Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Blood conditions: Before taking this medication, tell your doctor if you have sickle cell anemia or leukemia.
Blood pressure: Tell your doctor if you are taking medications to treat high blood pressure, as the combination of these medications with tadalafil may add to the blood-pressure-lowering effect of these medications.
Dehydration: If you lose a large amount of body fluids (dehydration) through excessive sweating; from not drinking enough fluids; or from being sick with a fever, vomiting, or diarrhea, contact your doctor. Dehydration can make you more likely to experience low blood pressure while you are taking this medication.
Grapefruit juice: Grapefruit juice can increase the amount of tadalafil in your bloodstream. Talk to your doctor about drinking grapefruit juice when taking this medication.
Hearing changes: If you experience a decrease or loss of hearing while taking this medication, seek immediate medical attention.
Heart problems: If you have heart disease or other heart problems, you may be more likely to experience low blood pressure while taking this medication and should discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Kidney function: If you have decreased kidney function, you may require a lower dose of this medication. Talk to your doctor. If you have severely reduced kidney function, you should not take this medication.
Liver function: If you have decreased liver function, you may require a lower dose of this medication. Talk to your doctor. People with severely reduced liver function should not take this medication.
Lung problems: Tadalafil is not recommended for people with a form of high blood pressure in the lungs called pulmonary veno-occlusive disease. If you have pulmonary veno-occlusive disease or experience sudden cough, shortness of breath, chest pain, or rapid breathing, talk to your doctor before taking this medication.
Nitrate-containing medications: Never take tadalafil with any medications that contain nitrates. Your blood pressure may suddenly drop to life-threatening levels if you take it with any nitrate-containing medication (e.g., nitroglycerin tablets, spray, or patches) or any other nitrates (e.g., isosorbide dinitrate or amyl nitrite "poppers"). You may experience dizziness, fainting spells, heart attack, or stroke.
Penis deformation: If you have a deformation of the penis such as angulation, cavernosal fibrosis, or Peyronie's disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Prolonged erection: Before taking this medication, tell your doctor if you have ever had an erection that lasted longer than 4 hours.
Vision problems: If you have or have had a temporary decrease or permanent loss of vision in one or both eyes, including a condition called non-arteritic anterior ischemic optic neuropathy (NAION), or if you have a condition called retinitis pigmentosa, tell your doctor before taking this medication.
This medication can cause partial or complete vision loss that may be temporary or permanent. If you experience a sudden loss of vision in one or both eyes or other vision related problems, tell your doctor immediately. If you do experience vision changes, do not drive or operate machinery until your vision returns to normal.
Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: It is not known if tadalafil passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of this medication have not been established for children with pulmonary hypertension.