DOSAGE FORMS AND STRENGTHS

Your healthcare provider will prescribe the dose that is right for you.

5.6 Alpha-blockers and Antihypertensives

(See “What Is The Most Important Information I Should Know About CIALIS?”) take any medicines called guanylate cyclase stimulators, such as riociguat. are allergic to CIALIS or ADCIRCA®, or any of its ingredients. See the end of this leaflet for a complete list of ingredients in CIALIS. Symptoms of an allergic reaction may include:rashhivesswelling of the lips, tongue, or throatdifficulty breathing or swallowing swelling of the lips, tongue, or throat Call your healthcare provider or get help right away if you have cialis canada over the counter any of the symptoms of an allergic reaction listed above. What Should I Tell My Healthcare Provider Before Taking CIALIS?

Benign prostatic hyperplasia

Only your healthcare provider and you can decide if CIALIS is right for you. Before taking CIALIS, tell your healthcare provider about all your medical problems, including if you: have heart problems such as angina, heart failure, irregular heartbeats, or have had a heart attack. Ask your healthcare provider if it is safe for you to have sexual activity. You should not take CIALIS if your healthcare provider has told you not to have sexual activity because of your health problems. have low blood pressure or have high blood pressure that is not controlled have retinitis pigmentosa, a rare genetic (runs in families) eye disease have ever had severe vision loss, including a condition called NAION have a deformed penis shape or Peyronie's disease have had an erection that lasted more than 4 hours have blood cell problems such as sickle cell anemia, multiple myeloma, or leukemia Tell your healthcare provider about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Some men can only take a low dose of CIALIS or may have to take it less often, because of medical conditions or medicines they take.

Variant Name	Active Ingredient	Potency	Available Forms	Price Range (USD)
Cialis Lily Classic	Tadalafil 10 mg	Moderate	Tablet	15-30
Cialis Lily Forte	Tadalafil 20 mg	High	Capsule	25-45
Cialis Lily Mini	Tadalafil 5 mg	Low	Chewable Tablet	10-20
Cialis Lily Ultra	Vardenafil 10 mg	Moderate	Tablet	20-40

Do not change your dose or the way you take CIALIS without talking to your healthcare provider.

Medication Type	Possible Interaction	Warning Level
Nitrates	Severe hypotension risk	High
Blood pressure meds	Enhanced effect, risk of hypotension	Moderate
Blood thinners	Increased bleeding risk	Moderate
CYP3A4 inhibitors	Prolonged drug effects	Moderate

Your healthcare provider may lower or raise your dose, depending on how your body reacts to CIALIS and your health condition.

Product	Dosage	Quantity + Bonus	Price
Cialis Black	80mg	10 Pills	43.27€ 41.21€	Buy
Cialis Generic	60mg	270 + 10 Pills	443.96€ 422.82€	Buy
Cialis Generic	5mg	90 + 6 Pills	115.91€ 110.39€	Buy
Cialis Super Active	20mg	20 + 4 Pills	92.35€ 87.95€	Buy
Cialis Professional	40mg	120 + 4 Pills	436.68€ 415.89€	Buy
Cialis Professional	40mg	270 + 6 Pills	898.37€ 855.59€	Buy
Cialis Generic	10mg	10 Pills	31.41€ 29.91€	Buy
Cialis Generic	40mg	20 Pills	59.47€ 56.64€	Buy
Cialis Generic	5mg	270 + 10 Pills	205.81€ 196.01€	Buy
Cialis Professional	40mg	10 Pills	65.09€ 61.99€	Buy
Cialis Professional	20mg	180 + 4 Pills	423.11€ 402.96€	Buy

CIALIS may be taken with or without meals.

5.10 Concomitant Use of Potent Inhibitors of Cytochrome P450 3A4 (CYP3A4)

CIALIS and other medicines may affect each other. Always check with your healthcare provider before starting or stopping any medicines. Especially tell your healthcare provider if you take any of the following*: medicines called nitrates (see “What Is The Most Important Information I Should Know About CIALIS?”) medicines called guanylate cyclase stimulators, such as riociguat (Adempas®), used to treat pulmonary hypertension These include Hytrin® (terazosin HCl), Flomax® (tamsulosin HCl), Cardura® (doxazosin mesylate), Minipress® (prazosin HCl), Uroxatral® (alfuzosin HCl), Jalyn® (dutasteride and tamsulosin HCl) or Rapaflo® (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. If CIALIS is taken with certain alpha blockers, your blood pressure could suddenly drop. If you take too much CIALIS, call your healthcare provider or emergency room right away.

Key Takeaways: Cialis vs Tadalafil

Physicians should also discuss with patients the increased risk of NAION among the general population in patients with a "crowded" optic disc, although evidence is insufficient to support screening of prospective users of PDE5 inhibitors, including CIALIS, for this uncommon condition [see Warnings and Precautions (5.4) and Adverse Reactions (6.2)]. Therefore, physicians should inform patients that substantial consumption of alcohol (e.g., 5 units or greater) in combination with CIALIS can increase the potential for orthostatic signs and symptoms, including increase in heart rate, decrease in standing blood pressure, dizziness, and headache [see Warnings and Precautions (5.9), Drug Interactions (7.1), and Clinical Pharmacology (12.2)]. Counseling of patients about the protective measures necessary to guard against sexually transmitted diseases, including Human Immunodeficiency Virus (HIV) should be considered. Physicians should instruct patients on the appropriate administration of CIALIS to allow optimal use. For CIALIS for use as needed in men with ED, patients should be instructed to take one tablet at least 30 minutes before anticipated sexual activity.

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In most patients, the ability to have sexual intercourse is improved for up to 36 hours. For CIALIS for once daily use in men with ED or ED/BPH, patients should be instructed to take one tablet at approximately the same time every day without regard for the timing of sexual activity. Cialis is effective at improving erectile function over the course of therapy. For CIALIS for once daily use in men with BPH, patients should be instructed to take one tablet at approximately the same time every day. Read this important information before you start taking CIALIS and each time you get a refill.

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You may also find it helpful to share this information with your partner. This information does not take the place of talking with your healthcare provider. You and your healthcare provider should talk about CIALIS when you start taking it and at regular checkups. If you do not understand the information, or have questions, talk with your healthcare provider or pharmacist. What Is The Most Important Information I Should Know About CIALIS? How Should I Take CIALIS for Symptoms of BPH?

17.7 Sudden Loss of Vision

Sexual activity can put an extra strain on your heart, especially if your heart is already weak from a heart attack or heart disease. See also “What Are The Possible Side Effects Of CIALIS?” CIALIS is a prescription medicine taken by mouth for the treatment of: men with symptoms of benign prostatic hyperplasia (BPH) ED is a condition where the penis does not fill with enough blood to harden and expand when a man is sexually excited, or when he cannot keep an erection. A man who has trouble getting or keeping an erection should see his healthcare provider for help if the condition bothers him. CIALIS helps increase blood flow to the penis and may help men with ED get and keep an erection satisfactory for sexual activity. Once a man has completed sexual activity, blood flow to his penis decreases, and his erection goes away.

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Some form of sexual stimulation is needed for an erection to happen with CIALIS. protect a man or his partner from sexually transmitted diseases, including HIV. Speak to your healthcare provider about ways to guard against sexually transmitted diseases. serve as a male form of birth control CIALIS is only for men over the age of 18, including men with diabetes or who have undergone prostatectomy. CIALIS for the Treatment of Symptoms of BPH BPH is a condition that happens in men, where the prostate gland enlarges which can cause urinary symptoms.

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CIALIS for the Treatment of ED and Symptoms of BPH ED and symptoms of BPH may happen in the same person and at the same time. Men who have both ED and symptoms of BPH may take CIALIS for the treatment of both conditions. CIALIS is not for women or children. CIALIS must be used only under a healthcare provider's care. use recreational drugs called “poppers” like amyl nitrite and butyl nitrite. For symptoms of BPH, CIALIS is taken once daily. Do not take CIALIS more than one time each day. Take one CIALIS tablet every day at about the same time of day.

17.10 Sexually Transmitted Disease

other medicines to treat high blood pressure (hypertension) medicines called HIV protease inhibitors, such as ritonavir (Norvir®, Kaletra®) some types of oral antifungals such as ketoconazole (Nizoral®), itraconazole (Sporanox®) some types of antibiotics such as clarithromycin (Biaxin®), telithromycin (Ketek®), erythromycin (several brand names exist. Please consult your healthcare provider to determine if you are taking this medicine). CIALIS is also marketed as ADCIRCA for the treatment of pulmonary arterial hypertension. Do not take sildenafil citrate (Revatio®) with CIALIS. Take CIALIS exactly as your healthcare provider prescribes it. If you miss a dose, you may take it when you remember but do not take more than one dose per day.

7.1 Potential for Pharmacodynamic Interactions with CIALIS

CIALIS can cause your blood pressure to drop suddenly to an unsafe level if it is taken with certain other medicines. You could get dizzy, faint, or have a heart attack or stroke. Never take CIALIS with any nitrate or guanylate cyclase stimulator medicines. Do not take CIALIS if you take any medicines called “nitrates.” Nitrates are commonly used to treat angina. Angina is a symptom of heart disease and can cause pain in your chest, jaw, or down your arm.

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Medicines called nitrates include nitroglycerin that is found in tablets, sprays, ointments, pastes, or patches. Nitrates can also be found in other medicines such as isosorbide dinitrate or isosorbide mononitrate. Some recreational drugs called “poppers” also contain nitrates, such as amyl nitrite and butyl nitrite. Do not take CIALIS if you take medicines called guanylate cyclase stimulators which include: Riociguat (Adempas®) a medicine that treats pulmonary arterial hypertension and chronic-thromboembolic pulmonary hypertension. Ask your healthcare provider or pharmacist if you are not sure if any of your medicines are nitrates or guanylate cyclase stimulators, such as riociguat.

Erectile Dysfunction

Tell all of your healthcare providers that you take CIALIS. If you need emergency medical care for a heart problem, it will be important for your healthcare provider to know when you last took CIALIS. After taking a single tablet, some of the active ingredient of CIALIS remains in your body for more than 2 days. The active ingredient can remain longer if you have problems with your kidneys or liver, or you are taking certain other medications (see “Can Other Medicines Affect CIALIS?”). Stop sexual activity and get medical help right away if you get symptoms such as chest pain, dizziness, or nausea during sex. How Should I Take CIALIS for ED? For ED, there are two ways to take CIALIS - either for use as needed OR for use once daily.

• Cost and insurance coverage vary widely by region and plan.
• Brand-name Cialis was historically very expensive.
• Most insurance plans now cover generic tadalafil with a copay.
• Medicare Part D plans typically cover it for approved indications.
• Prices can be compared using pharmacy discount cards or apps.
• Some online services offer telemedicine prescriptions and delivery.
• Always verify the legitimacy of any online pharmacy before purchasing.

Take one CIALIS tablet before you expect to have sexual activity.

• Drug interactions are a critical consideration for prescribers.
• As noted, nitrates (isosorbide, nitroglycerin) are absolutely contraindicated.
• Alpha-blockers (doxazosin, tamsulosin) require caution due to low blood pressure risk.
• Other blood pressure medications may have an additive effect.
• Strong CYP3A4 inhibitors (ketoconazole, ritonavir) increase tadalafil levels.
• CYP3A4 inducers (rifampin) may decrease tadalafil effectiveness.
• Always provide your doctor with a complete medication list.

You may be able to have sexual activity at 30 minutes after taking CIALIS and up to 36 hours after taking it.

I M P R E S S U M