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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.

The top drug-food interactions forCialisare as follows:

Cialis (tadalafil) is a phosphodiesterase (PDE-5) inhibitor. It works by helping to relax blood vessels, which helps to increase blood flow for the treatment of erectile dysfunction (ED).

ForCialis,it is recommended to avoid unnecessary potential drug interactions with grapefruit and grapefruit juice. However, you should avoid combining Cialis with nitrates or alpha-blockers, as they can elevate blood pressure. Additionally, some recreational drugs containing nitrates or nitrates with nitrates can cause dilation of the arteries, which can lead to dizziness or blood pressure-lowering effects. If you have any concerns or questions about combining Cialis with nitrates or nitrates, consult your doctor.

Cialis is contraindicated in individuals with certain blood cell disorders, including anemia or lymphoma.

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• Included in the final price list is a guarantee by the company that the listed product is authentic, effective and safe, and that the listed product is suitable for all patients.

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Health Questionnaire Required:

For your first order with us, after placing an order, you will be prompted to upload your ID and submit our health questionnaire, soour physician canreview your basic health information,in order to mail prescription medications. You will not need to do this for refill orders.

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