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There are two methods for administration of this medicine - once-a-day dose, and taken when required. It can be taken regardless of food, but your physician will determine the most suitable dose for you.

For once-a-day dose, the initial dose is of 2.5mg, taken at the same time each day, which can be increased by the doctor to 5mg, depending upon individual tolerability and response. For those who take it when needed, a 10mg dose is initially recommended, taken half an hour before engaging in sexual activity, which may be increased to 20mg, or decreased to 5mg, depending upon the medical condition of the individual. Adhere to the dose prescribed by your physician as taking a higher dose may result in serious side effects.

Some common side effects are:-

• Headache,Muscular pain, Backache, Indigestion, Diarrhea, Runny or stuffy nose, Flushing.

You should stop using this medicine and contact your doctor immediately if any of these symptoms persist or worsen, or any other unusual symptoms occur, such as:-

• Chest pain


• Priapism [painful or unduly prolonged erection]


• Sudden decrease or loss of hearing


• Sudden decrease or loss of vision


• Difficulty in distinguishing between different colors, such as between green and blue


• Fainting.

Some drugs taken alongwith Tadalafil can cause dangerously low BP, while others can decrease the effect of Tadalafil. These include:-

• Alpha-blocking drugs which are taken to treat high BP;


• CYP3A4 inhibitors [anti-fungals like Ketoconazole; or macrolide antibiotics like Erthromycin];


• CYP3A4 inducers [anti-epileptics like Phenytoin; or anti-tuberculosis like Rifampin];


• Anti-seizure medicines [like Carbamazepine, or Phenobarbital];


• HIV protease inhibitor [like Ritonavir].


Contraindication
Do not take Cialis if you:-

• Are allergic to Cialis, or any of its ingredients;


• Are taking Organic nitrates, which are meant to relieve angina [such as nitroglycerin, isosorbide dinitrate, isosorbide mononitrate, or glyceryl trinitrate spray];


• Are taking recreational drugs called "poppers" that also contain nitrates [such as amyl nitrite and butyl nitrite];


• Have had a myocardial infarction within the last 90 days, or have suffered from heart failure or a stroke in the last 6 months, or suffer from angina [especially during intercourse].

If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. In the unlikely event of the victim collapsing or not breathing, call local emergency services at 911.

Consult your health care professional about the risks of taking this medicine for your condition before starting on a course with this medicine.

If you experience loss of sight in one or both eyes stop this medication immediately and contact your doctor.

Do not drink alcohol while on this medication as this may increase the chances of low blood pressure, or erratic heart rates.

If you need to undergo any kind of surgery, inform your doctor you are taking this medicine.

Do not take more than one dose in a day.

Ask your doctor for more information.

It should be stored ideally at a room temperature of 25oC, or between 15oC-30oC protected heat, light and dampness; and, kept away from children and pets.

• At the onset of therapy, inform your physician if you have any heart problem, liver or kidney problems, stomach ulcers, blood pressure which may be low or high and remains unstable, bleeding problem, blood cell problems [such as sickle cell anemia/multiple myeloma/leukemia], retinitis pigmentosa [rare genetic eye disease], or if you’ve had a stroke, have a deformed penis, or ever had priapism [painful or prolonged erection].


• Also inform your physician about all the medicines - prescription and OTC, including all nutritional supplements-herbal products you are taking, and mention any allergies you have to food or medicine.


• Avoid excessive intake of alcohol, grapefruit or grapefruit juice while taking Cialis, for it can be fatal otherwise.


• Cialis is not meant for women.


• This medicine is not recommended for use in those below 18.


• Usage of this drug does not protect against sexually transmitted diseases - practice safe sex.

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