Do NOT use Cialis if:

• you are allergic to any ingredient in Cialis
• you have severe kidney problems and will be taking Cialis daily
• you have severe liver problems or certain hereditary degenerative eye problems (eg, retinitis pigmentosa)
• you have certain heart problems (eg, unstable angina, angina during sexual intercourse, uncontrolled irregular heartbeat), low blood pressure, or uncontrolled high blood pressure
• you have had a heart attack within the past 90 days or you have had severe heart failure or a stroke within the past 6 months
• you are taking a nitrate (eg, isosorbide, nitroglycerin) in any form (eg, tablet, capsule, patch, ointment), or nitroprusside
• you have been advised by your doctor to avoid sexual activity because of heart problems
• you use certain recreational drugs called "poppers" (eg, amyl nitrate or nitrite, butyl nitrate or nitrite)
• you take another PDE5 inhibitor (eg, sildenafil, vardenafil) or another medicine that contains tadalafil.

Contact your doctor or health care provider right away if any of these apply to you.

Some medical conditions may interact with Cialis. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have a deformed penis (eg, Peyronie disease, cavernosal fibrosis), blood cell problems (eg, sickle cell anemia, leukemia, multiple myeloma), or any other condition that may increase the risk of a prolonged erection (priapism)
• if you have a history of a prolonged (more than 4 hours) or painful erection (priapism)
• if you have a history of certain eye problems (eg, retinitis pigmentosa, sudden vision loss, optic neuropathy, macular degeneration) or hearing problems (eg, ringing in the ears, decreased hearing, hearing loss)
• if you have a history of liver or kidney problems, dialysis, lung problems (eg, pulmonary veno-occlusive disease), high or low blood pressure, ulcers, bleeding problems, heart problems (eg, heart failure, irregular heartbeat, aortic stenosis, angina), or blood vessel problems
• if you have a history of heart attack, stroke, or life-threatening irregular heartbeat.

Some medicines may interact with Cialis. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Alpha-blockers (eg, doxazosin), medicines for high blood pressure, nitrates (eg, isosorbide, nitroglycerin), or nitroprusside because severe low blood pressure with dizziness, lightheadedness, and fainting may occur
• Azole antifungals (eg, itraconazole), HIV protease inhibitors (eg, ritonavir), macrolide antibiotics (eg, erythromycin), or telithromycin because they may increase the risk of Cialis's side effects
• Barbiturates (eg, phenobarbital), carbamazepine, phenytoin, or rifampin because they may decrease Cialis's effectiveness.

This may not be a complete list of all interactions that may occur. Ask your health care provider if Cialis may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Important safety information:

• Cialis may cause dizziness, drowsiness, fainting, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Cialis with caution. Do not drive or perform other possible unsafe tasks until you know how you react to it.
• Cialis may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
• Do not drink large amounts of alcohol (eg, 5 drinks or more) while you take Cialis. Doing so may increase your risk of dizziness, headache, fast heartbeat, and low blood pressure.
• Patients with heart problems who take Cialis may be at increased risk for heart-related side effects, including heart attack or stroke. Symptoms of a heart attack may include chest, shoulder, neck, or jaw pain; numbness of an arm or leg; severe dizziness, headache, nausea, stomach pain, or vomiting; fainting; or vision changes. Symptoms of a stroke may include confusion; vision or speech changes; one-sided weakness; or fainting. Contact your doctor or seek medical attention right away if you experience these symptoms.
• Cialis may rarely cause a prolonged (eg, more than 4 hours) or painful erection. This could happen even when you are not having sex. If this is not treated right away, it could lead to permanent sexual problems such as impotence. Contact your doctor right away if this happens.
• Cialis does not stop the spread of HIV or other sexually transmitted diseases (STDs) to others through sexual contact. Use barrier methods of birth control (eg, condoms) if you have HIV infection or an STD.
• Cialis will not prevent pregnancy. If your partner may become pregnant and you wish to avoid pregnancy, be sure to use an effective form of birth control.
• Cialis may uncommonly cause mild, temporary vision changes (eg, blurred vision, sensitivity to light, blue/green color tint to vision). Contact your doctor if vision changes persist or are severe.
• Rarely, an eye problem called nonarteritic anterior ischemic optic neuropathy (NAION) has been reported in patients who took Cialis. This may lead to decreased vision or permanent loss of vision in some cases. If you notice a sudden decrease in vision or loss of vision in one or both eyes, contact your doctor right away.
• Sudden decreases in hearing and loss of hearing have been reported in some patients who have taken Cialis. Sometimes they also noticed ringing in the ears or dizziness. If you notice a sudden decrease or loss of hearing, contact your doctor right away.
• Do not use other medicines or treatments for ED while you are taking Cialis without first checking with your doctor.
• Use Cialis with caution in the elderly; they may be more sensitive to its effects.
• Cialis is not recommended for use in children younger than 18 years old.

All medicines may cause side effects, but many people have no, or minor, side effects.

Check with your doctor if any of these most common side effects persist or become bothersome:

Dizziness; flushing; headache; heartburn; mild back or muscle pain; stomach upset; stuffy or runny nose.

Seek medical attention right away if any of these severe side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; fainting; fast or irregular heartbeat; memory loss; numbness of an arm or leg; one-sided weakness; prolonged, painful erection; red, swollen, blistered, or peeling skin; ringing in the ears; seizures; severe or persistent back or muscle pain; severe or persistent dizziness; severe or persistent vision changes; sudden decrease or loss of hearing; sudden decrease or loss of vision in one or both eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider.