Cialis Patient information

What is Cialis used for?
Cialis is a prescription medicine taken by mouth for the treatment of erectile dysfunction (ED) in men. ED is a condition when a man cannot get, or keep, a hard erect penis suitable for sexual activity. Cialis may help a man with ED get and keep an erection when he is sexually excited.

How does Cialis work?
The active ingredient in CIALIS tablets, Tadalafil, belongs to a group of medicines called phosphodiesterase type 5 inhibitors. Following sexual stimulation, CIALIS works by helping the blood vessels in your penis to relax, allowing the flow of blood into your penis. The result of this is improved erectile function. CIALIS will not help you if you do not have erectile dysfunction.

What is the main ingredient in Cialis?
CIALIS tablets contain either 10 mg or 20 mg of the active ingredient tadalafil. CIALIS tablets also contain the following inactive ingredients: lactose monohydrate, croscarmellose sodium, hydroxypropylcellulose, microcrystalline cellulose, sodium laurilsulfate, magnesium stearate, hypromellose, triacetin, titanium dioxide (E171), iron oxide (E172) and talc. The chemical designation is pyrazino[1',2':1,6 ] pyrido [3,4-b]indole-1,4-dione,6-(1,3-benzodioxol-5-yl)-2,3,6,7,12,12a-hexahydro-2-methyl-,(6R,12aR)-. It is a crystalline solid that is practically insoluble in water and very slightly soluble in ethanol.

What it looks like?
CIALIS 10mg tablets are yellow almond-shaped tablets and have "C10" marked on one side. CIALIS 10mg tablets are blister packed and are available in cartons containing 4 tablets. CIALIS 20mg tables are yellow almond-shaped tablets and have "C20" marked on one side. CIALIS 20mg tablets are blister packed and are available in cartons containing 1, 2 or 4 tablets.

Who should not take Cialis?
CIALIS is not intended for use by women or by children under the age of 18 years. No special consideration is needed for the elderly or people with diabetes.

Warnings: Do not take Cialis under the following conditions:

• If you are taking medicines such as nitrates and alpha-blockers, and recreational drugs that contain nitrates called "poppers". Cialis can cause your blood pressure to drop suddenly to an unsafe level and could cause you to become dizzy, faint, or have a heart attack or stroke.
• If you have been told by your healthcare provider to not have sexual activity because of health problems.
• You have had an allergic reaction in the past to Tadalafil or any of the other ingredients of CIALIS. Some of the symptoms of an allergic reaction may include shortness of breath, wheezing or difficulty breathing; swelling of the face, lips, tongue or other parts of the body; rash, itching or hives on the skin.
• Do not take CIALIS after the expiry date printed on the pack or if the packaging is torn or shows signs of tampering.

Consult your doctor before you take Cialis

All medicines have risks and benefits. If you have any concerns about taking CIALIS, ask your doctor or health care professional.

Consult your doctor if you suffer from the following health problems:

• have heart problems such as angina, heart failure, irregular heartbeats, or have had a heart attack
• have had a stroke
• have low blood pressure or have high blood pressure that is not controlled
• have liver problems
• have kidney problems or require dialysis
• have retinitis pigmentosa , a rare genetic (runs in families) eye disease
• have stomach ulcers
• have a bleeding problem
• have a deformed penis shape or Peyronie's disease
• have had an erection that lasted more than 4 hours
• have blood cell problems such as sickle cell anemia, multiple myeloma , or leukemia
• For those who are lactose intolerant, be aware that CIALIS tablets contain a small amount of lactose (approximately 200mg for the 10mg tablet and 250mg for the 20mg tablet).

Consult your doctor if you are taking any other prescription or non-prescription medicines as they might affect each other. This is important if you are taking the following medicines:

• nitrates (used to treat heart conditions);
• rifampicin (an antibacterial product used amongst others against tuberculosis);
• ketoconazole or itraconazole (used against fungal infections)
• erythromycin (an antibacterial product);
• protease inhibitors (HIV treatments).
• alpha blockers like Hytrin' ( terazosin ), Flomax' ( tamsulosin ), Cardura ( doxazosin ), Minipress ( prazosin ) or Uroxatral' ( alfuzosin ).
• erythromycin
• Norvir (ritonavir ) or Crixivan (indinavir )
• ketoconazole or itraconazole (such as Nizoral' or Sporanox )
• other medicines or treatments for ED

Dosage

How to Take It?
CIALIS tablets are for oral use. Swallow the tablet whole with water. You may take CIALIS with or without food or alcohol.

How Much to Take?
The recommended dose is 20mg before sexual activity. You should NOT take CIALIS more than once a day.

When to Take It?
You can engage in sexual activity within half an hour of taking the tablet and up to 36 hours later. It may be possible for you to engage in sexual activity more than once - for example, in the evening and again in the morning. The amount of time CIALIS takes to work varies from person to person. After you have taken CIALIS you may wish to attempt sexual intercourse at different times to decide the best time range for you and your partner. Your dose may be lowered to 10mg based on your individual response to CIALIS. If you are not sure when to take CIALIS, ask your doctor or health care professional.

What to do incase of an overdose?
Immediately telephone your doctor for advice, or go to the Emergency Department at the nearest hospital. Do this even if there are no signs of discomfort or poisoning. You may need urgent medical attention. Symptoms of an overdose may include headache, dyspepsia (indigestion), back pain, muscular aches, nasal congestion and facial flushing.

Things You Must Not Do

• Do not use CIALIS to treat any other complaints unless your doctor tells you to.
• Do not give CIALIS tablets to others, even if they have similar conditions. Their doctor should decide if CIALIS is right for them.

Things to be Careful Of
Although the frequency of dizziness in men taking CIALIS was similar to that of men taking placebo (sugar pills) in clinical studies, you should be aware of how you react to CIALIS before you drive or operate machinery.

Possible side effects of Cialis
Tell your doctor or health care professional as soon as possible if you do not feel well while you are taking CIALIS. CIALIS helps most people with erectile dysfunction, but it may have unwanted side effects in a few people. Most of the side effects are mild to moderate in nature. Do not be alarmed by the following list of the most common possible side effects. You may not experience any of them. Ask your doctor or health care professional to answer any questions you may have. Tell your doctor or health care professional if you notice any of the following and they are troublesome, severe, or do not go away:

• headache;
• indigestion;
• back pain;
• muscle aches;
• nasal congestion;
• facial flushing;
• swelling of the eyelids;
• eye pain;
• conjunctival hyperaemia (red eyes);
• dizziness.
• Allergic reactions (including skin rashes) could occur.
• In rare instances it is possible that a prolonged and possibly painful erection may occur after taking CIALIS. If you have such an erection which lasts continuously for more than 4 hours, you should contact a doctor immediately.
• In case of chest pain occurring during or after sexual activity you should NOT use nitrates but you should seek immediate medical assistance.
• Vision changes, such as seeing a blue tinge to objects or having difficulty telling the difference between the colors blue and green

Tell your doctor or pharmacist if you notice anything that is making you feel unwell.

Storage
Keep your CIALIS tablets in the original package, and store below 25°C. Keep all medicines out of the reach and sight of children.

Disposal
If the expiry date on CIALIS has passed, ask your pharmacist what to do with any medicine that is left over.

P.S. Cialis is only for men with ED. Cialis is not for women or children. Cialis must be used only under a doctor's care.