1 INDICATIONS AND USAGE
Improves erectile function compared to placebo up to 36 hours post dose (2.1). CIALIS for once daily use: 2.5 mg taken once daily, without regard to timing of sexual activity. May increase to 5 mg based upon efficacy and tolerability (2.1). CIALIS may be taken without regard to food (2.2). Patients should not use CIALIS if sex is inadvisable due to cardiovascular status (5.1). Use of CIALIS with alpha blockers, antihypertensives or substantial amounts of alcohol (≥5 units) may lead to hypotension (5.6, 5.9). If taking potent inhibitors of CYP3A4, dose should be adjusted: CIALIS for use as needed: ≤10 mg every 72 hours. For once daily use: dose not to exceed 2.5 mg (5.10). Patients should seek emergency treatment if an erection lasts >4 hours.
| Brand Name | Manufacturer | Price (per 20mg tablet) | Certification | Notes |
|---|---|---|---|---|
| Cialis | Lilly | $30 | FDA, EMA | Original branded drug |
| Tadalafil Generic | Multiple | $8 - $15 | ISO-certified | Cheaper alternative |
| Adcirca | Lilly | Prescription only | FDA | For pulmonary hypertension |
| Tadylof | Local pharma | $10 - $12 | Local cert | Generic version |
Use CIALIS with caution in patients predisposed to priapism (5.3).
5.12 Effects on Bleeding
Patients should stop CIALIS and seek medical care if a sudden loss of vision occurs in one or both eyes, which could be a sign of Non Arteritic Ischemic Optic Neuropathy (NAION). Discuss increased risk of NAION in patients with history of NAION (5.4). Patients should stop CIALIS and seek prompt medical attention in the event of sudden decrease or loss of hearing (5.5). Most common adverse reactions (≥2%) include headache, dyspepsia, back pain, myalgia, nasal congestion, flushing, and pain in limb (6.1, 6.2). To report SUSPECTED ADVERSE REACTIONS, contact Eli Lilly and Company at 1-800-LillyRx (1-800-545-5979) or FDA at 1-800-FDA-1088 or See 17 for PATIENT COUNSELING INFORMATION and FDA-approved patient labeling.
Alternatives for erectile dysfunction (ED)
Table of Contents FULL PRESCRIBING INFORMATION: CONTENTS*1 INDICATIONS AND USAGE1.1 Erectile Dysfunction2 DOSAGE AND ADMINISTRATION2.1 Erectile Dysfunction2.2 Use with Food2.3 Use in Special Populations2.4 Concomitant Medications3 DOSAGE FORMS AND STRENGTHS4 CONTRAINDICATIONS4.1 Nitrates4.2 Hypersensitivity Reactions5 WARNINGS AND PRECAUTIONS5.1 Cardiovascular5.2 Potential for Drug Interactions When Taking CIALIS for Once Daily Use5.3 Prolonged Erection5.4 Eye5.5 Sudden Hearing Loss5.6 Alpha blockers and Antihypertensives5.7 Renal Insufficiency5.8 Hepatic Impairment5.9 Alcohol5.10 Concomitant Use of Potent Inhibitors of Cytochrome P450 3A4 (CYP3A4)5.11 Combination With Other PDE5 Inhibitors or Erectile Dysfunction Therapies5.12 Effects on Bleeding5.13 Counseling Patients About Sexually Transmitted Diseases6 ADVERSE REACTIONS6.1 Clinical Studies Experience6.2 Postmarketing Experience7 DRUG INTERACTIONS7.1 Potential for Pharmacodynamic Interactions with CIALIS7.2 Potential for Other Drugs to Affect CIALIS7.3 Potential for CIALIS to Affect Other Drugs8 USE IN SPECIFIC POPULATIONS8.1 Pregnancy8.3 Nursing Mothers8.4 Pediatric Use8.5 Geriatric Use8.6 Hepatic Impairment8.7 Renal Insufficiency10 OVERDOSAGE11 DESCRIPTION12 CLINICAL PHARMACOLOGY12.1 Mechanism of Action12.2 Pharmacodynamics12.3 Pharmacokinetics13 NONCLINICAL TOXICOLOGY13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility13.2 Animal Toxicology and/or Pharmacology14 CLINICAL STUDIES14.1 CIALIS for Use as Needed14.2 CIALIS for Once Daily Use16 HOW SUPPLIED/STORAGE AND HANDLING16.1 How Supplied16.2 Storage17 PATIENT COUNSELING INFORMATION17.1 Nitrates17.2 Cardiovascular Considerations17.3 Concomitant Use with Drugs Which Lower Blood Pressure17.4 Potential for Drug Interactions When Taking CIALIS for Once Daily Use17.5 Priapism17.6 Vision17.7 Sudden Hearing Loss17.8 Alcohol17.9 Sexually Transmitted Disease17.10 Recommended Administration*Sections or subsections omitted from the full prescribing information are not listed. Sections or subsections omitted from the full prescribing information are not listed. 2 DOSAGE AND ADMINISTRATION 2.1 Erectile DysfunctionCIALIS for Use as NeededThe recommended starting dose of CIALIS for use as needed in most patients is 10 mg, taken prior to anticipated sexual activity.The dose may be increased to 20 mg or decreased to 5 mg, based on individual efficacy and tolerability. The maximum recommended dosing frequency is once per day in most patients.CIALIS for use as needed was shown to improve erectile function compared to placebo up to 36 hours following dosing. Therefore, when advising patients on optimal use of CIALIS, this should be taken into consideration.2.3 Use in Special PopulationsRenal InsufficiencyCIALIS for Use as NeededMild (creatinine clearance 51 to 80 mL/min): No dose adjustment is required.Moderate (creatinine clearance 31 to 50 mL/min): A starting dose of 5 mg not more than once per day is recommended, and the maximum dose should be limited to 10 mg not more than once in every 48 hours.Severe (creatinine clearance <30 mL/min and on hemodialysis): The maximum recommended dose is 5 mg not more than once in every 72 hours [see Warnings and Precautions (5.7) and Use In Specific Populations (8.7)].CIALIS for Once Daily UseMild (creatinine clearance 51 to 80 mL/min): No dose adjustment is required.Moderate indian cialis generic (creatinine clearance 31 to 50 mL/min): No dose adjustment is required.Severe (creatinine clearance <30 mL/min and on hemodialysis): CIALIS for once daily use is not recommended [see Warnings and Precautions (5.7) and Use In Specific Populations (8.7)].Hepatic ImpairmentCIALIS for Use as NeededMild or moderate (Child Pugh Class A or B): The dose of CIALIS should not exceed 10 mg once per day. Patients should stop CIALIS and seek medical care if a sudden loss of vision occurs in one or both eyes, which could be a sign of Non Arteritic Ischemic Optic Neuropathy (NAION). Discuss increased risk of NAION in patients with history of NAION (5.4). Patients should stop CIALIS and seek prompt medical attention in the event of sudden decrease or loss of hearing (5.5). Most common adverse reactions (≥2%) include headache, dyspepsia, back pain, myalgia, nasal congestion, flushing, and pain in limb (6.1, 6.2). To report SUSPECTED ADVERSE REACTIONS, contact Eli Lilly and Company at 1-800-LillyRx (1-800-545-5979) or FDA at 1-800-FDA-1088 or See 17 for PATIENT COUNSELING INFORMATION and FDA-approved patient labeling. Table of Contents FULL PRESCRIBING INFORMATION: CONTENTS*1 INDICATIONS AND USAGE1.1 Erectile Dysfunction2 DOSAGE AND ADMINISTRATION2.1 Erectile Dysfunction2.2 Use with Food2.3 Use in Special Populations2.4 Concomitant Medications3 DOSAGE FORMS AND STRENGTHS4 CONTRAINDICATIONS4.1 Nitrates4.2 Hypersensitivity Reactions5 WARNINGS AND PRECAUTIONS5.1 Cardiovascular5.2 Potential for Drug Interactions When Taking CIALIS for Once Daily Use5.3 Prolonged Erection5.4 Eye5.5 Sudden Hearing Loss5.6 Alpha blockers and Antihypertensives5.7 Renal Insufficiency5.8 Hepatic Impairment5.9 Alcohol5.10 Concomitant Use of Potent Inhibitors of Cytochrome P450 3A4 (CYP3A4)5.11 Combination With Other PDE5 Inhibitors or Erectile Dysfunction Therapies5.12 Effects on Bleeding5.13 Counseling Patients About Sexually Transmitted Diseases6 ADVERSE REACTIONS6.1 Clinical Studies Experience6.2 Postmarketing Experience7 DRUG INTERACTIONS7.1 Potential for Pharmacodynamic Interactions with CIALIS7.2 Potential for Other Drugs to Affect CIALIS7.3 Potential for CIALIS to Affect Other Drugs8 USE IN SPECIFIC POPULATIONS8.1 Pregnancy8.3 Nursing Mothers8.4 Pediatric Use8.5 Geriatric Use8.6 Hepatic Impairment8.7 Renal Insufficiency10 OVERDOSAGE11 DESCRIPTION12 CLINICAL PHARMACOLOGY12.1 Mechanism of Action12.2 Pharmacodynamics12.3 Pharmacokinetics13 NONCLINICAL TOXICOLOGY13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility13.2 Animal Toxicology and/or Pharmacology14 CLINICAL STUDIES14.1 CIALIS for Use as Needed14.2 CIALIS for Once Daily Use16 HOW SUPPLIED/STORAGE AND HANDLING16.1 How Supplied16.2 Storage17 PATIENT COUNSELING INFORMATION17.1 Nitrates17.2 Cardiovascular Considerations17.3 Concomitant Use with Drugs Which Lower Blood Pressure17.4 Potential for Drug Interactions When Taking CIALIS for Once Daily Use17.5 Priapism17.6 Vision17.7 Sudden Hearing Loss17.8 Alcohol17.9 Sexually Transmitted Disease17.10 Recommended Administration*Sections or subsections omitted from the full prescribing information are not listed. Sections or subsections omitted from the full prescribing information are not listed.
- Generic tadalafil is available in various strengths, including 10mg and 20mg.
- Cialis 20mg is marketed under the brand name Cialis by Lilly.
- The medication was one of the first PDE5 inhibitors approved for ED.
- Cialis can be prescribed for pulmonary arterial hypertension under different names.
- Users should avoid grapefruit juice while taking Cialis.
- Tadalafil’s half-life is approximately 17.5 hours.
- Cialis 20mg can be used by men of various age groups.
- It’s essential to seek medical advice before starting Cialis.
- The medication is not intended for recreational use.
- Plain Cialis tablets are usually diamond-shaped.
- Cialis 20mg may cause priapism, a prolonged erection.
- The efficacy of Cialis can vary based on individual health.
2 DOSAGE AND ADMINISTRATION 2.1 Erectile DysfunctionCIALIS for Use as NeededThe recommended starting dose of CIALIS for use as needed in most patients is 10 mg, taken prior to anticipated sexual activity.The dose may be increased to 20 mg or decreased to 5 mg, based on individual efficacy and tolerability.
| Country | Legal Classification | Prescription Required | Sales Channels |
|---|---|---|---|
| USA | Prescription medication | Yes | Pharmacies, online with script |
| European Union | Prescription drug | Yes | Licensed pharmacies |
| Australia | Schedule 4 (Prescription Only) | Yes | Authorized pharmacies |
| India | OTC and prescription (varies) | Usually prescription | Authorized outlets |
The maximum recommended dosing frequency is once per day in most patients.CIALIS for use as needed was shown to improve erectile function compared to placebo up to 36 hours following dosing. Therefore, when advising patients on optimal use of CIALIS, this should be taken into consideration.2.3 Use in Special PopulationsRenal InsufficiencyCIALIS for Use as NeededMild (creatinine clearance 51 to 80 mL/min): No dose adjustment is required.Moderate (creatinine clearance 31 to 50 mL/min): A starting dose of 5 mg not more than once per day is recommended, and the maximum dose should be limited to 10 mg not more than once in every 48 hours.Severe (creatinine clearance <30 mL/min and on hemodialysis): The maximum recommended dose is 5 mg not more than once in every 72 hours [see Warnings and Precautions (5.7) and Use In Specific Populations (8.7)].CIALIS for Once Daily UseMild (creatinine clearance 51 to 80 mL/min): No dose adjustment is required.Moderate indian cialis generic (creatinine clearance 31 to 50 mL/min): No dose adjustment is required.Severe (creatinine clearance <30 mL/min and on hemodialysis): CIALIS for once daily use is not recommended [see Warnings and Precautions (5.7) and Use In Specific Populations (8.7)].Hepatic ImpairmentCIALIS for Use as NeededMild or moderate (Child Pugh Class A or B): The dose of CIALIS should not exceed 10 mg once per day.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Cialis Original | 20mg | 8 Pills | 61.70€ 58.76€ | |
| Cialis Generic | 60mg | 20 Pills | 65.61€ 62.49€ | |
| Cialis Generic | 40mg | 20 Pills | 59.47€ 56.64€ | |
| Cialis Generic | 40mg | 10 Pills | 37.79€ 35.99€ | |
| Cialis Black | 80mg | 30 + 2 Pills | 89.11€ 84.87€ | |
| Cialis Generic | 5mg | 270 + 10 Pills | 205.81€ 196.01€ | |
| Cialis Original | 20mg | 22 + 2 Pills | 129.20€ 123.05€ | |
| Cialis Generic | 20mg | 120 + 8 Pills | 188.15€ 179.19€ | |
| Cialis Black | 80mg | 60 + 4 Pills | 150.98€ 143.79€ | |
| Cialis Original | 20mg | 48 + 4 Pills | 224.69€ 213.99€ | |
| Cialis Generic | 20mg | 30 + 4 Pills | 68.05€ 64.81€ | |
| Cialis Generic | 40mg | 270 + 10 Pills | 382.19€ 363.99€ | |
| Cialis Professional | 20mg | 10 Pills | 48.29€ 45.99€ | |
| Cialis Generic | 20mg | 180 + 10 Pills | 254.09€ 241.99€ | |
| Cialis Soft Tabs | 20mg | 10 Pills | 39.03€ 37.17€ | |
| Cialis Generic | 40mg | 90 + 6 Pills | 171.35€ 163.19€ | |
| Cialis Generic | 60mg | 90 + 6 Pills | 196.67€ 187.30€ |
The use of CIALIS once per day has not been extensively evaluated in patients with hepatic insufficiency and therefore, caution is advised.Severe (Child Pugh Class C): The use of CIALIS is not recommended [see Warnings and Precautions (5.8) and Use in Specific Populations (8.6)].CIALIS for Once Daily UseMild or moderate (Child Pugh Class A or B): CIALIS for once daily use has not been extensively evaluated in patients with hepatic insufficiency.
4.2 Hypersensitivity Reactions
This is thought to result from the combined effects of nitrates and CIALIS on the nitric oxide/cGMP pathway [see Clinical Pharmacology (12.2)].4.2 Hypersensitivity Reactionsis contraindicated in patients with a known serious hypersensitivity to tadalafil (CIALIS or ADCIRCA). Hypersensitivity reactions have been reported, including Stevens-Johnson syndrome and exfoliative dermatitis [see Adverse Reactions (6.2)]. Administration of CIALIS to patients who are using any form of organic nitrate, either regularly and/or intermittently, is contraindicated. This is thought to result from the combined effects of nitrates and CIALIS on the nitric oxide/cGMP pathway [see Clinical Pharmacology (12.2)]. is contraindicated in patients with a known serious hypersensitivity to tadalafil (CIALIS or ADCIRCA).
Generic version
5 WARNINGS AND PRECAUTIONS Evaluation of erectile dysfunction should include an appropriate medical assessment to identify potential underlying causes, as well as treatment options.Before prescribing CIALIS, it is important to note the following:5.1 CardiovascularPhysicians should consider the cardiovascular status of their patients, since there is a degree of cardiac risk associated with sexual activity. Therefore, caution is advised if CIALIS for once daily use is prescribed to these patients.Severe (Child Pugh Class C): The use of CIALIS is not recommended [see Warnings and Precautions (5.8) and Use in Specific Populations (8.6)].2.4 Concomitant MedicationsAlpha BlockersWhen CIALIS is coadministered with an alpha blocker, patients should be stable on alpha-blocker therapy prior to initiating treatment with CIALIS, and CIALIS should be initiated at the lowest recommended dose [see Warnings and Precautions (5.6), Drug Interactions (7.1) and Clinical Pharmacology (12.2)]. The recommended starting dose of CIALIS for use as needed in most patients is 10 mg, taken prior to anticipated sexual activity.
Free Returns
Moderate (creatinine clearance 31 to 50 mL/min): No dose adjustment is required. Severe (creatinine clearance <30 mL/min and on hemodialysis): CIALIS for once daily use is not recommended [see Warnings and Precautions (5.7) and Use In Specific Populations (8.7)]. Mild or moderate (Child Pugh Class A or B): The dose of CIALIS should not exceed 10 mg once per day. The use of CIALIS once per day has not been extensively evaluated in patients with hepatic insufficiency and therefore, caution is advised. Severe (Child Pugh Class C): The use of CIALIS is not recommended [see Warnings and Precautions (5.8) and Use in Specific Populations (8.6)].
Tadalafil Blocks PDE5
Mild or moderate (Child Pugh Class A or B): CIALIS for once daily use has not been extensively evaluated in patients with hepatic insufficiency. Therefore, caution is advised if CIALIS for once daily use is prescribed to these patients. When CIALIS is coadministered with an alpha blocker, patients should be stable on alpha-blocker therapy prior to initiating treatment with CIALIS, and CIALIS should be initiated at the lowest recommended dose [see Warnings and Precautions (5.6), Drug Interactions (7.1) and Clinical Pharmacology (12.2)]. 4 CONTRAINDICATIONS 4.1 NitratesAdministration of CIALIS to patients who are using any form of organic nitrate, either regularly and/or intermittently, is contraindicated. In clinical pharmacology studies, CIALIS was shown to potentiate the hypotensive effect of nitrates. The dose may be increased to 20 mg or decreased to 5 mg, based on individual efficacy and tolerability.
5.8 Hepatic Impairment
Who should not use tadalafil?
The maximum recommended dosing frequency is once per day in most patients. CIALIS for use as needed was shown to improve erectile function compared to placebo up to 36 hours following dosing. Therefore, when advising patients on optimal use of CIALIS, this should be taken into consideration. Mild (creatinine clearance 51 to 80 mL/min): No dose adjustment is required. Moderate (creatinine clearance 31 to 50 mL/min): A starting dose of 5 mg not more than once per day is recommended, and the maximum dose should be limited to 10 mg not more than once in every 48 hours. Severe (creatinine clearance <30 mL/min and on hemodialysis): The maximum recommended dose is 5 mg not more than once in every 72 hours [see Warnings and Precautions (5.7) and Use In Specific Populations (8.7)].
12.2 Pharmacodynamics
Improves erectile function compared to placebo up to 36 hours post dose (2.1). CIALIS for once daily use: 2.5 mg taken once daily, without regard to timing of sexual activity. May increase to 5 mg based upon efficacy and tolerability (2.1). CIALIS may be taken without regard to food (2.2). Patients should not use CIALIS if sex is inadvisable due to cardiovascular status (5.1).
Overdose symptoms
Use of CIALIS with alpha blockers, antihypertensives or substantial amounts of alcohol (≥5 units) may lead to hypotension (5.6, 5.9). If taking potent inhibitors of CYP3A4, dose should be adjusted: CIALIS for use as needed: ≤10 mg every 72 hours. For once daily use: dose not to exceed 2.5 mg (5.10). Patients should seek emergency treatment if an erection lasts >4 hours. Use CIALIS with caution in patients predisposed to priapism (5.3). Moderate (creatinine clearance 31 to 50 mL/min): No dose adjustment is required.
- Cialis 20mg is effective for many men but not all.
- Tadalafil was initially used for treating angina before ED.
- Cialis is also marketed for daily low-dose use.
- Always follow the prescribing guidelines for safety.
- Use Cialis only under medical supervision if other health issues exist.
- Cialis 20mg interacts with some antihypertensive medications.
- The medication helps with both erectile and urinary symptoms.
- Be aware of potential side effects like dizziness and vision changes.
- Cialis has a rapid onset, usually within 30 minutes.
- The drug is approved by various health authorities worldwide.
- Combined use with certain recreational drugs is dangerous.
- Regular use can build confidence in managing ED.
Severe (creatinine clearance <30 mL/min and on hemodialysis): CIALIS for once daily use is not recommended [see Warnings and Precautions (5.7) and Use In Specific Populations (8.7)]. Mild or moderate (Child Pugh Class A or B): The dose of CIALIS should not exceed 10 mg once per day. The use of CIALIS once per day has not been extensively evaluated in patients with hepatic insufficiency and therefore, caution is advised. Severe (Child Pugh Class C): The use of CIALIS is not recommended [see Warnings and Precautions (5.8) and Use in Specific Populations (8.6)]. Mild or moderate (Child Pugh Class A or B): CIALIS for once daily use has not been extensively evaluated in patients with hepatic insufficiency. Therefore, caution is advised if CIALIS for once daily use is prescribed to these patients. When CIALIS is coadministered with an alpha blocker, patients should be stable on alpha-blocker therapy prior to initiating treatment with CIALIS, and CIALIS should be initiated at the lowest recommended dose [see Warnings and Precautions (5.6), Drug Interactions (7.1) and Clinical Pharmacology (12.2)]. 4 CONTRAINDICATIONS 4.1 NitratesAdministration of CIALIS to patients who are using any form of organic nitrate, either regularly and/or intermittently, is contraindicated. In clinical pharmacology studies, CIALIS was shown to potentiate the hypotensive effect of nitrates. This is thought to result from the combined effects of nitrates and CIALIS on the nitric oxide/cGMP pathway [see Clinical Pharmacology (12.2)].4.2 Hypersensitivity Reactionsis contraindicated in patients with a known serious hypersensitivity to tadalafil (CIALIS or ADCIRCA).
- Cialis 20mg can support improved sexual satisfaction.
- It is different from other PDE5 inhibitors like Viagra or Levitra.
- The medication has a relatively fast onset of action.
- Cialis is available in various countries worldwide.
- Consider potential risk factors before using Cialis.
- Cialis 20mg is usually well tolerated in most men.
- The medication has been patented and branded for years.
- Tadalafil’s mechanism involves inhibition of PDE5 enzyme.
- Cialis 20mg is effective in relaxing penile arteries.
- The drug’s effects can last from 24 to 36 hours.
- It is advised to avoid heavy or high-fat meals before use.
- Always consult with a healthcare provider for personalized advice.
Hypersensitivity reactions have been reported, including Stevens-Johnson syndrome and exfoliative dermatitis [see Adverse Reactions (6.2)].
| Standard | Description | Certification | Frequency of Inspection |
|---|---|---|---|
| Good Manufacturing Practice (GMP) | Ensures purity and efficacy of medicines | Yes | Annually |
| ISO 9001 | Quality management system | Yes | Every 2 years |
| Active Ingredient Testing | Confirm potency and purity | Yes | Before batch release |
| Packaging Validation | Ensures safety and integrity of packaging | Yes | Per batch |
Administration of CIALIS to patients who are using any form of organic nitrate, either regularly and/or intermittently, is contraindicated.
- Cialis 20mg requires a doctor's prescription in most regions.
- Some men prefer Cialis over other ED treatments due to longer effects.
- The medication can sometimes cause back pain or muscle aches.
- Cialis has been widely studied in clinical trials.
- In some cases, Cialis may be less effective with certain health conditions.
- The medication may influence blood pressure levels.
- Cialis 20mg should not be used in combination with riociguat.
- Men should avoid excessive alcohol consumption with Cialis.
- Regular assessment by a healthcare provider ensures safe use.
- Cialis’s long duration makes it suitable for spontaneous activity.
- Generic tadalafil provides a cost-effective alternative.
- Proper storage extends the medication's efficacy.
This is thought to result from the combined effects of nitrates and CIALIS on the nitric oxide/cGMP pathway [see Clinical Pharmacology (12.2)]. is contraindicated in patients with a known serious hypersensitivity to tadalafil (CIALIS or ADCIRCA).
7.1 Potential for Pharmacodynamic Interactions with CIALIS
The use of CIALIS once per day has not been extensively evaluated in patients with hepatic insufficiency and therefore, caution is advised.Severe (Child Pugh Class C): The use of CIALIS is not recommended [see Warnings and Precautions (5.8) and Use in Specific Populations (8.6)].CIALIS for Once Daily UseMild or moderate (Child Pugh Class A or B): CIALIS for once daily use has not been extensively evaluated in patients with hepatic insufficiency. Therefore, caution is advised if CIALIS for once daily use is prescribed to these patients.Severe (Child Pugh Class C): The use of CIALIS is not recommended [see Warnings and Precautions (5.8) and Use in Specific Populations (8.6)].2.4 Concomitant MedicationsAlpha BlockersWhen CIALIS is coadministered with an alpha blocker, patients should be stable on alpha-blocker therapy prior to initiating treatment with CIALIS, and CIALIS should be initiated at the lowest recommended dose [see Warnings and Precautions (5.6), Drug Interactions (7.1) and Clinical Pharmacology (12.2)]. The recommended starting dose of CIALIS for use as needed in most patients is 10 mg, taken prior to anticipated sexual activity. The dose may be increased to 20 mg or decreased to 5 mg, based on individual efficacy and tolerability. The maximum recommended dosing frequency is once per day in most patients.
How is tadalafil supplied (dosage forms)?
CIALIS for use as needed was shown to improve erectile function compared to placebo up to 36 hours following dosing. Therefore, when advising patients on optimal use of CIALIS, this should be taken into consideration. Mild (creatinine clearance 51 to 80 mL/min): No dose adjustment is required. Moderate (creatinine clearance 31 to 50 mL/min): A starting dose of 5 mg not more than once per day is recommended, and the maximum dose should be limited to 10 mg not more than once in every 48 hours. Severe (creatinine clearance <30 mL/min and on hemodialysis): The maximum recommended dose is 5 mg not more than once in every 72 hours [see Warnings and Precautions (5.7) and Use In Specific Populations (8.7)]. 5 WARNINGS AND PRECAUTIONS Evaluation of erectile dysfunction should include an appropriate medical assessment to identify potential underlying causes, as well as treatment options.Before prescribing CIALIS, it is important to note the following:5.1 CardiovascularPhysicians should consider the cardiovascular status of their patients, since there is a degree of cardiac risk associated with sexual activity.