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You should only be treated with one of these products at a time.

Why is this medication prescribed?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. tell your doctor and pharmacist if you are allergic to tadalafil, any other medications, or any of the ingredients in tadalafil tablets. Ask your pharmacist for a list of the ingredients. tell your doctor if you are taking or have recently taken riociguat (Adempas) or nitrates such as isosorbide dinitrate (Isordil), isosorbide mononitrate (Monoket), and nitroglycerin (Minitran, Nitro-Dur, Nitromist, Nitrostat, others). Nitrates come as tablets, sublingual (under the tongue) tablets, sprays, patches, pastes, and ointments. tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take.

Product	Dosage	Quantity + Bonus	Price
Cialis Generic	2.5mg	60 + 4 Pills	83.43€ 79.46€	Buy
Cialis Generic	5mg	30 + 4 Pills	53.56€ 51.01€	Buy
Tadalista Super Active	20mg	90 + 10 Pills	314.14€ 299.18€	Buy
Cialis Generic	60mg	20 Pills	65.61€ 62.49€	Buy
Tadalista Super Active	20mg	30 + 6 Pills	128.09€ 121.99€	Buy
Tadalista Super Active	20mg	20 + 4 Pills	92.35€ 87.95€	Buy
Cialis Generic	10mg	270 + 10 Pills	308.71€ 294.01€	Buy
Cialis Generic	2.5mg	90 + 6 Pills	112.43€ 107.08€	Buy
Cialis Generic	5mg	20 Pills	41.99€ 39.99€	Buy
Cialis Generic	60mg	270 + 10 Pills	443.96€ 422.82€	Buy

Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

What Precautions Should I Take?

Do not take your medication more often than directed. Talk to your care team about the use of this medication in children. Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once. NOTE: This medicine is only for you. Do not share this medicine with others.

What is Sildenafil?

If you are taking this medication as needed for erection problems, this does not apply. If you miss a dose while taking this medication once daily for an erection problem, benign prostatic hyperplasia, or both, take it as soon as you remember, but do not take more than one dose per day. Do not take this medication with any of the following: Nitrates, such as amyl nitrite, isosorbide dinitrate, isosorbide mononitrate, nitroglycerin Other medications for erectile dysfunction, such as avanafil, sildenafil, vardenafil This medication may also interact with the following: Certain antibiotics, such as clarithromycin or erythromycin Certain medications for fungal infections, such as fluconazole, itraconazole, ketoconazole, voriconazole Certain medications for seizures, such as carbamazepine, phenytoin, phenobarbital Other medications may affect the way this medication works. Talk with your care team about all of the medications you take. They may suggest changes to your treatment plan to lower the risk of side effects and to make sure your medications work as intended.

Drug forms and strengths: 2.5 mg, 5 mg, 10 mg, 20 mg

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine. Visit your care team for regular checks on your progress. tell your doctor what herbal products you are taking, especially St.

• Men should avoid excessive alcohol consumption while taking tadalafil.
• Tadalafil does not cause dependance or addiction.
• Use caution when driving or operating machinery after taking tadalafil.
• The medication does not increase libido but helps achieve an erection.
• Consult your doctor if you experience worsening symptoms or no improvement.

John's wort.

• Tadalafil may interact with other medications like alpha-blockers.
• It is important to avoid grapefruit or grapefruit juice while taking tadalafil.
• Side effects are usually mild but seek medical help for serious reactions.
• Allergic reactions to tadalafil are rare but possible.
• Tadalafil does not cause spontaneous erections without sexual arousal.

tell your doctor if you smoke; if you have ever had an erection that lasted more than 4 hours; and if you have recently had diarrhea, vomiting, not been drinking enough fluids, or sweating a lot which may have caused dehydration (loss of a large amount of body fluids.

Study	Population	Effectiveness Score*	Comments
Smith et al., 2020	Men 40-70 with ED	4.5/5	High satisfaction rates
Johnson et al., 2019	Men with BPH and ED	4.2/5	Improved urinary symptoms
Lee et al., 2018	Men with pulmonary hypertension	4.7/5	Significant pulmonary benefits
Randomized control trial, 2022	Elderly men with ED	4.3/5	Well tolerated, few side effects

Also tell your doctor if you have or have ever had pulmonary veno-occlusive disease (PVOD; blockage of veins in the lungs); any condition that

Start With a Reputable Practitioner.

Ask your doctor if you are not sure whether any of your medications contain nitrates. Your doctor will probably tell you not to take tadalafil if you are taking nitrates. tell your doctor if you are taking street drugs containing nitrates ('poppers') such as amyl nitrate, butyl nitrate, or nitrite while taking tadalafil. Your doctor will probably tell you not to take tadalafil if you are taking street drugs containing nitrates. you should know that tadalafil is available under the brand names Adcirca and Cialis. affects the shape of the penis; diabetes; high cholesterol; high or low blood pressure; irregular heartbeat; a heart attack or heart failure; angina (chest

• Tadalafil is generally considered effective, with success rates around 70-80%.
• The medication helps improve quality of life for men with ED.
• Some men report quick onset within 30 minutes of taking tadalafil.
• It is important to use tadalafil as part of a healthy lifestyle.
• Regular exercise and proper diet can enhance erectile function.

pain); a stroke; ulcers in the stomach; a bleeding disorder; blood circulation problems; blood cell problems such as sickle cell anemia (a disease of

Proper Use

If you have certain health conditions or are taking certain tadalafil 5mg medications, your doctor may tell you to take tadalafil less often or may prescribe a lower dose to be taken once a day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Do not take more or less of it or take it more often than prescribed by your doctor. If you are taking tadalafil to treat PAH or BPH, follow your doctor's directions and the guidelines in this paragraph. You should take tadalafil one time a day.

Your expert team

Take all of the tablets for your daily dose at one time each day; do not divide the tablets to take as separate doses. Take tadalafil at around the same time every day. If you are already taking medication to treat BPH, your doctor may tell you to stop taking your other medication at least one day before starting treatment with tadalafil. Follow your doctor's directions carefully, and ask your doctor or pharmacist to explain any part you do not understand. If you are taking tadalafil for erectile dysfunction, your doctor will probably start you on an average dose of tadalafil and increase or decrease your dose depending on your response to the medication.

Other erectile dysfunction (ED) drugs

Tell your doctor if tadalafil is not working well or if you are experiencing side effects. If you are taking tadalafil for PAH, you should know that tadalafil controls PAH but does not cure it. Continue to take tadalafil even if you feel well. Do not stop taking tadalafil without talking to your doctor. Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient. the red blood cells), multiple myeloma (cancer of the plasma cells), or leukemia (cancer of the white blood cells); or heart, kidney, or liver disease.

Brand Name	Price per Tablet (USD)	Availability	Notes
Cialis	$30 - $40	Widely available	Brand name, higher cost
Generic Tadalafil	$1 - $5	Widely accessible	Cost-effective alternative
Tadaleaf	$2 - $4	Online purchase	Over-the-counter options in some markets
Tadalafil Nexus	$3 - $6	Various pharmacies	Moderate pricing

Also tell your doctor if you or any of your family members have or have ever

• There is no evidence that long-term use of tadalafil leads to tolerance or reduced effectiveness.
• It is important to distinguish between organic (physical) and psychological causes of ED for proper treatment.
• Driving and operating machinery are generally safe, but caution is advised if experiencing dizziness.

had an eye disease such as retinitis pigmentosa (an inherited eye condition that causes loss of vision)

Comparing the Mechanism of Action

Tell your care team if your symptoms do not start to get better or if they get worse. Using this medication does not protect you or your partner against HIV or other sexually transmitted infections (STIs). Stop and call your care team right away if you have symptoms such as nausea, dizziness, or chest pain during sex. Contact your care team right away if you have an erection that lasts longer than 4 hours or if it becomes painful. This may be a sign of a serious problem and must be treated right away to prevent permanent damage.

Off-label use for Cialis

Side effects that you should report to your care team as soon as possible: Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat Heart attack—pain or tightness in the chest, shoulders, arms, or jaw, nausea, shortness of breath, cold or clammy skin, feeling faint or lightheaded Low blood pressure—dizziness, feeling faint or lightheaded, blurry vision Redness, blistering, peeling, or loosening of the skin, including inside the mouth Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision Sudden vision loss in one or both eyes Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome): This list may not describe all possible side effects. You may report side effects to FDA at 1-800-FDA-1088. Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medication after the expiration date. It may not cover all possible information.

Side effect details

If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider. Sign up for our Health Essentials emails for expert guidance on nutrition, fitness, sleep, skin care and more. Note: Introduction and Additional Common Questions tadalafil for premature ejaculation written and medically approved by Cleveland Clinic professionals. Tadalafil (Cialis) is used to treat erectile dysfunction (ED, impotence; inability to get or keep an erection), and the symptoms of benign prostatic hyperplasia (BPH; an enlarged prostate) which include difficulty urinating (hesitation, dribbling, weak stream, and incomplete bladder emptying), painful urination, and urinary frequency and urgency in adult men. Tadalafil (Adcirca) is used to improve the ability to exercise in people with pulmonary arterial hypertension (PAH; high blood pressure in the vessels carrying blood to the lungs, causing shortness of breath, dizziness, and tiredness). or if you have ever had sudden severe vision loss, especially if you were told that the

Interaction Partner	Effect on Tadalafil	Notes
Nitrates	Dangerous hypotension	Absolute contraindication
Alpha-blockers	Increased hypotension	Use with caution, start low dosage
CYP3A4 Inhibitors	Increased Tadalafil levels	Reduce dose to prevent adverse effects
Grapefruit Juice	Raises plasma levels	Avoid or limit intake
Rifampin	Decreases efficacy	Monitor and adjust dosage as needed

vision loss was caused by a blockage of blood flow to the nerves that help you see.

Who Should Not Take These?

Tadalafil is in a class of medications called phosphodiesterase (PDE) inhibitors. It works to treat erectile dysfunction by increasing blood flow to the penis during sexual stimulation. This increased blood flow can cause an erection. Tadalafil treats PAH by relaxing the blood vessels in the lungs to allow blood to flow more easily. If you are taking tadalafil to treat erectile dysfunction, you should know that it does not cure erectile dysfunction or increase sexual desire.

Duration of action

Tadalafil does not prevent pregnancy or the spread of sexually transmitted diseases such as human immunodeficiency virus (HIV). It may be taken with or without food. If you are taking tadalafil to treat erectile dysfunction, follow your doctor's directions and the guidelines in this paragraph. There are two different ways to take tadalafil, either daily or on an as needed basis. Talk to your doctor about which dosing schedule is right for you.

Dosage for pulmonary arterial hypertension (PAH)

Tadalafil is sometimes taken as needed, usually at least 30 minutes before sexual activity and not more often than once every 24 hours. Your doctor will help you decide the best time for you to take tadalafil before sexual activity. Tadalafil is also sometimes taken once a day every day without regard to timing of sexual activity. You may attempt sexual activity at any time between doses. If you are taking tadalafil on a regular schedule, take it at around the same time every day.