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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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  • Did you know?Using Copaxone with an antibiotic or metabolizing it with drugs can alter its effectiveness.
  • These may lead to a list of side effects that you will need to complete in order to find the one that's most beneficial for you. If you're trying to decide whether or not this medication is the best choice for you, please speak with your doctor or pharmacist.
  • Have your medical condition or take any medical treatments?If you have a medical condition or take any types of medications, your doctor will likely recommend an alternative medication or supplement that is more suitable for you.
  • C. Other Anti-Hypertensive Drugs (Ex. Prazosin, Lisinopril)

    Cialis has been shown to cause some mild side effects. Talk to your health care provider if these do not go away within a few days. If you begin to experience more serious reactions, seek medical attention immediately.

    Common side effects reported from Cialis use include:

    • Headache
    • Indigestion
    • Heartburn
    • Upset stomach
    • Gas
    • Nausea
    • Flushing

    More severe side effects include:

    • Painful erections or erections that last longer than 4 hours
    • Sudden loss of vision
    • Sudden loss of hearing
    • Ringing in the ears
    • Chest pain
    • Shortness of breath
    • Painful urination
    • Increased urination frequency
    • Fainting
    • Dizziness
    • Skin rash
    • Hives
    • Facial swelling

    If you experience any of these side effects, seek medical attention immediately. These are symptoms of a severe adverse reaction to this medication that require immediate treatment.

    As with all prescription medications, inform your doctor of any medical conditions you currently manage. Tell them about any and all medications, prescription drugs, and supplements you are taking before starting treatment with Cialis. Cialis can interact with bodily substances, causing potentially serious adverse reactions.

    Specifically, you should inform your health care provider of any alpha-blocker, antifungal, HIV protease inhibitor, or high blood pressure medication you are taking. Remember to mention any herbal products you use, especially St. John’s wort.

    In addition, let your doctor know if you have recently had heart surgery or experience chest pain during sex. If you experience any changes in your heartbeat or chest pain during sex, contact your health care provider immediately.

    Read More What is Cialis and How It Works In a new study, published in the online February 20th, 2023, researchers found that men who took Cialis had a lower likelihood of getting erectile dysfunction (ED) symptoms compared to men who did not take the medication. They also found that those who took Cialis had a reduced incidence of premature cardiovascular events, compared to those who did not take the medication.

    The researchers believe that this study, which was led by researchers at Brigham and Women's Hospital in Boston, found that those who took Cialis had a reduced ED incidence and a reduced ED severity compared to those who did not take the medication. They found that those who took Cialis had a reduced ED incidence and a reduced ED severity.

    The researchers also found that those who took Cialis had a reduced incidence of premature cardiovascular events and a reduced incidence of non-fatal cardiovascular events. They also found that those who took Cialis had a reduced ED severity.

    The researchers noted that men who take Cialis may have a lower likelihood of getting premature cardiovascular events compared to those who do not take the medication. They also noted that Cialis can interact with other medications, leading to adverse reactions.

    The researchers recommend that men who take Cialis not start taking their medication sooner than five days after their last dose of alpha-blocker medication, such as Viagra, or take them every day for a longer duration of time. This may mean that Cialis will not make any difference in the men who take Cialis, regardless of their ED symptoms.

    Women can contact their healthcare provider, who may advise them to take Cialis more than once daily.

    Cialis can cause potentially serious side effects which may need to be treated before it becomes a concern.

    As with the safety of all prescription medications, inform your doctor of any medical conditions you manage, including heart disease, diabetes, and high blood pressure.

    In addition, if you have any new or recently received any medication, including non-prescription medications, you should not take Cialis.

    How should I take Cialis?

    Cialis should be taken at the start of a new infection or if you have previously had an infection you did not get or seasonally exposed to Cialis. Depending on your health status, your doctor may recommend taking Cialis at least one dose per day.

    Erectile Dysfunction

    Erection problems (impotence) are very common, particularly in men over 40.

    Most men occasionally fail to get or keep an erection. This is usually due to stress, tiredness, anxiety or drinking too much alcohol, and it’s nothing to worry about.

    If it happens more often, it may be caused by physical or emotional problems.

    Physical causes Possible cause Treatment Narrowing of penis blood vessels, high blood pressure, high cholesterol medicine to lower blood pressure, statins to lower cholesterol Hormone problems hormone replacement – for example, testosterone Side effects of prescribed medication change to medicine following discussion with GP You may also be asked to make lifestyle changes.

    Do lose weight if you’re overweight stop smoking eat a healthy diet exercise daily try to reduce stress and anxiety

    Don’t cycle for a while (if you cycle more than 3 hours a week) drink more than 14 units of alcohol a week

  • Side Effects

    Possible side effects

    Like all medicines, this medicine can cause side effects, although not everybody gets them. These effects are normally mild to moderate in nature.

    If you experience any of the following side effects stop using the medicine and seek medical help immediately:

    allergic reactions including rashes (frequency uncommon). chest pain – do not use nitrates but seek immediate medical assistance (frequency uncommon). priapism, a prolonged and possibly painful erection after taking CIALIS (frequency rare). If you have such an erection, which lasts continuously for more than 4 hours you should contact a doctor immediately. sudden loss of vision (frequency rare). Other side effects have been reported:

    Common (seen in 1 to 10 in every 100 patients)

    headache, back pain, muscle aches, pain in arms and legs, facial flushing, nasal congestion, and indigestion. Uncommon (seen in 1 to 10 in every 1,000 patients)

    dizziness, stomach ache, feeling sick, being sick (vomiting), reflux, blurred vision, eye pain, difficulty in breathing, presence of blood in urine, prolonged erection, pounding heartbeat sensation, a fast heart rate, high blood pressure, low blood pressure, nose bleeds, ringing in the ears, swelling of the hands, feet or ankles and feeling tired. Rare (seen in 1 to 10 in every 10,000 patients)

    fainting, seizures and passing memory loss, swelling of the eyelids, red eyes, sudden decrease or loss of hearing, hives (itchy red welts on the surface of the skin), penile bleeding, presence of blood in semen and increased sweating. Heart attack and stroke have also been reported rarely in men taking CIALIS. Most of these men had known heart problems before taking this medicine.

    Partial, temporary, or permanent decrease or loss of vision in one or both eyes has been rarely reported.

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    Health Questionnaire Required:

    For your first order with us, after placing an order, you will be prompted to upload your ID and submit our health questionnaire, soour physician canreview your basic health information,in order to mail prescription medications. You will not need to do this for refill orders.

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