Tadalafil Risks, Warnings, and Complications

Precautions Before Starting Tadalafil

Tell your doctor if you have ever had an allergic reaction to tadalafil, any of the active or inactive ingredients in tadalafil formulations, other PDE-5 inhibitors, or any other medicines. Your pharmacy can give you a list of ingredients.

Give your doctor a complete list of medications, including prescription drugs, over-the-counter medicines, vitamins, supplements, and herbal products. This can help avoid possible interactions with certain medications.

Tadalafil may not be safe for people with certain medical conditions. Tell your doctor if you have had a prolonged erection that lasted more than 4 hours, dehydration (diarrhea, vomiting, inability to keep down fluids, excessive sweating), pulmonary veno-occlusive disease (PVOD or blocked veins in the lungs), abnormal shape or structural problems of the penis, high cholesterol, diabetes, high blood pressure, low blood pressure, arrhythmias (irregular heartbeat), recent myocardial infarction (heart attack), congestive heart failure, chest pain (angina), stroke, peptic ulcer disease, circulation problems, bleeding disorders, sickle cell anemia, leukemia, multiple myeloma, heart disease, liver or kidney disease. 

Also, tell your doctor if there is any history in your family of an inherited eye condition called retinitis pigmentosa that can cause loss of vision. Tell your doctor about any pre-existing eye problems or history of sudden vision loss, including blockage of blood flow in the nerves of the eye. 

If you are a woman and are taking tadalafil for pulmonary arterial hypertension, tell your doctor if you are pregnant or planning a pregnancy soon.

Precautions During Use of Tadalafil

Keep all your medical and laboratory appointments while taking tadalafil. Your healthcare professional may adjust your tadalafil dose based on your response and tolerability.

Talk to your doctor about the risks of drinking alcohol while on tadalafil. Drinking large amounts of alcohol while on this medicine can lead to severe side effects such as headache, dizziness, fast heartbeat, and low blood pressure. 

Talk to your doctor about whether you can eat grapefruit and drink grapefruit juice while taking tadalafil.

Call your doctor immediately if you develop chest pain during sexual activity. Refrain from further sexual activity until your doctor says it is okay.

Tell all your healthcare providers you are on tadalafil, especially before any surgery or emergency treatment for heart problems.

Tadalafil Drug Interactions

Taking tadalafil with certain other drugs can affect how the medications work. Possible drug interactions between tadalafil and other medications can increase the risk of severe adverse effects. Your doctor may need to change the doses of your medications, switch you to alternative treatments, or monitor your carefully for side effects if there are potential interactions.

You should not take tadalafil if you are currently taking or have recently taken riociguat (Adempas) or a nitrate medicine such as nitroglycerin (Nitrostat, Nitro-Dur, Minitran, Nitromist), isosorbide dinitrate (Dilatrate-SR, Isordil, in BiDil), or isosorbide mononitrate (Monoket). These medicines come as tablets, sublingual tablets, patches, ointments, sprays, and pastes.

Also, you should not take street drugs containing nitrates such as amyl nitrite (amyl nitrate) or butyl nitrate (commonly called poppers) while on tadalafil.

Tadalafil can also have interactions with the following medications:

• Alpha blockers such as alfuzosin (Uroxatral), tamsulosin (Flomax, in Jalyn), doxazosin (Cardura), terazosin, and prazosin (Minipress)
• Antiarrhythmics such as amiodarone (Cordarone, Pacerone), 
• Antifungal medications such as itraconazole (Onmel, Sporanox), fluconazole (Diflucan), ketoconazole (Nizoral, Extina, Ketozole, Xolegel), griseofulvin (Grifulvin, Gris-PEG), and voriconazole (Vfend)
• Antiemetics for nausea and vomiting such as aprepitant (Emend)
• Other medicines for pulmonary arterial hypertension such as bosentan (Tracleer)
• Antiepileptic drugs like carbamazepine (Epitol, Tegretol, Carbatrol, Teril), phenobarbital, and phenytoin (Dilantin, Phenytek)
• Antibiotics such as clarithromycin (Biaxin, in Prevpac), erythromycin (Erythrocin, E.E.S., E-Mycin), telithromycin (Ketek), rifabutin (Mycobutin), and rifampin (Rimactane, Rifadin, in Rifater, in Rifamate) 
• Calcium channel blockers such as diltiazem (Cardizem, Tiazac, Cartia) and verapamil (Calan, Verelan, Covera, in Tarka)
• HIV medicines such as efavirenz (Sustiva, in Atripla), indinavir (Crixivan), ritonavir (Norvir, in Kaletra), nevirapine (Viramune), and nelfinavir (Viracept)
• Cholesterol-lowering medicines such as lovastatin (Altocor, in Advicor)
• Antihypertensive medications for high blood pressure
• Antidepressants such as nefazodone and sertraline (Zoloft)
• Other drugs for the treatment of erectile dysfunction
• St. John’s wort

Give your doctor or pharmacist a complete list of your medications, including prescription drugs, over-the-counter medications, dietary supplements, and herbal remedies. Also, tell your health care professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medicines.

Adcirca Risks, Warnings, and Complications

Precautions Before Starting Adcirca

Tell your doctor if you have ever had an allergic reaction to tadalafil (Adcirca, Tadliq, Cialis), any of the active or inactive ingredients in tadalafil tablets or liquid suspension, other PDE5 inhibitors such as sildenafil (Viagra), vardenafil (Levitra), or avanafil (Stendra), or any other drugs. Your pharmacy can give you a list of ingredients.

Give your doctor and pharmacist a complete list of your medications, including prescription medicines, over-the-counter medicines, dietary supplements, and herbal products. This can help avoid potentially dangerous interactions between your medications.

Give your doctor a complete medical history. Adcirca may not be safe for people with certain medical conditions, such as smoking; a painful or prolonged erection lasting more than 4 hours; recent diarrhea, vomiting, excessive sweating, or dehydration (lack of enough fluids); pulmonary veno-occlusive disease (PVOD) or blockage of veins in the lungs; abnormal shape of the penis; high cholesterol; diabetes; high blood pressure or low blood pressure; irregular heartbeat; angina (chest pain); heart attack; heart failure; stroke; stomach ulcers; problems with blood circulation; bleeding disorders; problems with blood cells such as sickle cell disease; cancers such as multiple myeloma or leukemia; kidney disease; liver problems; a personal or family history of eye conditions such as retinitis pigmentosa; sudden vision loss; or sudden hearing loss.

If you are a woman taking Adcirca to treat pulmonary arterial hypertension, tell your doctor if you are pregnant, could be pregnant, or are planning a pregnancy soon. Also, tell your doctor if you plan to breast-feed an infant.

Precautions During Use of Adcirca

Keep all your medical and lab appointments while on treatment with Adcirca (tadalafil).

It can take several weeks for Adcirca to improve exercise ability. Continue taking Adcirca even if you feel well. This medicine can improve your exercise capacity (ability to do physical activity without shortness of breath or dizziness), but will not cure the underlying medical condition.

Avoid drinking alcoholic beverages while taking tadalafil. Drinking large amounts of alcohol while on Adcirca (tadalafil) can increase the risk of side effects such as headache, dizziness, fast heartbeat, and low blood pressure.

Tell your doctor if you become pregnant while taking Adcirca.

Tell all your doctors you are on Adcirca (tadalafil), including before any surgical procedures or dental treatments. Tell healthcare providers you are on tadalafil if you need emergency medical treatment for a heart condition.

Adcirca Drug Interactions

Taking Adcirca (tadalafil) with certain other drugs can affect how the medications work. Interactions between Adcirca and other medications may increase the risk of severe adverse effects. Your healthcare professional may change the dose, monitor you carefully for side effects, or switch you to a different medication if you are at risk of drug interactions.

Tell your doctor if you are currency taking or have recently taken the following medicines. You should not take them at the same time as tadalafil:

• Guanylate cyclase stimulators such as riociguat (Adempas), which are prescribed for pulmonary hypertension.
• Nitrates such as isosorbide mononitrate (Monoket), isosorbide dinitrate (Isordil), and nitroglycerin (Minitran, Nitro-Dur, Nitromist, Nitrostat, others). These medicines are prescribed for angina (chest pain) and heart disease and come in the form of tablets, sublingual tablets, patches, sprays, ointments, and pastes.

Also, tell your doctor if you are taking street (recreational) drugs called poppers that contain nitrates such as nitrite, amyl nitrate, and butyl nitrate. Your provider will likely not prescribe tadalafil if you are using street drugs that contain nitrates.

Tadalafil is also available under the brand name Cialis to treat erectile dysfunction. Do not take Adcirca and Cialis at the same time.

Tell your doctor and pharmacist if you are on the following prescription and nonprescription medications, which can also have interactions with tadalafil: 

• Alpha blockers such as doxazosin (Cardura), prazosin (Minipress), alfuzosin (Uroxatral), dutasteride (Avodart, in Jalyn), tamsulosin (Flomax, in Jalyn), silodosin (Rapaflo), and terazosin, which are used to treat high blood pressure and enlarged prostate gland
• Medications used to treat heart arrhythmias such as amiodarone (Cordarone, Pacerone)
• Antifungal drugs such as itraconazole (Onmel, Sporanox), fluconazole (Diflucan), ketoconazole (Ketozole, Nizoral, Extina, Xolegel), voriconazole (Vfend), and griseofulvin (Grifulvin, Gris-PEG)
• Antiemetic drugs such as aprepitant (Emend) used to treat nausea and vomiting related to surgery or chemotherapy 
• Antiepileptic drugs such as carbamazepine (Tegretol, Carbatrol, Epitol, others), phenobarbital, and phenytoin (Dilantin, Phenytek) 
• Certain antibiotics such as clarithromycin (Biaxin, in Prevpac), erythromycin (E.E.S., E-Mycin, Erythrocin), telithromycin (Ketek), rifabutin (Mycobutin), and rifampin (Rimactane, Rifadin, in Rifamate, in Rifater)
• Calcium channel blockers such as diltiazem (Cartia, Cardizem, Tiazac, others) and verapamil (Calan, Covera, Verelan, in Tarka)
• HIV medications such as efavirenz (Sustiva, in Atripla), indinavir (Crixivan), ritonavir (Norvir, in Kaletra), nelfinavir (Viracept), and nevirapine (Viramune)
• Cholesterol-lowering drugs such as lovastatin (Altocor, in Advicor)
• Drugs prescribed to treat high blood pressure
• Antidepressants such as nefazodone and sertraline (Zoloft)
• Medications prescribed for erectile dysfunction
• Other medicines prescribed for pulmonary arterial hypertension, such as bosentan (Tracleer) and others
• Herbal products such as St. John's wort

Give your doctor and pharmacist a complete list of your medications, including prescription drugs, over-the-counter medications, dietary supplements, and herbal remedies. Also, tell your healthcare professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medications.

What are the risks of taking Cialis (tadalafil)?

What should I tell my doctor before starting Cialis (tadalafil)?

 Tell your doctor if you are allergic to tadalafil, any of the ingredients in tadalafil tablets (your local pharmacy can provide you with a list), or have allergies to any other medications.

 Tell your healthcare provider about all your health conditions. Cialis may not be right for people with certain medical conditions like heart disease, liver disease, or kidney disease. This medicine also needs to be used with caution in patients with structural defects of the penis, such as Peyronie’s disease, and in patients at risk of priapism.

Give your doctor a list of all your current medications, including prescription drugs, over-the-counter medicines, dietary supplements, and natural products. This can help avoid serious drug interactions.

In particular, inform your doctor if you take or have recently taken nitrate drugs (Isordil, Monoket, Nitro-Dur, Nitrostat, Nitromist, and others) for angina (chest pain). These medications are available as tablets, pastes, ointments, patches, and sprays. Your doctor will probably not advise taking tadalafil if you are on any of these medications. Also, tell your doctor if you use street drugs that may contain nitrites (poppers). Taking tadalafil and using these recreational drugs together can be dangerous.

What precautions should I take while on Cialis (tadalafil)?

 Tell all your healthcare providers that you take Cialis. If you need emergency medical care for a heart condition, your healthcare providers should know when you took your last dose of Cialis.

Do not use Cialis if you are on treatment with nitrate drugs for angina (chest pain). Do not use recreational drugs like poppers while on Cialis treatment.

Tadalafil is available under the brand names Cialis and Adcirca. You should be on only one of these drugs at a time. 

Get emergency medical care if you experience priapism (a prolonged, painful erection that lasts more than 4 hours), sudden vision changes or vision loss in one or both eyes, or sudden decreased hearing or hearing loss.

Note that Cialis does not prevent pregnancy or protect you against sexually transmitted infections, including HIV/AIDS. Talk to your doctor if you have questions about preventing sexually transmitted diseases. Cialis can relieve symptoms of erectile dysfunction, but it will not cure ED or increase libido (sexual desire).

Women on Adcirca (tadalafil) for pulmonary arterial hypertension treatment should inform their doctor if they are pregnant, could be pregnant, or breastfeeding. 

What are Cialis (tadalafil) interactions?

Taking Cialis with certain medications can affect how it works or cause serious adverse effects. Your doctor may decide not to treat you with Cialis, give you a lower dose, change some of your other medicines, or monitor you carefully for side effects if there are known interactions between Cialis and your other medicines.

 Using Cialis with the following medications is not recommended:

•  certain antiretroviral drugs used for HIV treatment

• riociguat (Adempas) used to treat pulmonary hypertension

• nitrates (used in patients with heart disease)

There can also be interactions between Cialis and the following medicines such as:

This list does not describe all possible Cialis interactions. To avoid any potential interactions, give your healthcare provider a complete list of your medications, including prescription drugs, over-the-counter medicines, dietary supplements, and herbal products. Also, tell your healthcare provider if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with Cialis.