Cialis

• Treats symptoms of erectile dysfunction
• Temporary improves the ability to get an erection
• Starts to work after about 30 minutes
• Lasts for up to 36 hours
• Also available in dose for daily use

CIALIS is used to treat adult men with erectile dysfunction (ED). This is a condition in which a man is unable to achieve or sustain an erection adequate for gratifying sexual activity.

CIALIS belongs to a class of medicines known as phosphodiesterase type 5 inhibitors. CIALIS causes the blood vessels in the penis to relax, allowing more blood to enter the penis when you are sexually aroused. This will improve your ability to get an erection. CIALIS will not help you if you do not have erectile dysfunction.

It is important to note that CIALIS does not work if there is no sexual stimulation. You and your partner will need to engage in foreplay, just as you would if you were not taking a medicine for erectile dysfunction.

CIALIS tablets are for oral use. The tablet should be swallowed whole with some water. CIALIS can be taken either with or without food.

CIALIS offers two dosing options: incidental (occasional) use, or daily use (CIALIS Once a Day). CIALIS Once a Day is intended for men who anticipate having sexual activity at least twice a week.

Dosage

Incidental use

The recommended dose is:

• Adults: one 10-mg tablet once a day, approximately 30 minutes before sexual activity. If the recommended dose of 10 mg is too weak, your doctor may adjust the dose to 20 mg.

The effect of CIALIS can last up to 36 hours.

Daily use (CIALIS Once a Day)

If you have sexual activity at least twice a week, CIALIS can also be taken daily, in a lower dose. The tablet should be taken every day at the same time each day, also on days without sexual activity. If you take this medicine once daily, you will be able to get an erection 24 hours a day when sexually stimulated.

The recommended dose of CIALIS Once a Day is:

• Adults: one 5-mg tablet once a day. Your doctor may adjust the dose to 2.5 mg depending on your response.

You should NOT take CIALIS more than once a day. CIALIS 10 mg and 20 mg are not recommended for continuous daily use. Use CIALIS as directed by your doctor. You should check with your doctor or pharmacist if you are not sure.

Alcohol/driving

Drinking alcohol may affect your ability to get an erection. Drinking alcohol may temporarily lower your blood pressure. If you have taken or are planning to take CIALIS, avoid excessive drinking (blood alcohol level of 0.08% or greater), since this may increase the risk of dizziness when standing up.

Stay out of traffic if you experience side effects that make you feel less alert than normal (e.g., dizziness or blurred vision).

CIALIS should not be used if:

• You are allergic to tadalafil or any other ingredient in this medicine.
• You are taking any form of organic nitrate or nitric oxide donors such as amyl nitrite. This is a group of medicines (nitrates) used in the treatment of angina pectoris (chronic chest pain). CIALIS has been shown to increase the effects of these medicines. You are taking any form of nitrate or are unsure, tell your doctor.
• You have serious heart disease or have had a recent heart attack.
• You have had a recent stroke.
• You have low blood pressure or uncontrolled high blood pressure.
• You have ever had loss of vision because of non-arteritic anterior ischemic optic neuropathy (NAION), a condition sometimes described as 'stroke of the eye'.

When should this medicine be used with caution?

Be aware that sexual activity carries a possible risk to patients with heart disease because it puts extra strain on your heart. If you have a heart problem you should tell your doctor.

The following are reasons why CIALIS may also not be suitable for you. If any of them apply to you, talk to your doctor before you take the medicine:

• You have sickle cell anaemia (an abnormality of red blood cells), multiple myeloma (cancer of the bone marrow), leukaemia (cancer of the blood cells) or any deformation of your penis.
• You have a serious liver problem.
• You have a serious kidney problem.

It is not known if CIALIS is effective in patients who have undergone pelvic surgery or radical non-nerve-sparing prostatectomy.

If you experience sudden decrease or loss of vision, stop taking CIALIS and contact your doctor immediately.

CIALIS is not to be used in women and adolescents under 18 years of age.

Other medicines and Cialis

Please tell your doctor if you are taking or have recently taken any other medicines, including medicines obtained without a prescription, because they might interact. This is particularly important if you are treated with nitrates as you should not take CIALIS if you are taking these medicines.

A type of medicine called an alpha blocker is sometimes used to treat high blood pressure and enlarged prostate. Tell your doctor if you are being treated for either of these conditions or if you take other medicines to treat high blood pressure.

If you are taking medicines that can inhibit an enzyme called CYP3A4 (for example ketoconazole or protease inhibitors for treatment of HIV) the frequency of side effects might increase.

Do not take CIALIS with other medicines if your doctor tells you that you may not.

You should not use CIALIS together with any other treatments for erectile dysfunction.

Like all medicines CIALIS can cause side effects, although not everyone gets them. These effects are normally mild to moderate in nature. The most common side effects are:

• Headache.
• Back pain.
• Muscle ache.
• Facial flushing.
• Nasal congestion.
• Dizziness.
• Stomach or intestinal problems.

Other reported side effects of CIALIS include:

• Skin rash.
• Blurred vision.
• Eye pain.
• Increased sweating.
• Faster than normal heartbeat (tachycardia), palpitations.
• High/low blood pressure.
• Chest pain.

See the package leaflet for a complete list of side effects. Consult a doctor if the side effects are severe or if you experience side effects that are not listed on the package leaflet.

The active substance is tadalafil. Each tablet contains 2.5 mg, 5 mg, 10 mg or 20 mg of tadalafil.