DOSAGE FORMS AND STRENGTHS

danazol will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Country / Region	Legal Status	Notes
USA	Prescription-only	FDA regulated
UK	Prescription-only	MHRA regulated
Canada	Prescription-controlled	Health Canada approval
Australia	Prescription-only	TGA regulated
India	Available via prescription	Widely available

drospirenonedrospirenone will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Further information

rilzabrutinibrilzabrutinib increases levels of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor for tadalafil adverse effects if coadministered with moderate CYP3A4 inhibitors. rilzabrutinib increases levels of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. rucaparibrucaparib will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Adjust dosage of CYP3A4 substrates, if clinically indicated.

US Brand Name

rucaparib will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. rufinamiderufinamide will decrease the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. rufinamide will decrease the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. sacubitril/valsartantadalafil increases effects of sacubitril/valsartan by pharmacodynamic synergism. tadalafil increases effects of sacubitril/valsartan by pharmacodynamic synergism.

What should I do if I accidentally use too much tadalafil?

Possible additive vasorelaxation, leading to low blood pressure. Coadministration of sepiapterin with drugs affecting nitric oxide-mediated relaxation may cause additive vasodilation and further reduce blood pressure. silodosintadalafil increases effects of silodosin by pharmacodynamic synergism. tadalafil increases effects of silodosin by pharmacodynamic synergism. sotaloltadalafil increases effects of sotalol by pharmacodynamic synergism. drospirenone will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. larotrectiniblarotrectinib will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

• If you miss a scheduled dose, take it as soon as you can.
• Avoid taking two doses within a 24-hour period.
• If you miss a dose, simply resume your regular schedule.
• Never double the dosage to catch up on a missed one.
• Inform your doctor if you accidentally miss a dose.
• Taking the pill late is usually better than skipping it entirely.
• Use a pill organizer to help prevent missed doses.
• Do not take extra medication to make up for the missed dose.
• Keep track of your doses in a calendar or app.
• Do not take medication on an empty stomach if not usual.

larotrectinib will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Product	Dosage	Quantity + Bonus	Price
Cialis Original	20mg	92 + 4 Pills	377.99€ 359.99€	Buy
Cialis Generic	10mg	180 + 8 Pills	236.88€ 225.60€	Buy
Cialis Professional	20mg	30 Pills	104.57€ 99.59€	Buy
Cialis Generic	40mg	10 Pills	37.79€ 35.99€	Buy
Cialis Generic	40mg	90 + 6 Pills	171.35€ 163.19€	Buy
Cialis Professional	20mg	60 + 2 Pills	183.83€ 175.08€	Buy
Cialis Generic	10mg	20 Pills	48.23€ 45.93€	Buy
Cialis Generic	2.5mg	120 + 6 Pills	128.93€ 122.79€	Buy
Cialis Generic	2.5mg	180 + 10 Pills	154.86€ 147.49€	Buy
Cialis Super Active	20mg	20 + 4 Pills	92.35€ 87.95€	Buy
Cialis Generic	60mg	270 + 10 Pills	443.96€ 422.82€	Buy
Cialis Super Active	20mg	180 + 20 Pills	521.59€ 496.75€	Buy

ranolazineranolazine will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

• Take the missed dose immediately if you remember.
• If you miss a dose, skip it and continue with the next.
• Do not take two doses at the same time.
• Do not take extra pills to make up for the missed dose.
• Keep track of your medication usage in a log.
• Inform your doctor if you miss doses often.
• Do not take medication on an empty stomach if not usual.
• Ensure you have a steady supply of pills for the week.
• Missed doses can affect your treatment plan.
• Do not take medication without a prescription.

Ranolazine may theoretically increase plasma concentrations of CYP3A4 substrates, such as tadalafil.

8.4 Pediatric Use

timololtadalafil increases effects of timolol by pharmacodynamic synergism. tadalafil increases effects of timolol by pharmacodynamic synergism. tipranavirtipranavir will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. tipranavir will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. tobramycin inhaledtobramycin inhaled and tadalafil both increase nephrotoxicity and/or ototoxicity.

Related treatment guides

Avoid concurrent or sequential use to decrease risk for ototoxicity tobramycin inhaled and tadalafil both increase nephrotoxicity and/or ototoxicity. Avoid concurrent or sequential use to decrease risk for ototoxicity topiramatetopiramate will decrease the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. topiramate will decrease the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. torsemidetadalafil increases effects of torsemide by pharmacodynamic synergism. tadalafil increases effects of torsemide by pharmacodynamic synergism.

Dosage for erectile dysfunction (ED)

trandolapriltadalafil increases effects of trandolapril by pharmacodynamic synergism. tadalafil increases effects of trandolapril by pharmacodynamic synergism. triamterenetadalafil increases effects of triamterene by pharmacodynamic synergism. tadalafil cialis vidalista 60mg increases effects of triamterene by pharmacodynamic synergism. valsartantadalafil increases effects of valsartan by pharmacodynamic synergism. ranolazine will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Interaction Partner	Effect	Clinical Advice
Alpha-Blockers	Increased risk of hypotension	Use caution, monitor blood pressure
CYP3A4 Inhibitors	Increased tadalafil levels	Dose adjustment may be needed
Alcohol	Enhanced side effects (dizziness, hypotension)	Limit intake during use
Ritonavir	Elevated plasma levels	Dose adjustment or avoidance

Visual field defect, retinal vein occlusion, retinal artery occlusion, and non–arteritic anterior ischemic optic neuropathy (NAION) Hypersensitivity, including Stevens-Johnson syndrome and exfoliative dermatitis Guanylate cyclase (sGC) stimulators (eg, riociguat); concomitant use can cause hypotension Coadministration with nitrates (either regularly and/or intermittently) and nitric oxide donors Do not use nitrates within 48 hr of the last dose of macitentan/tadalafil This potentiation is thought to result from the combined effects of nitrates and tadalafil on the nitric oxide/cGMP pathway The potentiation is consistent with the effects of PDE5 inhibition on the nitric oxide/cyclic guanosine monophosphate (cGMP) pathway Use caution in patients with anatomic deformation of penis, cardiovascular disease, left ventricular outflow obstruction, myocardial infarction in preceding 90 days, unstable angina, angina occurring during sexual intercourse, NYHA class 2 or greater heart failure in preceding 6 months, uncontrolled arrhythmias,

Key Takeaways: Cialis vs Tadalafil

tadalafil increases effects of valsartan by pharmacodynamic synergism. Comment: Avoid combination; duplicate therapy is not recommended. verapamilverapamil will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. verapamil will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. voriconazolevoriconazole will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Muscular Dystrophy (Orphan)

voriconazole will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. zafirlukastzafirlukast will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. zafirlukast will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. acetazolamideacetazolamide will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. acetazolamide will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

How should I store tadalafil?

anastrozoleanastrozole will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. anastrozole will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. cyclophosphamidecyclophosphamide will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. cyclophosphamide will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. danazoldanazol will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. hypotension, uncontrolled hypertension, cerebrovascular accident in preceding 6 months, bleeding disorders, active peptic ulcer disease, liver disease, renal impairment, conditions predisposing to priapism, concomitant use of CYP3A4 inhibitors May cause dose-related impairment of color discrimination; use caution in patients with retinitis pigmentosa Evaluate underlying causes of erectile dysfunction or BPH before initiating therapy Do not use nitrates within 48 hours of last dose of tadalafil Drug has vasodilatory properties that may result in transient decreases in blood pressure; prior to prescribing, carefully consider whether patients with underlying cardiovascular disease could be affected adversely by such vasodilatory effects; patients with preexisting hypotension, with autonomic dysfunction, with left ventricular outflow obstruction, may be particularly sensitive to actions of vasodilators When used to treat erectile dysfunction, non-arteritic anterior ischemic optic neuropathy (NAION), a cause of decreased vision including permanent loss

Medication	Dose Range	Onset Time	Duration	Notes
Tadalafil (Cialis)	2.5 mg - 20 mg	30-60 min	Up to 36 hours	Longest duration among ED meds
Sildenafil (Viagra)	25 mg - 100 mg	30-60 min	4-6 hours	Takes effect quickly
Vardenafil (Levitra)	2.5 mg - 20 mg	30-60 min	Up to 12 hours	Similar to Cialis but shorter duration

of vision, reported postmarketing; if vision problems arise, discontinue, and contact physician CYP3A4 inhibitors (eg, erythromycin, ketoconazole, itraconazole, indinavir, ritonavir) may significantly increase tadalafil serum levels CYP3A4 inducers (eg, rifampin, St John’s wort) may decrease tadalafil serum levels Potentiates hypotensive effect of nitrates (see Contraindications) Concomitant use with alpha blockers (other than tamsulosin 0.4 mg/day) should be stabilized before initiation of phosphodiesterase (PDE)-5 inhibitors; patients with instability on alpha-blocker therapy alone are at increased risk for symptomatic hypotension with concurrent PDE-5 inhibitor therapy Not to be taken with other PDE-5 inhibitors (eg, sildenafil, vardenafil) Not recommended in patients with pulmonary veno-occlusive disease Advise patients to seek emergency treatment if an erection lasts >4 hr Limited data from case series with use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes Pregnant women with untreated pulmonary arterial hypertension are at risk for heart failure, stroke, preterm delivery, and maternal and fetal death In animal reproduction studies, no adverse developmental effects were observed with oral administration to pregnant rats or mice during organogenesis at exposures 7 times the exposure at maximum recommended human dose (MRHD) of 40 mg/day based on AUC There are no data on presence of drug and/or its metabolites in human milk, effects on breastfed child, or on milk production; drug and/or its metabolites are present in milk of lactating rats at concentrations approximately 2.4-times that found in the plasma; when a drug is present in animal milk, it is likely that the drug will be present in human milk Controlled studies in pregnant women show no evidence of fetal risk.

6.1 Clinical Studies Experience

tadalafil increases effects of sotalol by pharmacodynamic synergism. spironolactonetadalafil increases effects of spironolactone by pharmacodynamic synergism. tadalafil increases effects of spironolactone by pharmacodynamic synergism. St John's WortSt John's Wort will decrease the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. St John's Wort will decrease the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

24/7 Support

Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. tecovirimattecovirimat will decrease the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered. tecovirimat will decrease the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. telmisartantadalafil increases effects of telmisartan by pharmacodynamic synergism.

Cialis and other medications

tadalafil increases effects of telmisartan by pharmacodynamic synergism. terazosintadalafil increases cialis tablet 5 mg effects of terazosin by pharmacodynamic synergism. tadalafil increases effects of terazosin by pharmacodynamic synergism. tetracyclinetetracycline will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. tetracycline will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.