Cialis Together

Always use this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure how to use this medicine.

The recommended dose for adults:

One 10mg tablet, taken when required, prior to sexual activity. Cialis should be taken at least 30 minutes before sexual activity. Do not take more than one dose within a 24 hour period. This should be swallowed whole with water and may be taken with or without food.

Depending on effectiveness and tolerability, the dose may be increased to 20mg if necessary. Any dose adjustments should be made following advice from your prescriber.

Cialis may remain effective for up to 36 hours after taking the tablet, although this can vary between individuals.

Cialis are intended for use prior to anticipated sexual activity and are not recommended for continuous daily use. Cialis will only work when you are sexually stimulated and does not increase sexual desire.

Drinking alcohol may affect your ability to get an erection and may temporarily lower your blood pressure. Excessive alcohol consumption should be avoided when taking Cialis, as it may increase the risk of side effects such as dizziness when standing.

If you take more Cialis than you should

You may experience an increase in side effects and their severity. You should not take more tablets than your doctor tells you to. Contact your doctor if you take more tablets than you should.

Seeking medical attention

Prolonged erections and priapism have been reported with Cialis. In the event of an erection that persists for longer than 4 hours, medical attention is required. This is to prevent penile tissue damage and permanent loss of potency.

Like all medicines, this medicine can cause side effects, although not everybody gets them. Some of the side effects are temporary with continued treatment or disappeared when treatment is stopped.

Side Effects

Common

• Headache
• Back pain
• Muscle aches
• Pain in arms and legs
• Facial flushing
• Nasal congestion
• Indigestion.

Uncommon

Dizziness, stomach ache, feeling sick, being sick (vomiting), reflux, blurred vision, eye pain, difficulty in breathing, presence of blood in urine, prolonged erection, pounding heartbeat sensation, a fast heart rate, high blood pressure, low blood pressure, nose bleeds, ringing in the ears, swelling of the hands, feet or ankles and feeling tired.

Rare

Fainting, seizures and passing memory loss, swelling of the eyelids, red eyes, sudden decrease or loss of hearing, hives (itchy red welts on the surface of the skin), penile bleeding, presence of blood in semen and increased sweating, migraine, swelling of the face, serious allergic reaction which causes swelling of the face or throat, serious skin rashes, some disorders affecting blood flow to the eyes, irregular heartbeats, angina and sudden cardiac death.

Heart attack and stroke have also been reported rarely in men taking Cialis. Most of these men had known heart problems before taking this medicine.

Partial, temporary, or permanent decrease or loss of vision in one or both eyes.

Distorted, dimmed, blurred central vision or sudden decrease of vision.

Serious Side Effects

If you experience any of the following side effects stop using the medicine and seek medical help immediately:

• allergic reactions including rashes
• chest pain – do not use nitrates but seek immediate medical assistance
• priapism, a prolonged and possibly painful erection after taking Tadalafil. If you have such an erection, which lasts continuously for more than 4 hours, you should contact a doctor immediately
• sudden loss of vision, distorted, dimmed, blurred central vision or sudden decrease of vision

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.

Warning & Precautions

Do not take Cialis if you:

• are allergic to cialis or any of the other ingredients of this medicine
• are taking any form of organic nitrate or nitric oxide donors such as amyl nitrite. This is a group of medicines (“nitrates”) used in the treatment of angina pectoris (“chest pain”). Cialis has been shown to increase the effects of these medicines. If you are taking any form of nitrate or are unsure tell your doctor.
• have serious heart disease or recently had a heart attack within the last 90 days.
• recently had a stroke within the last 6 months.– have low blood pressure or uncontrolled high blood pressure.
• ever had loss of vision because of non-arteritic anterior ischemic optic neuropathy (NAION), a condition described as “stroke of the eye”.
• are taking riociguat. This drug is used to treat pulmonary arterial hypertension (i.e., high blood pressure in the lungs) and chronic thromboembolic pulmonary hypertension (i.e., high blood pressure in the lungs secondary to blood clots). PDE5 inhibitors, such as Tadalafil, have been shown to increase the hypotensive effects of this medicine. If you are taking riociguat or are unsure tell your doctor.

Talk to your doctor or pharmacist before taking Cialis. Be aware that sexual activity carries a possible risk to patients with heart disease because it puts an extra strain on your heart. If you have a heart problem you should tell your doctor.

Before taking the tablets, tell your doctor if you have:

• sickle cell anaemia (an abnormality of red blood cells).
• multiple myeloma (cancer of the bone marrow).
• leukaemia (cancer of the blood cells).
• any deformation of your penis.
• a serious liver problem.
• a severe kidney problem.

It is not known if Cialis is effective in patients who have had:

• pelvic surgery.
• removal of all or part of the prostate gland in which nerves of the prostate are cut (radical non-nerve-sparing prostatectomy).

If you experience sudden decrease or loss of vision or your vision is distorted, dimmed while you are taking Cialis stop taking Cialis and contact your doctor immediately.

Decreased or sudden hearing loss has been noted in some patients taking Cialis. Although it is not known if the event is directly related to Cialis, if you experience decreased or sudden hearing loss, stop taking Cialis and contact your doctor immediately.

Cialis is not intended for use by women.

Age Restrictions

Men aged 18 years and over.

Other Medicines and Conditions

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, including medicines available without prescription and herbal medicines.

Do not take Cialis if you are already taking nitrates.

Some medicines may be affected by Cialis or they may affect how well Cialis will work.

Tell your doctor or pharmacist if you are already taking:

• an alpha blocker (used to treat high blood pressure or urinary symptoms associated with benign prostatic hyperplasia)
• other medicines to treat high blood pressure
• riociguat
• a 5- alpha reductase inhibitor (used to treat benign prostatic hyperplasia).– medicines such as ketoconazole tablets (to treat fungal infections) and protease inhibitors for treatment of AIDS or HIV infection
• phenobarbital, phenytoin and carbamazepine (anticonvulsant medicines)
• rifampicin, erythromycin, clarithromycin or itraconazole
• other treatments for erectile dysfunction

Cialis with drink and alcohol

Drinking alcohol may affect your ability to get an erection and may temporarily lower your blood pressure. If you have taken or are planning to take Cialis, avoid excessive drinking (blood alcohol level of 0.08 % or greater), since this may increase the risk of dizziness when standing up.

Fertility

A reduction in sperm was seen in some men. These effects are unlikely to lead to a lack of fertility.

Driving and using machines

Some men taking Tadalafil in clinical studies have reported dizziness. Check carefully how you react to the tablets before driving or using machines.

Pregnancy and Breastfeeding

This medicine is not suitable for use in pregnancy and breastfeeding.

Patient Information Leaflet

https://www.medicines.org.uk/emc/files/pil.14803.pdf

Ingredients

• Active Ingredients: Tadalafil
• Other Ingredients: Tablet Core: lactose monohydrate, croscarmellose sodium, hydroxypropylcellulose, microcrystalline cellulose, sodium laurilsulfate, magnesium stearate. Tablet Coating: lactose monohydrate, hypromellose, triacetin, titanium dioxide (E171), iron oxide yellow (E172), talc.

Product Information

• Brand Name: Cialis Together
• Route of Administration: Oral
• Legal Classification: P-med
• Strength: 10mg
• Dosage From: Tablet

Storage

• Keep this medicine out of the sight and reach of children.
• Do not use this medicine after the expiry date which is stated on the carton and blister after ‘EXP’. The expiry date refers to the last day of that month.
• This medicinal product does not require any special storage conditions.
• Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

Advice & Helpful Links

https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/