrates are commonly used to treat angina. Angina is a symptom of heart disease and can cause pain in your chest, jaw, or down your arm. Medicines called nitrates include nitroglycerin that is found in tablets, sprays, ointments, pastes, or patches. Nitrates can also be found in other medicines such as isosorbidedinitrate or isosorbide mononitrate. Some recreational drugs called "poppers" also contain nitrates, such as amyl nitrite and butyl nitrite. Do not use CIALIS if you are using these drugs. Ask your doctor or pharmacist if you are not sure if any of your medicines are nitrates.

you have been told by your healthcare provider to not have sexual activity because of health problems. Sexual activity can put an extra strain on your heart, especially if your heart is already weak from a heart attack or heart disease.
are allergic to CIALIS or any of its ingredients. The active ingredient in CIALIS is called tadalafil. See the end of this leaflet for a complete list of ingredients.

What should you discuss with your doctor before taking CIALIS?
Before taking CIALIS, tell your doctor about all your medical problems, including if you:
have heart problems such as angina, heart failure, irregular heartbeats, or have had a heart attack. Ask your doctor if it is safe for you to have sexual activity.

• have low blood pressure or have high blood pressure that is not controlled
• have had a stroke
• have liver problems
• have kidney problems or require dialysis
  have retinitis pigmentosa, a rare genetic (runs in families) eye disease
• have stomach ulcers
• have a bleeding problem
• have a deformed penis shape or Peyronie's disease
• have had an erection that lasted more than 4 hours
• have blood cell problems such as sickle cell anemia, multiple myeloma, or leukemia

General Information about CIALIS:
Medicines are sometimes prescribed for conditions other than those described in patient information leaflets. Do not use CIALIS for a condition for which it was not prescribed. Do not give CIALIS to other people, even if they have the same symptoms that you have. It may harm them.

What are the possible side effects of CIALIS?
The most common side effects with CIALIS are headache, indigestion, back pain, muscle aches, flushing, and stuffy or runny nose. These side effects usually go away after a few hours. Patients who get back pain and muscle aches usually get it 12 to 24 hours after taking CIALIS. Back pain and muscle aches usually go away by themselves within 48 hours. Call your doctor if you get a side effect that bothers you or one that will not go away.

CIALIS may uncommonly cause an erection that won't go away (priapism). If you get an erection that lasts more than 4 hours, get medical help right away. Priapism must be treated as soon as possible or lasting damage can happen to your penis including the inability to have erections.

CIALIS may uncommonly cause vision changes, such as seeing a blue tinge to objects or having difficulty telling the difference between the colors blue and green.

In rare instances, men taking PDE5 inhibitors (oral erectile dysfunction medicines, including CIALIS) reported a sudden decrease or loss of vision in one or both eyes. It is not possible to determine whether these events are related directly to these medicines, to other factors such as high blood pressure or diabetes, or to a combination of these. If you experience sudden decrease or loss of vision, stop taking PDE5 inhibitors, including CIALIS, and call a doctor right away.

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