Warnings


What are the risks of taking Cialis (tadalafil)?


Cialis is not suitable for everyone. It is approved for use in adult men 18 years and older to treat erectile dysfunction and symptoms of benign prostatic hyperplasia. Cialis is not for women or children. This medicine can cause serious health problems in certain groups of patients. Some of the risks of taking Cialis include:

Other risks of lisinopril use include:

  • Risk of heart attack: Cialis is not recommended in patients who have had a stroke, heart attack, or symptoms of heart failure in the last six months. The safety of this medicine is uncertain in such patients. In addition, this medicine needs to be used with caution in people with high blood pressure or chest pain symptoms. Talk to your doctor about other treatment options for erectile dysfunction if you have an existing heart condition.
  • Low blood pressure: If you are taking medications called alpha-blockers for high blood pressure, Cialis may not be right for you. The combination can cause blood pressure to drop too low. Likewise, you should never take Cialis with nitrate medications for angina (chest pain) because this can cause blood pressure to fall to dangerously low levels. While on Cialis treatment, be sure to arise slowly from a sitting or lying position, placing your feet on the floor for a few minutes before standing up. Getting up too quickly can lead to dizziness and falls.
  • Priapism: Cialis can cause a prolonged and painful erection lasting more than 4 hours in some men. This condition is called priapism, and it requires emergency medical care. Without medical attention, priapism can cause irreversible damage to the penis. The risk of this occurring is higher in men with Peyronie’s disease (bent penis) and sickle cell anemia.
  • Hearing loss: Rarely, Cialis can cause adverse effects like ringing in the ears, dizziness, and hearing loss. If you experience any of these symptoms, go to the emergency room without delay.
  • Vision changes: Some people may experience vision changes or vision loss in one or both eyes while on Cialis. This is a rare adverse effect, and it requires immediate medical attention to prevent permanent eye damage. 
  • Drug interactions: Elderly patients (age 65+), patients with liver or kidney disease, and those taking blood pressure medications like alpha-blockers, nitrates, or certain antifungals and HIV drugs are at increased risk of Cialis side effects. Talk to your doctor about other treatment options for erectile dysfunction if you fall into any of these categories.

Your doctor or pharmacist can prescribe other treatments for erectile dysfunction if you are at a high risk of side effects or complications from Cialis use.




What should I tell my doctor before starting Cialis (tadalafil)?

 Tell your doctor if you are allergic to tadalafil, any of the ingredients in tadalafil tablets (your local pharmacy can provide you with a list), or have allergies to any other medications.

 Tell your healthcare provider about all your health conditions. Cialis may not be right for people with certain medical conditions like heart disease, liver disease, or kidney disease. This medicine also needs to be used with caution in patients with structural defects of the penis, such as Peyronie’s disease, and in patients at risk of priapism.

Give your doctor a list of all your current medications, including prescription drugs, over-the-counter medicines, dietary supplements, and natural products. This can help avoid serious drug interactions.

In particular, inform your doctor if you take or have recently taken nitrate drugs (Isordil, Monoket, Nitro-Dur, Nitrostat, Nitromist, and others) for angina (chest pain). These medications are available as tablets, pastes, ointments, patches, and sprays. Your doctor will probably not advise taking tadalafil if you are on any of these medications. Also, tell your doctor if you use street drugs that may contain nitrites (poppers). Taking tadalafil and using these recreational drugs together can be dangerous.

What precautions should I take while on Cialis (tadalafil)?

 Tell all your healthcare providers that you take Cialis. If you need emergency medical care for a heart condition, your healthcare providers should know when you took your last dose of Cialis.

Do not use Cialis if you are on treatment with nitrate drugs for angina (chest pain). Do not use recreational drugs like poppers while on Cialis treatment.

Tadalafil is available under the brand names Cialis and Adcirca. You should be on only one of these drugs at a time. 

Get emergency medical care if you experience priapism (a prolonged, painful erection that lasts more than 4 hours), sudden vision changes or vision loss in one or both eyes, or sudden decreased hearing or hearing loss.

Note that Cialis does not prevent pregnancy or protect you against sexually transmitted infections, including HIV/AIDS. Talk to your doctor if you have questions about preventing sexually transmitted diseases. Cialis can relieve symptoms of erectile dysfunction, but it will not cure ED or increase libido (sexual desire).

Women on Adcirca (tadalafil) for pulmonary arterial hypertension treatment should inform their doctor if they are pregnant, could be pregnant, or breastfeeding. 

What are Cialis (tadalafil) interactions?

Taking Cialis with certain medications can affect how it works or cause serious adverse effects. Your doctor may decide not to treat you with Cialis, give you a lower dose, change some of your other medicines, or monitor you carefully for side effects if there are known interactions between Cialis and your other medicines.

 Using Cialis with the following medications is not recommended:

  •  certain antiretroviral drugs used for HIV treatment
  • riociguat (Adempas) used to treat pulmonary hypertension

  • nitrates (used in patients with heart disease)

There can also be interactions between Cialis and the following medicines such as:

  • alpha blockers (Uroxatral, Cardura, Minipress, Rapaflo, Flomax and others)
  • certain antifungals (Diflucan, Grifulvin, Sporanox, Ketazole, Nizoral, and others)
  • carbamazepine (Tegretol, Carbatrol, and others)


  • other medications or treatments for erectile dysfunction
  • other medications or treatments for pulmonary arterial hypertension
  • diltiazem (Cartia, Cardizem, Tiazac, and others)
  • efavirenz (Sustiva and others)
  • erythromycin


This list does not describe all possible Cialis interactions. To avoid any potential interactions, give your healthcare provider a complete list of your medications, including prescription drugs, over-the-counter medicines, dietary supplements, and herbal products. Also, tell your healthcare provider if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with Cialis.