Tadalafil

• Tadalafil is used to treat male sexual function problems, including impotence or erectile dysfunction (ED). In combination with sexual stimulation, Tadalafil works by increasing blood flow to the penis to help a man get and keep an erection.
• This drug does not protect against sexually transmitted diseases such as HIV, hepatitis B, gonorrhea and syphilis. Practice "safe sex" using latex condoms. 
• Request a medical provider callback from your patient dashboard for more details.

• Take this medication by mouth, with or without food, as directed by your medical provider. Do not take Tadalafil more than once daily.
• The manufacturer directs patients to swallow this medication whole. However, many similar drugs—immediate-release tablets, for example—can be split or crushed. Follow your medical provider's directions on how to take this medication.
• Your prescribed dosage is based on your medical condition, response to treatment and other medications you may be taking. Be sure to tell your medical provider and pharmacist about all the products you use, including prescription drugs, nonprescription drugs and herbal products.
• Your medical provider will determine the best way for you to take Tadalafil. Follow your medical provider's directions exactly since your dosage depends on how you are taking it.

• To treat erectile dysfunction, there are two ways that Tadalafil may be prescribed:

  • The first way to treat ED is to take it as needed, usually at least 30 minutes before sexual activity. Tadalafil's effect on sexual ability may last up to 36 hours.
  • The second way is to take the medication once a day, every day. If you take it this way, you may attempt sexual activity at any time between your doses. However, when taken on a daily basis, Tadalafil should be prescribed and taken at a lower dosage. 
• If you are taking Tadalafil to treat both ED and benign prostatic hyperplasia (BPH), take it as directed by your medical provider, usually once a day. You may attempt sexual activity at any time between your doses.
• If you are taking Tadalafil once daily for BPH, ED, or for both, take it regularly to get the most benefit from it. To help you remember, take it at the same time each day.
• Request a medical provider callback if your condition does not improve or worsens, or if you have any questions.

• Headache, stomach upset, back pain, muscle pain, stuffy nose, flushing or dizziness may occur. If any of these effects last or get worse, request a medical provider callback promptly.
• To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.
• Remember that this medication has been prescribed because your medical provider has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
• Sexual activity may put extra strain on your heart, especially if you have heart problems. If you have heart problems and experience any of these serious side effects while having sex, stop and get medical help right away: severe dizziness, fainting, chest/jaw/left arm pain or nausea.

• In rare cases, sudden decreased vision, including permanent blindness in one or both eyes (NAION) may occur. If you experience this, stop taking Tadalafil and get medical help right away. You have a slightly greater chance of developing NAION if you have:

  • Heart disease
  • Diabetes 
  • High cholesterol
  • Certain other eye problems, including "crowded disk"
  • High blood pressure
  • Are over 50
  • Are a smoker
• In rare cases, a sudden decrease or loss of hearing—sometimes combined with ringing in the ears and dizziness—may occur. If you experience this, stop taking Tadalafil and get medical help right away.
• In the rare event you have a painful or prolonged erection lasting 4 or more hours, stop using this drug and get medical help right away to prevent permanent complications.
• A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the  face/tongue/throat), severe dizziness or trouble breathing.
• This is not a complete list of possible side effects. If you notice other effects not listed above, contact us. You may also report side effects to the FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

• Before taking Tadalafil, tell your medical provider or pharmacist if you are allergic to it or have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Request a medical provider callback for more details.

• Before using this medication, provide us with your medical history, especially of:

  • Heart problems such as heart attack or life-threatening irregular heartbeat in the past 6 months
  • Chest pain/angina
  • Heart failure
  • Stroke in the past 6 months
  • Kidney disease
  • Liver disease
  • High or low blood pressure
  • Dehydration
  • Penis conditions such as angulation, fibrosis/scarring or Peyronie's disease
  • History of painful/prolonged erection (priapism)
  • Conditions that may increase the risk of priapism such as sickle cell anemia, leukemia or multiple myeloma
  • Eye problems such as retinitis pigmentosa, sudden decreased vision or NAION
  • Bleeding disorders 
  • Active stomach ulcers
• This drug may make you dizzy, especially when combined with alcohol or marijuana (cannabis). Do not drive, use machinery, or do anything that requires alertness until you can do it safely. Limit alcoholic beverages. Let us know if you are using marijuana.
• Before having surgery, tell your prescriber about all the products you use including prescription drugs, nonprescription drugs and herbal products.

• Drug interactions may change how your medications work or increase your risk for serious side effects.
• This webpage does not contain all possible drug interactions. Keep a list of all the products you use, including prescription/nonprescription drugs and herbal products, and share it with your prescriber. 
• Do not start, stop or change the dosage of any medicines without your medical provider's approval.
• Tadalafil can cause a serious drop in your blood pressure when used with nitrates, possibly leading to dizziness, fainting and in rare cases heart attack or stroke. Do not use any of the following with Tadalafil or within 48 hours of your last dose of Tadalafil: certain drugs used to treat chest pain/angina, including nitrates such as nitroglycerin and Isosorbide, or recreational drugs containing amyl or butyl nitrite, known as “poppers.”
• If you are also taking an alpha blocker medication such as Doxazosin or Tamsulosin to treat an enlarged prostate/BPH or high blood pressure, your blood pressure may get too low, leading to dizziness or fainting. Your medical provider may start treatment with a lower dose of Tadalafil or adjust your alpha blocker medication to minimize your risk of low blood pressure.

• Other medications can affect the removal of Tadalafil from your body, which may affect how Tadalafil works. Examples include:

  • Azole antifungals such as Itraconazole and Ketoconazole
  • Macrolide antibiotics like Clarithromycin and Erythromycin
  • HIV protease inhibitors such as Fosamprenavir and Ritonavir
  • Rifampin
• Do not take this medication with any other product that contains Tadalafil or other similar medications used to treat erectile dysfunction or pulmonary hypertension such as Sildenafil or Vardenafil.
• Riociguat may interact with this drug.

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call your local poison control center at 1-800-222-1222 right away.

Do not share this medication with others.

• If you are taking this medication on a regular schedule and you miss a dose, take it as soon as you remember.
• If it is near the time of the next dose, skip the missed dose and take your next dose at the regular time. 
• Do not double the dose to catch up.

• Store at room temperature away from light and moisture.
• Do not store in the bathroom. Keep all medications away from children and pets.
• Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.