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Whether you can take Tadalafil at the same time as your other medications will depend on which medications you are taking.

You are required to complete a short medical consultation questionnaire that asks for any medications that you are prescribed from your GP and will indicate the medications that can’t be taken alongside Tadalafil.

There are several medicines which should not be taken concurrently with Tadalafil. Medicines which can have potentially serious interactions with Tadalafil include :-

• Any alpha-blocker medicines e.g. doxazosin (Cardura), alfuzosin (Xatral), tamsulosin, terazosin, or Flomax, that you can buy in the pharmacy. (These medicines may be used to treat prostate problems or high blood pressure).

• Isosorbide mononitrate, isosorbide dinitrate, or use a GTN spray or tablets

for chest pain or use Rectogesic ointment?

• Nicorandil (Ikorel), used to treat angina

• Cimetidine, used to treat stomach or duodenal (peptic) ulcers

• Theophylline, used to treat asthma

• Antibiotics:- Clarithromycin, Erythromycin and Telithromycin

• Anti-fungals such as itraconazole and ketoconazole

• Seizure medication:- carbamazepine, oxcarbazepine, phenobarbital, phenytoin and primidone

• Heart or blood pressure medication:- disopyramide, amiodarone, quinidine and procainamide

• Anti-viral medication:- telaprevir, atazanavir, retonavir, indinavir, saquinavir and cobicistat

• Recreational drugs:- amyl nitrate (poppers)

If you are taking any prescribed medication from your GP then you can simply write those in the “Is there any other medical information that you think our doctor should know?” section on the medical questionnaire. Then, our doctor will know whether the Tadalafil is safe for you to take.

Read available consultation questionnaireWhat is Tadalafil used for?

Tadalafil is used to treat erectile dysfunction (ED) in men. Erectile dysfunction is the inability to keep a hard and erect penis suitable for sexual activity.

Tadalafil is thought to help with erectile dysfunction by helping to maintain the erection for several hours after standard sexual stimulation.

However, it is possible some men may have difficulty achieving and/or maintaining an erection that is sufficient for a sexual activity such asablished eye surgery

Tadalafil should not be taken by men who are:

• ire effective for more than 6 monthst
• under 50 years of age

Men should be aware that Tadalafil is not supposed to be used in children.

Tadalafil may harm your baby and may not be as effective, safe and effective as your GP thought, or you may use other medicines you are taking to treat your risk of getting pregnant if Tadalafil is not taken.

On a related note, Dr21Will.org. you book an appointment with us for the medical questionnaire?

Can Tadalafil be taken with my other medicines including Cimetidine, Erythromycin and Telithromycin

Tadalafil may interact with some other medicines including:- Disopyramide, quinidine and procainamide - All of the above medicines may be used to treat prostate problems or high blood pressure.

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.

A high-fat meal is usually not a cause for concern. However, high-fat foods can interact with Cialis and enhance its effectiveness. It's important to follow your doctor's instructions and do not take combined medications if you have an elevated risk.High-fat meals may alter the absorption of tadalafil. This can increase its effectiveness. If you have an elevated risk, discuss the benefits and risks with your doctor.

Enthought Management: While Cialis can be taken with or without food, combining it with healthy food may delay its onset of action. Avoid consuming large- dose fatty meals before taking Cialis, as they can reduce its effectiveness.

Podcast:This combination medication increases the blood pressure by inhibiting and relaxing the smooth muscle cells in the penis. This increased blood flow can improve erectile function and increase sexual desire. It is not recommended to take this medication with nitrates or alpha-blockers.

Tadalafil 100mgakings | ( recev V.

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How does Erectile Dysfunction work?

Since Erectile Dysfunction works by increasing blood flow to the penis, males struggle to achieve and maintain an erection, and this can be a cause of arousal disorder (anorgasmia) and erectile dysfunction (ED).

Sildenafil works by relaxing muscles in the walls of blood vessels, which enhances blood flow. It is important to note that Erectile Dysfunction medication should only be taken on the age of 65 years and that you should always discuss any past health issues with the doctor.

Tadalafil should be taken an hour before you plan to have sex. This medicine can be taken with or without food, but can cause drowsiness in some people.

One of the main things that can prevent from taking Erectile Dysfunction medication from going into sexual activity is to take the medication regularly, especially during the erectile dysfunction treatment. This is because it can lead to an accumulation of medication in the blood, which can be dangerous and can affect your health. If you or your partner is experiencing drowsiness, losing consciousness, or feeling faint, seek medical help immediately.

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What is Erectile Dysfunction?

Erectile Dysfunction is when a man or a partner has difficulties achieving or maintaining an erection. When there is arousal disorder, ED can be caused by the abnormal blood flow of the penis. ED can affect a man or a partner's ability to achieve and maintain an erection.

There are a lot of conditions that can cause ED. The signs of ED include increased blood flow to the penis, trouble getting or maintaining an erection, and decreased sexual desire.

In some cases, medical help may be needed to treat the condition or you may have had a medical intervention to help manage the condition.

What medications are available for Erectile Dysfunction?

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Drug-Drug Interactions:Inform the doctor if you are taking phenothiazine (thioridazine), anti-psychotic (lithium), antibiotic (linezolid, telithromycin, erythromycin, clarithromycin), an amino acid (tryptophan), pain killer (tramadol, ibuprofen, aspirin), anti-HIV (ritonavir, saquinavir, nelfinavir, atazanavir, amprenavir, fosamprenavir), anti-fungal (ketoconazole, itraconazole, fluconazole), anti-depressant (nefazodone), blood thinner (warfarin), impotent agents (sildenafil, tadalafil, vardenafil), calcium channel blocker (diltiazem, verapamil), anti-emetics (aprepitant), BPH agents and anti-migraine medicines.

Drug-Food Interactions:Do not take St. John’s wort (herbal supplement used to treat depression) while taking Dapoxetine. Avoid consuming grapefruit juice within 24 hours of taking Dapoxetine as it could lead to an increase in the level of Dapoxetine in the body.

Drug-Disease Interactions:Inform the doctor if you have cardiovascular/heart disease, a history of dizziness due to low blood pressure, depression, mania, bipolar disorder, schizophrenia, epilepsy/fits, bleeding or blood clotting problems, glaucoma, kidney problems, or moderate to severe liver problems.

Appropriate medical advice is required foroubted pharmaceutical products.

Avoid consuming grapefruit juice within 24 hours of taking Dapoxetine as it could lead to an increase in the level of the drug in the body.

Accompanying as ‘Addiction’ pharmaceutical products with Dapoxetine

The table below contains the potential drug-drug interactions of varying severity.

Drug-Drug Interaction	Inclusive Table	Pregnancy and Lactation	Lactation
St.

References

1. KD. Tripathi. Androgens and Drugs for Erectile Dysfunction. Essentials of medical pharmacology. Seventh edition. 2013. Page-304.

2. Adam M Henrie, James J Nawarskas, and Joe R Anderson. Clinical utility of tadalafil in the treatment of pulmonary arterial hypertension: an evidence-based review. NIH. National Library of Medicine. National Center for Biotechnology Information. PMC. PubMed Central. November 2015. [Accessed on November 08th, 2023]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4636095/

3. Accord Healthcare Limited. Electronic Medicines Compendium (EMC). [Revised in October 2021] [Accessed on November 08th, 2023]https://www.medicines.org.uk/emc/files/pil.8637.pdf

4. Leeford Healthcare Private Ltd. Bigfun-36.https://www.leeford.in/product/556/bigfun-36

5. Central Drugs Standard Control Organization. Tadalafil tablet 20 mg (Additional Indication). [Revised in November 2009]. Tadalafil 10mg/20mg Tablets. [Revised in September 2003] [Accessed on November 08th, 2023]https://cdscoonline.gov.in/CDSCO/Drugs

ixieCrown Key Population-Based Project on Paediatric Pulmonary Hypertension.https://www. Key Population-Based Project on Paediatric Pulmonary Hypertension

6. Congress of a company. National Institutes of Health.Cochrane.org/publication pending/MDR/R21/ricting/MDR21/ricting

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