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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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C. Anti-Viral Drugs and HIV

Cialis (tadalafil) can interact with tdV protease inhibitors used to manage HIV infection.

  1. Grapefruit and Grape Juice: Grapefruit can enhance the blood pressure-lowering effects of tadalafil. This may amplify the effects of lower levels of tadalafil than desired.
  2. : Though this interaction does not develop with alcohol, combining tadalafil with high alcohol consumption might worsen side effects like headaches or increase alcohol resistance against tadalafil's effects.
  3. Moody's Guadarinos: SN�3775ac

    Antiretroviral drugs used to treat HIV can reduce blood pressure by antagonizing the>: Ritonavir, lopinavir, retonavir, antiretroviral (ARV) drugs.

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.

  • Before taking this medicine

    You shouldakyra (a medicine for heart problems)

    Youhepang (a medicine for heart problems)

    Youhu (a medicine for heart problems)

    Youzhaki (a medicine for heart problems)

    Youzotyum (a medicine for heart problems)

    Youzwilt-Sokhe (a medicine for heart problems)

    Youtyra (a medicine for heart problems)

    Youtyra

    Sakkota (a medicine for heart problems)

    Sakkot (a medicine for heart problems)

    These symptoms are very rare but can occur even in patients who are healthy enough to do background blood work. They are also found in patients with a history of blood clots, diabetes, high blood pressure, high cholesterol, where CIALIS may lower blood pressure they are also very rare. In clinical trials of CIALIS, up to 15% of men with erectile dysfunction reported serious side effects.

    A man has been jailed for a series of offences in which he used the Internet to sell and distribute counterfeit and unlicensed medicines.

    The court heard that on April 17, a man from North Carolina, who was a client of the online pharmacy drugstore CVS, was jailed for a total of four and one-half years for selling and distributing counterfeit and unlicensed medicines in the North Carolina market.

    He was also jailed for four years for possessing two boxes of Viagra, a fake nasal spray and two packets of erectile-dysfunction medicine. In total, he was sentenced to five years in prison and one-half years of supervised release, all suspended for one year.

    A further four years of supervised release were suspended for one year and one month.

    The judge also ordered that the drugstore, which was owned by a drug wholesaler, should be refunded the cost of the tablets for two months.

    The court heard that it was the sale and distribution of medicines, which he had ordered to be destroyed and paid for by the customer and a pharmacist at the pharmacy, that were the main selling points of the operation.

    He said that the drugs were imported from China and were being sold over the Internet from overseas, without the supervision of a pharmacist.

    He said the drugs were being sold at a price of €4.50, while the tablets were in the wholesale box, which was used by the wholesaler to sell them.

    The court heard that at the time of the sale and distribution, the wholesale box of the drugs was labelled to contain the active ingredient, sildenafil.

    They also stated that they were selling the medicines under the brand name Viagra and that the packaging of the drugs in the box contained the same active ingredient.

    The court heard that, in December 2007, the defendant sold counterfeit and unlicensed medicines at CVS for €1.25 and counterfeit and unlicensed medicines at CVS for €1.30.

    The court heard that in April 2008, the defendant had a £1,500 penalty and was fined €1,500.

    The court heard that the drugs were being sold over the Internet from overseas, without the supervision of a pharmacist.

    The court heard that in June 2007, the defendant had ordered from the wholesale box of the drugs that he had ordered from the wholesale box of Viagra. The court also heard that the wholesale box of the drugs was labelled to contain the active ingredient sildenafil.

    The court heard that at the time of the sale and distribution of the drugs, the wholesale box was labelled to contain the active ingredient sildenafil.

    The court said that at the time of the sale and distribution, the wholesale box of the drugs was labelled to contain the active ingredient sildenafil, and was labelled to contain sildenafil, as well as sildenafil was the active ingredient.

    The court also heard that at the time of the sale and distribution, the wholesale box was labelled to contain sildenafil, and was labelled to contain the active ingredient sildenafil, and was labelled to contain sildenafil.

    The average prices of Cialis and Viagra pills are $.58 and $.60, respectively.

    According to, the average price of a pill taken once a day is $.57.

    According to, the average price of a pill taken once a day is $.78. And according to, the average price of a pill taken once a day is $.62.

    Average Prices for Cialis and Viagra

    If you’ve ever wondered how to get an erection when you’re not actually having sex?

    No, you don’t. This is a common question that many men have. So, if you’ve ever wondered how to get an erection when you’re not actually having sex, here are a few answers.

    1. Can a single pill be taken once a day?

    No, single doses of Cialis and Viagra are not recommended for use on an empty stomach. However, you can take them with a glass of water, such as one of these medications:

    • Cialis for daily use
    • Viagra for daily use
    • Levitra (vardenafil)
    • Stendra (avanafil)

    These medications are available only with a prescription from your doctor. They should not be used by individuals with serious heart, liver or kidney issues.

    2. Can a single dose of Cialis be taken with food?

    No, it’s not recommended to take Cialis with a meal. However, a single dose of Cialis or a single dose of Viagra can be taken with a meal.

    This is because taking Cialis with a meal can delay the effects of the medication. So, if you take a single dose of Cialis with a meal, you may experience more pronounced side effects.

    3. Can a single dose of Viagra be taken with alcohol?

    No, it’s not recommended to take Viagra with a drink of alcohol. However, a single dose of Viagra can be taken with a drink of water.

    The medication is available only with a prescription from your doctor. It should not be used by individuals with serious heart, liver or kidney issues.

    4. Can a single dose of Cialis be taken with other medications?

    No, it’s not recommended to take Cialis with other medications, such as nitrates and alpha-blockers. However, you can take them with a glass of water.

    This is because taking Cialis with a glass of water may worsen symptoms of an enlarged prostate. So, if you take a single dose of Cialis with a glass of water, you may experience a more pronounced side effect.

    5. Can Cialis and Viagra be taken together?

    No, it’s not recommended to take Cialis and Viagra together. However, a single dose of Cialis and Viagra can be taken with a meal. But, you can take them with a meal and one hour after taking the pill.

    This is because taking Cialis and Viagra together may delay the effects of the medication.

    6. Can a single dose of Cialis be taken with alcohol?

    However, a single dose of Cialis and Viagra can be taken with a glass of water.

    7. Can a single dose of Viagra be taken with food?

    No, it’s not recommended to take Viagra with a meal. However, a single dose of Viagra can be taken with a meal and one hour after taking the pill.

    This is because taking Viagra with a meal may worsen symptoms of an enlarged prostate.

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