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Interactions

A. Top Drug-Drug Interactions:

1.Nitrates (e.g., nitroglycerin, isosorbide dinitrate): Cialis and nitrates both lower blood pressure. Taking them together can cause a significant and potentially life-threatening drop in blood pressure (hypotension), leading to dizziness, fainting, or even heart attack or stroke. It is contraindicated to use Cialis with nitrates or recreational "poppers" (amyl nitrites).

2.Alpha-blockers (e.g., prazosin, terazosin, tamsulosin): Both Cialis and alpha-blockers relax blood vessels, which can lead to excessive blood pressure reduction when used together. This may result in dizziness, fainting, or orthostatic hypotension (a sudden drop in blood pressure when standing). If needed, your doctor may adjust the dosage or recommend spacing the medications.

3.Other antihypertensive drugs (e.g., atenolol, propranolol, enalapril, lisinopril): Cialis can enhance the blood-pressure-lowering effects of these medications. While this interaction is usually less severe than with nitrates or alpha-blockers, it can still cause dizziness or fainting in sensitive individuals. Close monitoring of blood pressure is recommended.

Other Drug-Drug interactions:

• Ketoconazole, itraconazole (used to manage fungal infection)
• Protease inhibitors (used to manage HIV infection) Ex. ritonavir, lopinavir
• Phenobarbital, phenytoin, carbamazepine (medicines used for fits)
• Rifampicin, erythromycin, clarithromycin (medicines used for bacterial infections)
• Other medicines used to improve blood flow to the penis (Ex. sildenafil)

B. Drug-Food Interactions:

Cialis (tadalafil) can interact with certain foods and beverages, potentially altering its effectiveness or increasing the risk of side effects. Here are the key drug-food interactions to be aware of:

1. Grapefruit and Grapefruit Juice: Grapefruit can increase the levels of tadalafil in your blood by interfering with its metabolism. This may amplify side effects, such as headaches, dizziness, or low blood pressure. Avoid consuming grapefruit or grapefruit juice while taking Cialis.
2. Alcohol: Drinking alcohol with Cialis can enhance the blood pressure-lowering effects of the medication, leading to symptoms like dizziness, lightheadedness, or fainting. Limiting alcohol intake is recommended while using Cialis.
3. High-Fat Meals: While Cialis can be taken with or without food, consuming it with a high-fat meal may delay its onset of action. Opt for lighter meals if rapid effectiveness is needed.
4. Caffeine: Though not a direct interaction, combining Cialis with high caffeine intake might worsen side effects like headaches or increase heart rate in sensitive individuals.

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Key Takeaways

• Cialis (tadalafil) is a prescription medication designed to treat erectile dysfunction (ED) in men.
• Symptoms of diabetes can include difficulty achieving and maintaining an erection, and side effects of Cialis can include dizziness, headache, and fainting.
• Fluid is essential for blood flow to the penis, which may lead to fainting or symptoms of heart problems like chest pain.
• Use Cialis with caution in individuals with heart disease, and conversations with healthcare providers are recommended to avoid sensitive individuals.
• Not recommended for individuals with pre-existing cardiovascular conditions or a history of these conditions.
• Individuals taking heart disease medications may be at increased risk for adverse cardiovascular events, including cardiovascular-tenderness.
• Cialis should be used with caution and terazosin should be used as it decreases the risk of side effects.

Whether you can take Tadalafil at the same time as your other medications will depend on which medications you are taking.

You are required to complete a short medical consultation questionnaire that asks for any medications that you are prescribed from your GP and will indicate the medications that can’t be taken alongside Tadalafil.

There are several medicines which should not be taken concurrently with Tadalafil. Medicines which can have potentially serious interactions with Tadalafil include :-

• Any alpha-blocker medicines e.g. doxazosin (Cardura), alfuzosin (Xatral), tamsulosin, terazosin, or Flomax, that you can buy in the pharmacy. (These medicines may be used to treat prostate problems or high blood pressure).

• Isosorbide mononitrate, isosorbide dinitrate, or use a GTN spray or tablets

for chest pain or use Rectogesic ointment?

• Nicorandil (Ikorel), used to treat angina

• Cimetidine, used to treat stomach or duodenal (peptic) ulcers

• Theophylline, used to treat asthma

• Antibiotics:- Clarithromycin, Erythromycin and Telithromycin

• Anti-fungals such as itraconazole and ketoconazole

• Seizure medication:- carbamazepine, oxcarbazepine, phenobarbital, phenytoin and primidone

• Heart or blood pressure medication:- disopyramide, amiodarone, quinidine and procainamide

• Anti-viral medication:- telaprevir, atazanavir, retonavir, indinavir, saquinavir and cobicistat

• Recreational drugs:- amyl nitrate (poppers)

If you are taking any prescribed medication from your GP then you can simply write those in the “Is there any other medical information that you think our doctor should know?” section on the medical questionnaire. Then, our doctor will know whether the Tadalafil is safe for you to take.

Read available consultation questions posted by Dr Fox atOur Place:

• How to split Tadalafil
• How to take Tadalafil with or without a blood pressure medication
• WhatTo expect with Tadalafil taking the full course
• Where to take the full prescribing information
• Who should use Tadalafil?
• Tadalafil’s side effects
• When to avoid:- high blood pressure-narrowing-enlargement-blood pressure-narrowing-angle-heart-tract-angle
• How to manage:-diabetic foot ulcers-diabetic ulcers-dental ulcers-temporary ulcers
• Severity of any side effect?

Is the full text of this medicine valid?

• Tadalafil cannot be taken with other blood pressure medication. Therefore, you may need to take a different dose or three times theACHALIFEsterdamlanding.
• Dr Fox does not recommend drinking alcohol whilstusing Tadalafil.
• If you have any thoughts are there any treatment suggestions?

• Talk to your GP or pharmacist If you believe that Tadalafil can’t be taken alongside yourother medications then we recommend that you speak to your pharmacist or physician first regarding the possible benefits and potential risks of Tadalafil alongside your other medications.
• Tadalafil is not suitable for you. Do not take Tadalafil if you are taking any alpha-blocker medication such as e.g. alfuzosin, for example. Also, do not take Tadalafil if you are taking a long-term medication like disopyramide or amylose.

References:

1. Miniccia, C. C., M. V. L. M. S. et. al. The safety and efficacy of Tadalafil in patients with erectile dysfunction.

Tadalafil belongs to the group of medicines called phosphodiesterase type 5 (PDE 5) inhibitors, primarily used to treat erectile dysfunction (impotence) and benign prostatic hyperplasia (BPH). Erectile dysfunction is the inability to keep a hard and erect penis suitable for sexual activity. Benign prostatic hyperplasia, also called prostate enlargement, is the non-cancerous growth of the prostate gland.

Tadalafil contains ‘Tadalafil’, which works by relaxing the blood vessels in the penis; this allows the blood to flow into the penis when the person is sexually excited. Thereby, it helps to treat erectile dysfunction. Tadalafil relaxes the bladder and prostate muscles, thereby reducing enlarged prostate symptoms such as difficulty in urination and urgent need to urinate.

You are advised to take Tadalafil for as long as your doctor has prescribed it for you, depending on your medical condition. In some cases, you may experience certain common side effects, such as headache, back pain, muscle pain, pain in the legs and arms, nasal congestion, indigestion, and facial flushing. Most of these side effects do not require medical attention and will resolve gradually over time. However, you are advised to talk to your doctor if you experience these side effects persistently.

Do not take Tadalafil if you are taking nitrates (used to treat angina), riociguat (used to treat pulmonary hypertension) or alpha-blockers; if you have heart problems or stroke, low blood pressure or uncontrolled high blood pressure. Tadalafil is not intended for use in women. Tadalafil may cause dizziness, so drive with caution. Avoid consuming alcohol as it might cause increased dizziness. Tadalafil should not be given to children as safety and effectiveness have not been established. Keep your doctor informed about your health condition and the medicines you are taking to avoid unpleasant side effects.

Read the label of

Tadalafilichil Name or Generic Name: TadalafilCoadministration There has been an increasing occurrence of drug interactions with other medications. It may result in the combination of the drugs increasing the risk of side effects such as serious blood pressure (hypertension), low blood pressure (vascular disorders), and breast cancer. These complications can occur when the medications co-administered with drugs that are not used with medications that are used only by one person. This could lead to reduced effectiveness of the treatment and an increased risk of blood clots.

If you are using this medication for the first time, you should not use it. The interaction with Cialis or other tadalafil oral medications may occur if you have had a heart attack within the last six months and if you are also taking nitrates. You should inform your doctor if you are taking any other medications. If you are taking any of these medications, you should avoid taking Tadalafil.

Tadalafil may cause lower breastuity (light-colored breast tissue) due to an increased risk of breast cancer. You are advised to use caution when breast-feeding.

Read the warning label of

Tadalafil Generic Name: CialisTadalafil Brand Name: Tadalafil Dosage: Initial Generic: 25mg Once Daily: 5mg

If you are taking medications to treat erectile dysfunction, such as nitrates, alpha-blockers or used in prostate surgery, you may experience headaches, dizziness, dizziness/fainting and swollen legs. These side effects are usually mild and temporary. Consult your doctor before taking tadalafil for erectile dysfunction.

Tadalafil may interact with certain medications, vitamins, antibiotics, antifungals, HIV drugs, blood clot meds, HIV/AIDS virus or hepatitis C medications. Before taking tadalafil, tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbs. Some medicines may interact with Tadalafil. This includes antibiotics, antifungals, HIV drugs, blood clot meds, certain vitamins, anti-HIV drugs, blood pressure meds, HIV drugs, blood thinners, blood cancer meds, sleeping pills, herbal products and other herbal supplements. Do not take tadalafil if you are taking any of the following medications as they may interact: nitrates, alpha-blockers, used in prostate surgery, riociguat (used to treat pulmonary hypertension).

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