Do not take this medicine with any of the following medications:

-nitrates like amyl nitrite, isosorbide dinitrate, isosorbide mononitrate, nitroglycerin
-other medicines for erectile dysfunction like avanafil, sildenafil, vardenafil
-other tadalafil products (Adcirca)
-riociguat

This medicine may also interact with the following medications:

-certain drugs for high blood pressure
-certain drugs for the treatment of HIV infection or AIDS
-certain drugs used for fungal or yeast infections, like fluconazole, itraconazole, ketoconazole, and voriconazole
-certain drugs used for seizures like carbamazepine, phenytoin, and phenobarbital
-grapefruit juice
-macrolide antibiotics like clarithromycin, erythromycin, troleandomycin
-medicines for prostate problems
-rifabutin, rifampin or rifapentine

They need to know if you have any of these conditions:

-bleeding disorders
-eye or vision problems, including a rare inherited eye disease called retinitis pigmentosa
-anatomical deformation of the penis, Peyronie''s disease, or history of priapism (painful and prolonged erection)
-heart disease, angina, a history of heart attack, irregular heart beats, or other heart problems
-high or low blood pressure
-history of blood diseases, like sickle cell anemia or leukemia
-history of stomach bleeding
-kidney disease
-liver disease
-stroke
-an unusual or allergic reaction to tadalafil, other medicines, foods, dyes, or preservatives
-pregnant or trying to get pregnant
-breast-feeding

If you notice any changes in your vision while taking this drug, call your doctor or health care professional as soon as possible. Stop using this medicine and call your health care provider right away if you have a loss of sight in one or both eyes.

Contact your doctor or health care professional right away if the erection lasts longer than 4 hours or if it becomes painful. This may be a sign of serious problem and must be treated right away to prevent permanent damage.

If you experience symptoms of nausea, dizziness, chest pain or arm pain upon initiation of sexual activity after taking this medicine, you should refrain from further activity and call your doctor or health care professional as soon as possible.

Do not drink alcohol to excess (examples, 5 glasses of wine or 5 shots of whiskey) when taking this medicine. When taken in excess, alcohol can increase your chances of getting a headache or getting dizzy, increasing your heart rate or lowering your blood pressure.

Using this medicine does not protect you or your partner against HIV infection (the virus that causes AIDS) or other sexually transmitted diseases.

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medicine after the expiration date.