Cialis
What is Cialis and when should it be used?
Erectile dysfunction
This occurs when a man cannot achieve or maintain a hard erect penis for sexual activity. Cialis has been demonstrated to greatly enhance the capacity to attain and sustain a firm erection for sexual intercourse.
After sexual stimulation, Cialis helps to dilate the blood vessels in your penis, allowing blood to flow into your penis. The result is a better erection. Drug will not help you if you do not suffer from erectile dysfunction. It's important to know that Cialis has no effect on erectile dysfunction without sexual stimulation. An amorous prelude may be necessary, as if you had not been taking erectile dysfunction medication.
Benign prostatic hyperplasia
Urinary tract symptoms related to benign prostatic hyperplasia (BPH), a common condition where the prostate enlarges with age, include challenges in initiating urination, a sensation of incomplete bladder emptying, and a frequent urge to urinate, including at night. Cialis enhances blood flow to the prostate and bladder muscles, helping to relax these muscles and potentially alleviate BPH symptoms. Clinical evidence indicates that Cialis can start improving urinary tract symptoms as soon as 1 to 2 weeks after beginning treatment.
What does Cialis contain?
A film-coated tablet contains 2.5 mg, 5 mg, 10 mg or 20 mg of tadalafil and excipients (in particular lactose).
What packaging is available on the market?
2.5 mg: boxes of 28 film-coated tablets.
5 mg: boxes of 28 or 84 film-coated tablets.
10 mg: boxes of 4 film-coated tablets.
20 mg: boxes of 4, 8 or 12 film-coated tablets.
How do I use Cialis?
Always follow the instructions given by your doctor.
Erectile dysfunction
Cialis 10 mg and 20 mg: the recommended dose is one 10 mg film-coated tablet to be taken between 30 minutes and 36 hours before sexual activity. The ideal interval between taking Cialis and sexual activity must therefore be determined for each individual.
If it is not sufficiently effective, your doctor may increase the dose to 20 mg. The maximum daily dose of 20 mg should not be exceeded. It is not recommended to take Cialis every day for a long time.
The maximum daily dose is 10 mg for patients with moderate to severe renal impairment or mild to moderate hepatic impairment.
Cialis 2.5 mg and 5 mg: taking this drug daily may be beneficial for men who are sexually active twice a week or more often. The recommended dose is one 2.5 mg tablet each day, which should be taken at approximately the same time each day. Depending on your response to Cialis, your doctor may increase your dose to 5 mg.
For people with severe kidney or liver dysfunction, daily use of tadalafil is not recommended.
It is important to know that Cialis has no effect if there is no sexual stimulation. A loving prelude for the couple may be necessary, as if you had not been taking erectile dysfunction medication.
Benign prostatic hyperplasia
The dose is one 5 mg tablet a day. It should always be taken at approximately the same time of day. If necessary, your doctor may reduce the dose to one 2.5 mg tablet a day.
If you have both benign prostatic hyperplasia and erectile dysfunction, the dosage remains one 5 mg tablet a day. In this case, you should not take additional Cialis as required.
DO NOT take Cialis more often than once a day.
People under the age of 18 should not take this medicine.
Swallow the film-coated tablet whole with a little water. You can take tablets with or without food. Alcohol consumption may affect your ability to obtain an erection. Taking alcohol may temporarily lower your blood pressure. If you have taken or plan to take Cialis, avoid excess alcohol (blood alcohol level equal to or greater than 0.08%), as it may increase the risk of dizziness when standing.
It is not recommended that 10 mg and 20 mg film-coated tablets be taken daily for prolonged periods.
The onset of action of Cialis varies from person to person.
If you have taken more tablets than you should have
Tell your doctor.
What side effects can Cialis have?
Like all medicines, tadalafil can cause side effects. These side effects are normally mild to moderate.
The following side effects may occur when taking Cialis:
Headache, back pain, muscle pain, pain in the extremities, flushing of the face, blocked nose and digestive disturbances have been frequently reported.
Occasionally, dizziness, abdominal pain, nausea, vomiting, acid reflux, blurred vision, eye pain, difficulty breathing, palpitations, increased heart rate, allergic reactions, skin rash, prolonged erections, hypertension, hypotension, nosebleeds, swelling of the hands, feet or ankles, fatigue and chest pain have been reported.
In addition, transient memory loss, swelling of the eyelids, redness of the conjunctiva (red eyes), visual field impairment, myocardial infarction, disturbances of consciousness, transient ischaemic attacks, stroke, urticaria, increased sweating, severely prolonged erections have been reported in rare cases (see below).
In rare cases, a prolonged and possibly painful erection may occur after taking Cialis. If you experience an erection lasting more than 4 hours, contact your doctor immediately.
If you experience chest pain during or after sexual intercourse, do NOT use nitrates, but seek medical advice immediately.
Sudden loss of vision or a sudden decrease in visual acuity in one or both eyes has been reported very rarely in men who have taken Cialis. If you experience sudden loss of vision or a sudden decrease in visual acuity, stop taking this medicament and contact your doctor.
There have been isolated reports of partial deafness in one or both ears or total deafness, sometimes accompanied by tinnitus and/or dizziness.
It is not possible to determine whether these events were directly related to the use of phosphodiesterase type 5 inhibitors.
Isolated cases of migraine, seizures, unstable angina pectoris, heart rhythm disturbances, sudden cardiac death, allergic reactions including swelling of the face, lips, tongue or throat associated with breathing or swallowing problems, skin rashes and urticaria (in such cases you should consult your doctor immediately) and swelling of the face have been reported.
In some men, a decrease in sperm concentration has been observed.
If you notice any side effects not mentioned in this leaflet, please tell your doctor or pharmacist.
When should Cialis not be used?
Never take this medicine:
- if you have a allergy or hypersensitivity to tadalafil or any other components of Cialis;
- if you have severe liver failure;
- if you have a serious heart condition or have recently had a heart attack;
- if you have recently suffered a stroke;
- if you have uncontrolled hypotension or hypertension;
- if you are taking nitrates or nitric oxide donors such as trinitroglycerin, isosorbide dinitrate or molsidomine. These medicines are used in the treatment of angina pectoris ("chest pain") and heart failure, and may be administered in the form of tablets, chewable capsules, plasters, ointments, etc. The simultaneous use of Cialis and these medicines may lead to a dangerous drop in blood pressure and cardiovascular collapse. Tell your doctor if you are taking any medicines of this type or if you have any doubts about them.
For the same reason, during your treatment with Cialis, you should avoid illegally obtained "poppers" (containing amyl nitrite).
- if you are taking riociguat. This medication is prescribed for managing pulmonary arterial hypertension (elevated blood pressure in the lungs) and chronic thromboembolic pulmonary hypertension (elevated lung blood pressure due to blood clots). Phosphodiesterase type 5 (PDE5) inhibitors, have demonstrated the ability to amplify the blood pressure-reducing effects of this drug. Consult your doctor if you are using riociguat or if you have any concerns.
- if you have ever experienced loss of vision in one eye due to inadequate blood supply to your eyes (non-arteritic anterior ischaemic optic neuropathy [NOIAN]);
- if you have a family history of certain rare hereditary eye diseases (such as retinitis pigmentosa).
What precautions should be taken when taking Cialis?
As benign prostatic hyperplasia can cause the same symptoms as prostate cancer, your doctor will first carry out an examination before starting treatment with Cialis, to rule out prostate cancer. Medication is not suitable for the treatment of prostate cancer.
Sexual activity carries a potential risk for patients with severe heart disease, due to the extra strain on the heart. If you experience chest pain during sexual activity, you should abstain from further sexual intercourse and inform your doctor as soon as possible. Tadalafil is not recommended for these patients. Tell your doctor if you have had a heart attack or stroke or if you suffer from angina pectoris, heart failure, irregular heartbeats, low blood pressure or uncontrolled high blood pressure.
As benign prostatic hyperplasia can cause the same symptoms as prostate cancer, your doctor will examine you before starting treatment with Cialis to exclude prostate cancer. Tadalafil is not suitable for the treatment of prostate cancer.
You should also tell your doctor if you have liver or kidney failure or if you have ever suffered serious sight loss.
If you suffer from sickle cell anaemia (a malformation of the red blood cells), multiple myeloma (cancer of the bone marrow) or leukaemia (cancer of the blood cells), you should only be treated with Cialis with caution, as with these diseases there is a risk of excessively long painful erections (priapism). If an erection of this type lasts for more than 4 hours, contact your doctor immediately.
Tell your doctor if you are taking riociguat.
Cialis should also be used with caution if you have penile deformity or disease.
It is not known whether Cialis is effective in the treatment of erectile dysfunction in patients who have:
- have undergone surgery in the pelvic region;
- have undergone complete or partial removal of the prostate with sectioning of the prostate nerves (radical removal of the prostate using a technique that does not preserve the nerves).
The efficacy of tadalafil in patients with spinal cord injury or other neurological conditions is not known.
If you experience a sudden decrease or loss of vision or hearing, stop taking Cialis and inform your doctor immediately.
A large study has found evidence of an increased risk of retinal detachment with regular use of PDE5 inhibitors. If you notice signs of retinal detachment, such as flashes of light, black spots, a dark haze, or a decreased field of vision, seek immediate medical attention from an ophthalmologist.
Interactions with other medicines or food
Tadalafil increases the antihypertensive effect of medicines containing organic nitrates or other nitric oxide donors (e.g. trinitroglycerin, isosorbide dinitrate or molsidomine). If you are being treated with drugs of this type, you should not take Cialis. Drug also increases the antihypertensive effect of medicines called alpha-blockers (e.g. doxazosin) sometimes used in the treatment of hypertension and prostatic hyperplasia. Tell your doctor if you are taking alpha-blockers or if you are being treated for either of these conditions.
If you have heart disease and need emergency treatment for serious problems, it is essential that you or those around you inform the doctor treating you that you are taking Cialis. In this case, you should ask not to be treated with nitrates or other nitric oxide donors.
Rifampicin (an antibiotic used, among other things, to treat tuberculosis) accelerates the breakdown of Cialis. Ketoconazole and itraconazole (used to treat fungal infections), erythromycin (an antibiotic), protease inhibitors such as ritonavir and saquinavir (used to treat HIV infections) and grapefruit juice may inhibit the breakdown of Cialis. Tell your doctor if you are taking any of these medicines, as their dosage may need to be adjusted. Do not take Cialis at the same time as grapefruit juice.
Do not take Cialis concurrently with other medications used to treat erectile dysfunction.
Important information about certain ingredients
Medication contains lactose. Therefore, only take this medicine after consulting your doctor if you know that you are intolerant to certain sugars.
Effect of Cialis on ability to drive and use machines
Tadalafil may cause dizziness. You should therefore know how you react to Cialis before driving a car or operating machinery.
