17 PATIENT COUNSELING INFORMATION

Adults—5 milligrams (mg) once a day, taken at about the same time each day, without regard for the timing of sexual activity. For treatment of benign prostatic hyperplasia (daily use): If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep out of the reach of children. Do not keep outdated medicine or medicine no longer needed. Ask your healthcare professional how you should dispose of any medicine you do not use. It is important that you tell all of your doctors that you take tadalafil.

More about Cialis (tadalafil)

Do not use this medicine if you are also using riociguat (Adempas®) or a nitrate medicine, often used to treat angina (chest pain). Some illegal ("street") drugs called "poppers" (such as amyl nitrate, butyl nitrate, or nitrite) also contain nitrates. If you need to use a nitrate medicine, take it at least 48 hours after your last dose of tadalafil. Do not drink excessive amounts of alcohol (eg, 5 or more glasses of wine or 5 or more shots of whiskey) when taking tadalafil. When taken in excess, alcohol can increase your chances of getting a headache or dizziness, increase your heart rate, or lower your blood pressure.

US Brand Name

If you experience sudden loss of vision in one or both eyes, contact your doctor immediately. Check with your doctor right away if you have a sudden decrease in hearing or loss of hearing, which may be accompanied by dizziness and ringing in the ears. Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements. Along with its needed effects, a medicine may cause some unwanted effects. If you need emergency medical care for a heart problem, it is important that your doctor knows when you last took tadalafil.

Product	Dosage	Quantity + Bonus	Price
Cialis Generic	10mg	60 + 6 Pills	105.81€ 100.77€	Buy
Cialis Generic	20mg	270 + 10 Pills	335.21€ 319.25€	Buy
Cialis Soft Tabs	20mg	20 + 2 Pills	66.98€ 63.79€	Buy
Cialis Generic	20mg	60 + 6 Pills	117.76€ 112.15€	Buy
Cialis Generic	60mg	90 + 6 Pills	196.67€ 187.30€	Buy
Cialis Generic	10mg	10 Pills	31.41€ 29.91€	Buy
Cialis Generic	20mg	90 + 6 Pills	154.71€ 147.34€	Buy
Cialis Generic	20mg	360 + 10 Pills	427.34€ 406.99€	Buy
Cialis Generic	10mg	120 + 6 Pills	178.49€ 169.99€	Buy
Cialis Professional	40mg	10 Pills	65.09€ 61.99€	Buy
Cialis Generic	40mg	120 + 8 Pills	206.98€ 197.12€	Buy

If you will be taking this medicine for pulmonary arterial hypertension, it is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood and urine tests may be needed to check for unwanted effects.

Tadalafil side effects

Adults—5 milligrams (mg) once a day, taken at about the same time each day, without regard for the timing of sexual activity. For treatment of benign prostatic hyperplasia (daily use): If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep out of the reach of children.

In Treatment of Pulmonary arterial hypertension (PAH)

Do not keep outdated medicine or medicine no longer needed. Ask your healthcare professional how you should dispose of any medicine you do not use. It is important that you tell all of your doctors that you take tadalafil. If you need emergency medical care for a heart problem, it is important that your doctor knows when you last took tadalafil. If you will be taking this medicine for pulmonary arterial hypertension, it is very important that your doctor check your progress at regular visits. If you take tadalafil for pulmonary arterial hypertension, do not take Cialis® or other PDE5 inhibitors, including sildenafil (Revatio® or Viagra®) or vardenafil (Levitra®). If you take too much tadalafil or take it together with these medicines, the chance for side effects will be higher. If you experience a prolonged erection for more than 4 hours or a painful erection for more than 6 hours, contact your doctor immediately. This condition may require prompt medical treatment to prevent serious and permanent damage to your penis. This medicine does not protect you against sexually transmitted diseases (including HIV or AIDS). Use protective measures and ask your doctor if you have any questions about this. It is important to tell your doctor about any heart problems you have now or may have had in the past.

What should I know about storage and disposal of this medication?

CIALIS may be taken without regard to food (2.2). Use of CIALIS with alpha blockers, antihypertensives or substantial amounts of alcohol (≥5 units) may lead to hypotension (5.6, 5.9). If taking potent inhibitors of CYP3A4, dose should be adjusted: CIALIS for use as needed: ≤10 mg every 72 hours. For once daily use: dose not to exceed 2.5 mg (5.10). Patients should seek emergency treatment if an erection lasts >4 hours.

Side effects and risks

Patients should stop CIALIS and seek medical care if a sudden loss of vision occurs in one or both eyes, which could be a sign of Non Arteritic Ischemic Optic Neuropathy (NAION). Discuss increased risk of NAION in patients with history of NAION (5.4). Most common adverse reactions (≥2%) include headache, dyspepsia, back pain, myalgia, nasal congestion, flushing, and pain in limb (6.1, 6.2). To report SUSPECTED ADVERSE REACTIONS, contact Eli Lilly and Company at 1-800-LillyRx (1-800-545-5979) or FDA at 1-800-FDA-1088 or See 17 for PATIENT COUNSELING INFORMATION and FDA-approved patient labeling. Table of Contents FULL PRESCRIBING INFORMATION: CONTENTS*1 INDICATIONS AND USAGE1.1 Erectile Dysfunction2 DOSAGE AND ADMINISTRATION2.1 Erectile Dysfunction2.2 Use with Food2.3 Use in Special Populations2.4 Concomitant Medications3 DOSAGE FORMS AND STRENGTHS4 CONTRAINDICATIONS4.1 Nitrates4.2 Hypersensitivity Reactions5 WARNINGS AND PRECAUTIONS5.1 Cardiovascular5.2 Potential for Drug Interactions When Taking CIALIS for Once Daily Use5.3 Prolonged Erection5.4 Eye5.5 Sudden Hearing Loss5.6 Alpha blockers and Antihypertensives5.7 Renal Insufficiency5.8 Hepatic Impairment5.9 Alcohol5.10 Concomitant Use of Potent Inhibitors of Cytochrome P450 3A4 (CYP3A4)5.11 Combination With Other PDE5 Inhibitors or Erectile Dysfunction Therapies5.12 Effects on Bleeding5.13 Counseling Patients About Sexually Transmitted Diseases6 ADVERSE REACTIONS6.1 Clinical Studies Experience6.2 Postmarketing Experience7 DRUG INTERACTIONS7.1 Potential for Pharmacodynamic Interactions with CIALIS7.2 Potential for Other Drugs to Affect CIALIS7.3 Potential for CIALIS to Affect Other Drugs8 USE IN SPECIFIC POPULATIONS8.1 Pregnancy8.3 Nursing Mothers8.4 Pediatric Use8.5 Geriatric Use8.6 Hepatic Impairment8.7 Renal Insufficiency10 OVERDOSAGE11 DESCRIPTION12 CLINICAL PHARMACOLOGY12.1 Mechanism of Action12.2 Pharmacodynamics12.3 Pharmacokinetics13 NONCLINICAL TOXICOLOGY13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility13.2 Animal Toxicology and/or Pharmacology14 CLINICAL STUDIES14.1 CIALIS for Use as Needed14.2 CIALIS for Once Daily Use16 HOW SUPPLIED/STORAGE AND HANDLING16.1 How Supplied16.2 Storage17 PATIENT COUNSELING INFORMATION17.1 Nitrates17.2 Cardiovascular Considerations17.3 Concomitant Use with Drugs Which Lower Blood Pressure17.4 Potential for Drug Interactions When Taking CIALIS for Once Daily Use17.5 Priapism17.6 Vision17.7 Sudden Hearing Loss17.8 Alcohol17.9 Sexually Transmitted Disease17.10 Recommended Administration*Sections or subsections omitted from the full prescribing information are not listed. This medicine can cause serious side effects in patients with heart problems. Do not use this medicine if you are also using riociguat (Adempas®) or a nitrate medicine, often used to treat angina (chest pain). Some illegal ("street") drugs called "poppers" (such as amyl nitrate, butyl nitrate, or nitrite) also contain nitrates. If you need to use a nitrate medicine, take it at least 48 hours after your last dose of tadalafil. Do not drink excessive amounts of alcohol (eg, 5 or more glasses of wine or 5 or more shots of whiskey) when taking tadalafil.

• Cialis 10mg contains tadalafil as its active ingredient.
• Common side effects include headache and flushing.
• Consult your doctor before using Cialis if on other medications.
• Cialis should be stored at room temperature away from moisture.
• Avoid grapefruit juice while taking Cialis.
• Cialis may cause a drop in blood pressure.
• Do not use Cialis if allergic to tadalafil.
• Notify your doctor if you experience vision changes.

When taken in excess, alcohol can increase your chances of getting a headache or dizziness, increase your heart rate, or lower your blood pressure.

Region	Average Price per 10mg Tablet	Brand Options	Generic Availability
United States	$10 - $20	Cialis, Tadalis	Widely available
European Countries	€8 - €18	Cialis, Tadalafil	Readily accessible
India	₹50 - ₹150	Tadaflo, Tadagra	Affordable options
Australia	AUD 15 - AUD 25	Cialis, Tadalafil	Easily purchased
Online Vendors	Varies	Multiple brands	Verify authenticity

If you experience sudden loss of vision in one or both eyes, contact your doctor immediately. Check with your doctor right away if you have a sudden decrease in hearing or loss of hearing, which may be accompanied by dizziness and ringing in the ears. Do not take other medicines unless they have been discussed with your doctor.

• Cialis 10mg is effective for many men, but not all.
• It is important to start with the lowest effective dose.
• Do not take Cialis if you have severe cardiovascular disease.
• Cialis may cause dizziness in some users.
• Alcohol increases the risk of side effects when combined.
• Always tell your doctor if you experience chest pain.
• Cialis may adversely interact with certain antifungal drugs.
• Be cautious about rapid sexual activity if prone to dizziness.

This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements. Along with its needed effects, a medicine may cause some unwanted effects.

• Cialis 10mg can be taken with or without food.
• It is a popular choice among ED medications worldwide.
• The medication is digital and easily available online.
• Always check for legitimate pharmacies when purchasing.
• Understand that efficacy can vary between individuals.
• Don’t attempt to increase dosage on your own.
• Cialis is not intended for recreational use.
• Seek medical advice if you have persistent erectile issues.

Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur: faintness or lightheadedness when getting up suddenly from a lying or sitting position pain or discomfort in the arms, jaw, back, or neck Painful or prolonged erection of the penis blistering, peeling, or loosening of the skin fast, irregular, pounding, or racing heartbeat or pulse inability to move the arms, legs, or facial muscles numbness or tingling of the face, hands, or feet red skin lesions, often with a purple center sores, ulcers, or white spots in the mouth or on the lips swelling of the feet or lower legs Some side effects may occur that usually do not need medical attention. These side cialis canadian pharmacy no prescription effects may go away during treatment as your body adjusts to the medicine.

Taking tadalafil with other medicines, food and drink

This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood and urine tests may be needed to check for unwanted effects. If you take tadalafil for pulmonary arterial hypertension, do not take Cialis® or other PDE5 inhibitors, including sildenafil (Revatio® or Viagra®) or vardenafil (Levitra®). If you take too much tadalafil or take it together with these medicines, the chance for side effects will be higher. If you experience a prolonged erection for more than 4 hours or a painful erection for more than 6 hours, contact your doctor immediately.

13 Nonclinical Toxicology

This condition may require prompt medical treatment to prevent serious and permanent damage to your penis. This medicine does not protect you against sexually transmitted diseases (including HIV or AIDS). Use protective measures and ask your doctor if you have any questions about this. It is important to tell your doctor about any heart problems you have now or may have had in the past. This medicine can cause serious side effects in patients with heart problems. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings burning feeling in the chest or stomach feeling of constant movement of self or surroundings feeling of warmth, redness of the face, neck, arms and occasionally, upper chest redness, pain, swelling of the eye, eyelid, or inner lining of the eyelid swelling or puffiness of the eyes or face Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088. Contains inactivated NDC Code(s)NDC Code(s): 21695-028-10, 21695-029-10, 21695-029-16, 21695-029-30 If you are a consumer or patient please visit this version. See full prescribing information for CIALIS.CIALIS (tadalafil) tablet, film coated for oral useInitial U.S. Approval: 2003INDICATIONS AND USAGECIALIS® is a phosphodiesterase 5 (PDE5) inhibitor indicated for erectile dysfunction (ED) (1.1).DOSAGE AND ADMINISTRATIONCIALIS for use as needed: Starting dose: 10 mg up to once daily. Improves erectile function compared to placebo up to 36 hours post dose (2.1).CIALIS for once daily use: 2.5 mg taken once daily, without regard to timing of sexual activity. May increase to 5 mg based upon efficacy and tolerability (2.1).CIALIS may be taken without regard to food (2.2).DOSAGE FORMS AND STRENGTHSTablets (not scored): 2.5 mg, 5 mg, 10 mg, 20 mg (3).CONTRAINDICATIONSWARNINGS AND PRECAUTIONSPatients should not use CIALIS if sex is inadvisable due to cardiovascular status (5.1).Use of CIALIS with alpha blockers, antihypertensives or substantial amounts of alcohol (≥5 units) may lead to hypotension (5.6, 5.9).If taking potent inhibitors of CYP3A4, dose should be adjusted: CIALIS for use as needed: ≤10 mg every 72 hours.

When should I see my doctor?

Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur: faintness or lightheadedness when getting up suddenly from a lying or sitting position pain or discomfort in the arms, jaw, back, or neck Painful or prolonged erection of the penis blistering, peeling, or loosening of the skin fast, irregular, pounding, or racing heartbeat or pulse inability to move the arms, legs, or facial muscles numbness or tingling of the face, hands, or feet red skin lesions, often with a purple center sores, ulcers, or white spots in the mouth or on the lips swelling of the feet or lower legs Some side effects may occur that usually do not need medical attention. These side cialis canadian pharmacy no prescription effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings burning feeling in the chest or stomach feeling of constant movement of self or surroundings feeling of warmth, redness of the face, neck, arms and occasionally, upper chest redness, pain, swelling of the eye, eyelid, or inner lining of the eyelid swelling or puffiness of the eyes or face Other side effects not listed may also occur in some patients.

Dosage for pulmonary arterial hypertension (PAH)

If you notice any other effects, check with your healthcare professional. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088. Contains inactivated NDC Code(s)NDC Code(s): 21695-028-10, 21695-029-10, 21695-029-16, 21695-029-30 If you are a consumer or patient please visit this version. See full prescribing information for CIALIS.CIALIS (tadalafil) tablet, film coated for oral useInitial U.S. For once daily use: dose not to exceed 2.5 mg (5.10).Patients should seek emergency treatment if an erection lasts >4 hours. Use CIALIS with caution in patients predisposed to priapism (5.3).Patients should stop CIALIS and seek medical care if a sudden loss of vision occurs in one or both eyes, which could be a sign of Non Arteritic Ischemic Optic Neuropathy (NAION).

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Discuss increased risk of NAION in patients with history of NAION (5.4).Patients should stop CIALIS and seek prompt medical attention in the event of sudden decrease or loss of hearing (5.5).ADVERSE REACTIONSMost common adverse reactions (≥2%) include headache, dyspepsia, back pain, myalgia, nasal congestion, flushing, and pain in limb (6.1, 6.2).To report SUSPECTED ADVERSE REACTIONS, contact Eli Lilly and Company at 1-800-LillyRx (1-800-545-5979) or FDA at 1-800-FDA-1088 or INTERACTIONSSee 17 for PATIENT COUNSELING INFORMATION and FDA-approved patient labeling.Revised: 7/2009 CIALIS® is a phosphodiesterase 5 (PDE5) inhibitor indicated for erectile dysfunction (ED) (1.1). CIALIS for use as needed: Starting dose: 10 mg up to once daily. Improves erectile function compared to placebo up to 36 hours post dose (2.1). CIALIS for once daily use: 2.5 mg taken once daily, without regard to timing of sexual activity. May increase to 5 mg based upon efficacy and tolerability (2.1). CIALIS may be taken without regard to food (2.2). Use of CIALIS with alpha blockers, antihypertensives or substantial amounts of alcohol (≥5 units) may lead to hypotension (5.6, 5.9). If taking potent inhibitors of CYP3A4, dose should be adjusted: CIALIS for use as needed: ≤10 mg every 72 hours. For once daily use: dose not to exceed 2.5 mg (5.10).

Before Using

Approval: 2003INDICATIONS AND USAGECIALIS® is a phosphodiesterase 5 (PDE5) inhibitor indicated for erectile dysfunction (ED) (1.1).DOSAGE AND ADMINISTRATIONCIALIS for use as needed: Starting dose: 10 mg up to once daily. Improves erectile function compared to placebo up to 36 hours post dose (2.1).CIALIS for once daily use: 2.5 mg taken once daily, without regard to timing of sexual activity. May increase to 5 mg based upon efficacy and tolerability (2.1).CIALIS may be taken without regard to food (2.2).DOSAGE FORMS AND STRENGTHSTablets (not scored): 2.5 mg, 5 mg, 10 mg, 20 mg (3).CONTRAINDICATIONSWARNINGS AND PRECAUTIONSPatients should not use CIALIS if sex is inadvisable due to cardiovascular status (5.1).Use of CIALIS with alpha blockers, antihypertensives or substantial amounts of alcohol (≥5 units) may lead to hypotension (5.6, 5.9).If taking potent inhibitors of CYP3A4, dose should be adjusted: CIALIS for use as needed: ≤10 mg every 72 hours. For once daily use: dose not to exceed 2.5 mg (5.10).Patients should seek emergency treatment if an erection lasts >4 hours. Use CIALIS with caution in patients predisposed to priapism (5.3).Patients should stop CIALIS and seek medical care if a sudden loss of vision occurs in one or both eyes, which could be a sign of Non Arteritic Ischemic Optic Neuropathy (NAION).

Provider: Lilly Cares Foundation Patient Assistance Program

Discuss increased risk of NAION in patients with history of NAION (5.4).Patients should stop CIALIS and seek prompt medical attention in the event of sudden decrease or loss of hearing (5.5).ADVERSE REACTIONSMost common adverse reactions (≥2%) include headache, dyspepsia, back pain, myalgia, nasal congestion, flushing, and pain in limb (6.1, 6.2).To report SUSPECTED ADVERSE REACTIONS, contact Eli Lilly and Company at 1-800-LillyRx (1-800-545-5979) or FDA at 1-800-FDA-1088 or INTERACTIONSSee 17 for PATIENT COUNSELING INFORMATION and FDA-approved patient labeling.Revised: 7/2009 CIALIS® is a phosphodiesterase 5 (PDE5) inhibitor indicated for erectile dysfunction (ED) (1.1). CIALIS for use as needed: Starting dose: 10 mg up to once daily. Improves erectile function compared to placebo up to 36 hours post dose (2.1). CIALIS for once daily use: 2.5 mg taken once daily, without regard to timing of sexual activity. May increase to 5 mg based upon efficacy and tolerability (2.1). Patients should seek emergency treatment if an erection lasts >4 hours. Patients should stop CIALIS and seek medical care if a sudden loss of vision occurs in one or both eyes, which could be a sign of Non Arteritic Ischemic Optic Neuropathy (NAION). Discuss increased risk of NAION in patients with history of NAION (5.4). Most common adverse reactions (≥2%) include headache, dyspepsia, back pain, myalgia, nasal congestion, flushing, and pain in limb (6.1, 6.2). To report SUSPECTED ADVERSE REACTIONS, contact Eli Lilly and Company at 1-800-LillyRx (1-800-545-5979) or FDA at 1-800-FDA-1088 or See 17 for PATIENT COUNSELING INFORMATION and FDA-approved patient labeling. Table of Contents FULL PRESCRIBING INFORMATION: CONTENTS*1 INDICATIONS AND USAGE1.1 Erectile Dysfunction2 DOSAGE AND ADMINISTRATION2.1 Erectile Dysfunction2.2 Use with Food2.3 Use in Special Populations2.4 Concomitant Medications3 DOSAGE FORMS AND STRENGTHS4 CONTRAINDICATIONS4.1 Nitrates4.2 Hypersensitivity Reactions5 WARNINGS AND PRECAUTIONS5.1 Cardiovascular5.2 Potential for Drug Interactions When Taking CIALIS for Once Daily Use5.3 Prolonged Erection5.4 Eye5.5 Sudden Hearing Loss5.6 Alpha blockers and Antihypertensives5.7 Renal Insufficiency5.8 Hepatic Impairment5.9 Alcohol5.10 Concomitant Use of Potent Inhibitors of Cytochrome P450 3A4 (CYP3A4)5.11 Combination With Other PDE5 Inhibitors or Erectile Dysfunction Therapies5.12 Effects on Bleeding5.13 Counseling Patients About Sexually Transmitted Diseases6 ADVERSE REACTIONS6.1 Clinical Studies Experience6.2 Postmarketing Experience7 DRUG INTERACTIONS7.1 Potential for Pharmacodynamic Interactions with CIALIS7.2 Potential for Other Drugs to Affect CIALIS7.3 Potential for CIALIS to Affect Other Drugs8 USE IN SPECIFIC POPULATIONS8.1 Pregnancy8.3 Nursing Mothers8.4 Pediatric Use8.5 Geriatric Use8.6 Hepatic Impairment8.7 Renal Insufficiency10 OVERDOSAGE11 DESCRIPTION12 CLINICAL PHARMACOLOGY12.1 Mechanism of Action12.2 Pharmacodynamics12.3 Pharmacokinetics13 NONCLINICAL TOXICOLOGY13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility13.2 Animal Toxicology and/or Pharmacology14 CLINICAL STUDIES14.1 CIALIS for Use as Needed14.2 CIALIS for Once Daily Use16 HOW SUPPLIED/STORAGE AND HANDLING16.1 How Supplied16.2 Storage17 PATIENT COUNSELING INFORMATION17.1 Nitrates17.2 Cardiovascular Considerations17.3 Concomitant Use with Drugs Which Lower Blood Pressure17.4 Potential for Drug Interactions When Taking CIALIS for Once Daily Use17.5 Priapism17.6 Vision17.7 Sudden Hearing Loss17.8 Alcohol17.9 Sexually Transmitted Disease17.10 Recommended Administration*Sections or subsections omitted from the full prescribing information are not listed.

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