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what to tell your doctor to get cialis

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Cialis

What is Cialis?

Cialis (tadalafil) relaxes muscles found in the walls of blood vessels and increases blood flow to particular areas of the body.

Cialis is used to treat erectile dysfunction (impotence) and symptoms of benign prostatic hypertrophy (enlarged prostate).

Another brand of tadalafil is Adcirca, which is used to treat pulmonary arterial hypertension. Do not take Cialis while also taking Adcirca, unless your doctor tells you to.

Important information

Some medicines can cause unwanted or dangerous effects when used with Cialis. Tell your doctor about all your current medicines, especially riociguat (Adempas).

Do not take Cialis if you are also using a nitrate drug for chest pain or heart problems, including nitroglycerin, isosorbide dinitrate, isosorbide mononitrate, and some recreational drugs such as "poppers". Taking Cialis with a nitrate medicine can cause a sudden and serious decrease in blood pressure.

Contact your doctor or seek emergency medical attention if your erection is painful or lasts longer than 4 hours. A prolonged erection (priapism) can damage the penis.

Stop using Cialis and get emergency medical help if you have sudden vision loss.

Before taking this medicine

You should not take Cialis if you are allergic to tadalafil, or:

if you take other medicines to treat pulmonary arterial hypertension, such as riociguat (Adempas).

Do not take Cialis if you are also using a nitrate drug for chest pain or heart problems. This includes nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate. Nitrates are also found in some recreational drugs such as amyl nitrate or nitrite ("poppers"). Taking Cialis with a nitrate medicine can cause a sudden and serious decrease in blood pressure.

To make sure Cialis is safe for you, tell your doctor if you have any of these other conditions:

heart disease or heart rhythm problems, coronary artery disease;

a recent heart attack (within the past 90 days);

a recent history (in the past 6 months) of a stroke, or congestive heart failure;

angina (chest pain), high or low blood pressure;

liver or kidney disease (or if you are on dialysis);

a blood cell disorder such as sickle cell anemia, multiple myeloma, or leukemia;

a bleeding disorder such as hemophilia;

a stomach ulcer;

retinitis pigmentosa (an inherited condition of the eye);

a physical deformity of the penis (such as Peyronie's disease); or

if you have been told you should not have sexual intercourse for health reasons.

Cialis can decrease blood flow to the optic nerve of the eye, causing sudden vision loss. This has occurred in a small number of people taking Viagra or other drugs similar to tadalafil. Most of these people also had certain pre-existing eye problems or risk factors for blood vessel disorders (such as heart disease, diabetes, high blood pressure, high cholesterol, coronary artery disease, smoking, or being over 50 years old). It is not clear whether Cialis is the actual cause of vision loss.

tadalafil is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether tadalafil passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How should I take Cialis?

Cialis is usually taken only once per day. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Cialis can be taken with or without food.

Do not break or split a tablet. Swallow it whole.

For erectile dysfunction, take this medicine just before sexual activity but not more than once per day.

Cialis can help achieve an erection when sexual stimulation occurs. An erection will not occur just by taking a pill. Follow your doctor's instructions.

During sexual activity, if you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw, stop and call your doctor right away. You could be having a serious side effect of Cialis.

Do not take Cialis for erectile dysfunction if you are taking Adcirca for pulmonary arterial hypertension.

Store at room temperature away from moisture and heat.

Cialis dosing information

Usual Adult Dose for Erectile Dysfunction:

Use as needed for ED:
-Initial dose: 10 mg orally once a day, as needed, prior to sexual activity
-Maintenance dose: 5 to 20 mg orally once a day, as needed, prior to sexual activity based on individual efficacy and tolerability

Comment: Consider that this drug has shown to improve erectile dysfunction up to 36 hours following dosing, when used as needed.

Once a day use for ED:
-Initial dose: 2.5 mg orally once a day at approximately the same time, without regard to timing of sexual activity
-Maintenance dose: 2.5 to 5 mg orally once a day based on individual efficacy and tolerability.

Once daily use for ED and Benign Prostatic Hyperplasia (BPH):
-5 mg orally once a day at approximately the same time, without regard to timing of sexual activity

Use: Treatment of erectile dysfunction (ED)

Usual Adult Dose for Benign Prostatic Hyperplasia:

Once daily use for BPH:
-5 mg orally once a day at approximately the same time

Concomitant administration with finasteride:
-5 mg orally once a day at approximately the same time, for up to 26 weeks

Comments: The incremental benefit of this drug decreases from 4 weeks until 26 weeks. The incremental benefit of this drug beyond 26 weeks is unknown.

Once daily use for ED and BPH:
-5 mg orally once a day at approximately the same time, without regard to timing of sexual activity

Use: Treatment of the signs and symptoms of benign prostatic hyperplasia (BPH)

What happens if I miss a dose?

If Cialis is used as needed, you are not likely to be on a dosing schedule.

If you take Cialis every day and you miss a dose, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Cialis?

Drinking alcohol with this medicine can cause side effects.

Grapefruit and grapefruit juice may interact with tadalafil and lead to unwanted side effects. Avoid the use of grapefruit products while taking this medicine.

Avoid using any other medicines to treat impotence, such as alprostadil or yohimbine, without first talking to your doctor.

Cialis side effects

Get emergency medical help if you have any signs of an allergic reaction to Cialis: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using Cialis and get emergency medical help if you have:

erection is painful or lasts longer than 4 hours (prolonged erection can damage the penis);

vision changes or sudden vision loss; or

heart attack symptoms - chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating.

Also call your doctor right away if you have:

ringing in your ears, or sudden hearing loss;

swelling in your hands, ankles, or feet;

shortness of breath;

About ED & BPH (erectile dysfunction & benign prostatic hyperplasia)

About ED

ED is a medical condition that causes problems getting or maintaining an erection. It affects approximately 18 million men in the United States, but is treatable in most cases. ED is more common in older men, but can happen at almost any age.

Not all men experience ED in the same way. ED may be mild in severity, resulting in occasional problems, or more severe, with erection problems that happen often—or always. Problems may include:

  • You can't get an erection at all
  • You get an erection, but it's not hard enough for penetration
  • You get an erection, but you can't maintain it until sexual activity is over

Increased risk factors for ED

  • High blood pressure (hypertension)
  • Diabetes (high blood sugar)
  • High cholesterol
  • Nerve diseases (such as Parkinson's disease A disorder that kills or damages nerve cells in a part of the brain that controls how muscles move. Symptoms may include shaking, stiffness, slow movement, and poor balance and coordination. or multiple sclerosis)
  • Surgery or injury (especially prostate A gland in a man’s body located near the base of his penis. The prostate secretes a fluid that makes up the main portion of the fluid (semen) that a man ejaculates during an orgasm. bladder, or rectal surgery)
  • Abnormal hormone levels (testosterone or thyroid)
  • Lifestyle factors (like smoking, drinking alcohol in excess, being overweight, not being physically active, or using recreational drugs)
  • Side effect of some medications (including high blood pressure medication and antihistamines)
  • Emotional or personal issues (such as ongoing stress or relationship problems, depression, or anxiety about sexual performance)

About BPH

BPH is a medical condition in which the prostate A gland in a man’s body located near the base of his penis. The prostate secretes a fluid that makes up the main portion of the fluid (semen) that a man ejaculates during an orgasm. becomes enlarged and can cause problems associated with urination. ED and BPH are separate conditions, but they often coexist, and both are treatable .

Symptoms of BPH* can increase with age and may include:

  • Needing to go frequently or urgently
  • Stopping or starting during urination
  • Needing to push or strain during urination
  • Having a weak urine stream
  • Incomplete emptying of the bladder
  • Needing to go excessively at night

*Treatment of individual symptoms may vary.

Causes of the urinary symptoms of BPH

When everything is working normally, the bladder stores urine until it is full, then empties all of the urine at once. The urine leaves the body through a thin tube called the urethra, which is surrounded by the prostate gland.

With BPH, the prostate gland enlarges and can eventually interfere with urination by partially blocking the urethra.

Talk to your doctor & partner

If you're experiencing either or both of these common conditions, the key to getting help is to make an appointment with your doctor. That’s the only way to know if you need treatment.

Start the conversation

It may not be easy for you to talk to your doctor about certain issues. But the more information you are able to share about yourself, the easier it will be for your doctor to properly diagnose your condition.

Download and fill out the symptom checklists below to help start the conversation at your next appointment.

Talking to your partner

About ED

How do I talk about ED
with my partner? My partner has ED.
What should I know?

About BPH

How do I talk about BPH Enlargement of the prostate gland that can lead to urination and bladder problems if the enlarged gland begins to press on the urethra.
with my partner? My partner also has BPH
symptoms. What should I know?

Want more information?

To help you learn more about ED and BPH, here’s a list of well-respected associations and Web sites that provide important information you can use when deciding how to treat your condition.

Urology Care Foundation National Institute of Diabetes
and Digestive and Kidney
Diseases (NIDDK) Sexual Medicine Society
of North America (SMSNA)

TD92261 11/2014 В©2014, LILLY USA, LLC. ALL RIGHTS RESERVED.

Indications: CIALIS is approved to treat erectile dysfunction (ED), the signs and symptoms of benign prostatic hyperplasia (BPH), and both ED and the signs and symptoms of BPH. Taking CIALIS with finasteride when starting BPH treatment has been studied for 26 weeks. CIALIS is not for women or children.

IMPORTANT SAFETY INFORMATION FOR CIALIS

What Is The Most Important Information I Should Know About CIALIS?

Do not take CIALIS if you:take medicines called “nitrates” such as nitroglycerin or other medications like isosorbide dinitrate or isosorbide mononitrate, which are often prescribed for chest pain as the combination may cause an unsafe drop in blood pressure; or use recreational drugs called “poppers” like amyl nitrite and butyl nitrite. take medicines called guanylate cyclase stimulators such as riociguat (Adempas ® ),* a medicine used to treat pulmonary hypertension as the combination may cause an unsafe drop in blood pressure. are allergic to CIALIS or ADCIRCA ® (tadalafil), or any of its ingredients. Call your healthcare provider or get help right away if you experience any symptoms of an allergic reaction, such as rash, hives, swelling of the lips, tongue or throat, or difficulty breathing or swallowing.

After taking a single tablet, some of the active ingredient of CIALIS remains in your body for more than 2 days. The active ingredient can remain longer if you have problems with your kidneys or liver, or you are taking certain other medications.

Stop sexual activity and get medical help right away if you get symptoms such as chest pain, dizziness, or nausea during sex. Sexual activity can put an extra strain on your heart, especially if it is already weak from a heart attack or heart disease.

What Should I Tell My Healthcare Provider Before Taking CIALIS?

CIALIS is not right for everyone. Only your healthcare provider and you can decide if CIALIS is right for you. Ask your healthcare provider if your heart is healthy enough for you to have sexual activity. Do not take CIALIS if your healthcare provider has told you not to have sexual activity because of your health problems. Before taking CIALIS, tell your healthcare provider about all your medical problems, particularly if you have or ever had: heart problems such as chest pain (angina), heart failure, irregular heartbeats, or heart attack pulmonary hypertensionlow blood pressure or high blood pressure that is not controlled strokeliver or kidney problems or require dialysisretinitis pigmentosa. a rare genetic (runs in families) eye disease severe vision loss, including a condition called NAIONstomach ulcers or a bleeding problema deformed penis shape or Peyronie’s disease an erection that lasted more than 4 hoursblood cell problems such as sickle cell anemia, multiple myeloma, or leukemia

Can Other Medicines Affect CIALIS?

Tell your healthcare provider about all the medicines you take, especially: medicines called "nitrates" which are often prescribed for chest pain medicines called guanylate cyclase stimulators, such as riociguat (Adempas ® ), used to treat pulmonary arterial hypertension and chronic-thromboembolic hypertension alpha-blockers often prescribed for prostate problems blood pressure medications medicines for HIV or some types of oral antifungal medications some types of antibiotics such as clarithromycin, telithromycin, erythromycin (several brand names exist, please contact your healthcare provider to determine if you are taking this medicine) other medicines or treatments for erectile dysfunction (ED) CIALIS is also marketed as ADCIRCA for the treatment of pulmonary arterial hypertension. Do not take both CIALIS and ADCIRCA. Do not take sildenafil citrate (Revatio ® )* with CIALIS.

How Should I Take CIALIS?

CIALIS should not be taken more than one time each day. If you miss a dose, you may take it when you remember but do not take more than one dose per day. Take CIALIS exactly as your healthcare provider prescribes it.

What Should I Avoid While Taking CIALIS?

Do not use other ED medicines or ED treatments. Do not drink too much alcohol (for example, 5 glasses of wine or 5 shots of whiskey). Drinking too much alcohol can increase your chances of getting a headache or getting dizzy, increasing your heart rate, or lowering your blood pressure.

What Are The Possible Side Effects Of CIALIS?

The most common side effects with CIALIS are: headache, indigestion, back pain, muscle aches, flushing, and stuffy or runny nose. These side effects usually go away after a few hours. Men who get back pain and muscle aches usually get it 12 to 24 hours after taking CIALIS. Back pain and muscle aches usually go away within 2 days. Call your healthcare provider if you get any side effect that bothers you or one that does not go away.

Uncommon but serious side effects include:
An erection that won’t go away: If you get an erection lasting more than 4 hours, seek immediate medical help to avoid long-term injury.

In rare instances, men taking prescription ED tablets, including CIALIS, reported a sudden decrease or loss of vision or hearing (sometimes with ringing in the ears and dizziness). It’s not possible to determine if these events are related directly to the ED tablets or to other factors. If you have a sudden decrease or loss of vision or hearing, stop taking any ED tablet, including CIALIS and call a healthcare provider right away.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call
1-800-FDA-1088 .

CIALIS does not:
Cure ED, increase a man's sexual desire, protect a man or his partner from sexually transmitted diseases, including HIV or serve as a male form of birth control.

CIALIS is available by prescription only.

*The brand listed is a trademark of its respective owner and is not a trademark of Eli Lilly and Company. The maker of this brand is not affiliated with and does not endorse Eli Lilly and Company or its products.

TD CON ISI 16SEP2015

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