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If you've tried taking Cialis or generic Viagra, you probably thought that you'd be a bit of a hero in case you've been waiting for the next dose.

But you've probably seen the ads for the drugs before, and you've probably heard about them, too.

"You can't take Cialis without a prescription," says a woman in a woman's voice in a voice that's a little bit too close to the lines of Cialis. "If you're on Viagra, you don't get the same treatment," says the woman in the voice.

It's the most common problem among men who take medications for erectile dysfunction. But you don't know what the problem is, because it can take a little longer to see the effects, because your body is getting used to the drug more quickly.

Cialis is a little more expensive than Viagra, and a little more expensive because of the extra time required for it to kick in. And generic versions of Cialis have become much more popular, especially in Europe, where Viagra and Cialis are used as an erectile dysfunction treatment.

"I think it's becoming more and more popular," says a 45-year-old man who's been taking Cialis for a month or so. "I've been on it for about four years."

He's been taking it for about a week now, and the side effects are nothing to worry about. But he's been using it regularly for a couple of months and still experiencing some of the same symptoms, he says.

When you take a pill, you get a small, short time to the effects. "I've had a bad experience with Viagra," he says. "It took me a while to find out that it was an over-the-counter remedy."

The man said he didn't know what the problem was, but he wasn't sure he could keep it under control.

One of the first symptoms was headache, and one of the first headaches he had when he took Cialis was a little, but it was nothing. He didn't have any kind of erection, and he didn't feel hungry.

He also didn't feel any kind of erectile dysfunction, he says. "I didn't have any problems, and I didn't want to have any problems. It was just something I did."

But there was a side effect, too, of taking Viagra, he says. "I have to remember what I should do in case Viagra is prescribed, but there was nothing in that list of side effects."

But the man said he wasn't sure what that was.

"I don't know anything about Viagra," the man said. "But if it's been on the list for a year or so, I'm not sure it was Viagra."

For the man, there were other side effects, too.

"I just didn't want to be here," he said.

It's a good habit, he says, and he'll take it whenever he has to, he says, because he can. He doesn't want to risk himself, but he has to try to keep it up.

You have to take Cialis in the morning, and you have to take Viagra at least two hours before you take Cialis.

There was a little light-headedness in the man's voice when he said he didn't know what the problem was, but he didn't have any sort of erection. And he didn't feel hungry.

It's not easy, you might think. There is a drug, there are times, but it's always hard to be on the same page with a drug.

"I'm not going to lie to anyone else and say I'm not going to be able to take Cialis," he says.

He's a pretty good guy, and he can take it. But if he can't, he can't do it. He can't use it at all. He has to go to the pharmacy for a drug and try to get the money back, but if he has to, he can't use it.

It can take a while to get used to the drug, but the man can be very, very careful, says the man, and he can take it whenever he wants.

The man can take Cialis at any time, but he can also take it with a glass of water.

And he can take it with food.

The most common side effects of Cialis are flushing, headache, blurred vision, and indigestion. Talk to your doctor or pharmacist if any of these side effects bother you.

If you’re taking tadalafil (Cialis), you’re expected to tolerate this medication well. However, if you experience sudden side effects or have a history of serious heart problems, such as heart failure or severe heart failure, your doctor may need to adjust your dosage. You can still take Cialis, but you’ll need to meet with a doctor for a prescription, but it can be taken exactly as prescribed by your doctor.

Tell your doctor if you are not sure whether you are taking tadalafil or if you need to take Cialis more or less frequently than prescribed. Your doctor can help you find a better treatment. Taking more than the prescribed dose can cause side effects, and regular use of Cialis can increase your risk of developing side effects.

If you experience serious side effects, such as chest pain or shortness of breath, call your doctor.

Muscle aches and pain when standing and walking are the most common side effects of Cialis. These side effects affect about 10% of users, and 10% to 15% of people taking medicine for pain may experience side effects that bother you.

Muscle pain, tenderness, or weakness is the most common side effect of Cialis. This side effect usually doesn’t last long and is replaced by more serious muscle pain or tenderness or weakness. If you have any of these side effects, call your doctor immediately or go to the Accident and Emergency at your local urgent services team for advice.

If you miss a dose of Cialis and your period doesn’t occur until the next day, take it as soon as you remember. However, you should take a slightly larger dose of Cialis than you usually take, so that you may be sure to take it the next day.

Try to avoid large doses of Cialis even if you feel better just before you start taking your medicine. You can take Cialis with or without food, but you may reduce your food intake by replacing it with a reduced-calorie meal. Eat a low-fat diet in advance of taking your medicine and your period begins.

If you are taking Cialis again after a few weeks, talk to your doctor about changing your dose.

If you are taking Cialis again to treat a side effect of erection problems (such as decreased sex drive or trouble getting or keeping an erection), such as erectile dysfunction, talk to your doctor as soon as you remember and try again.

Don’t take Cialis if you are taking tadalafil to treat or prevent or treat an enlarged prostate (benign prostatic hyperplasia-BPH). This condition can cause pain, vision problems, and an enlarged himmodin. If you experience any of these symptoms, such as chest pain, nausea, shock, or persistent dizziness, talk to your doctor before you take Cialis again.

Remember that Cialis has been prescribed to you because you are supposed to be able to use it with nitrates (medicines used to treat angina) or any other medication even if you don’t feel sexually transmitted disease (such as STIs) when taken with Cialis. You may have questions at anytime.

Read more:Does Cialis lower blood pressure

Like most prescription medications, Cialis can cause side effects, and some people have experienced serious side effects after taking it.

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.
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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.
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C. Recreational Orlistat:

Cialis (tadalafil) can increase blood pressure levels by inhibiting the metabolism of stomach cleared muscle tissue. This increase in tissue sensitivity can increase the risk of contracting HIV infection or experiencing chest pain. If you take Cialis to treat these effects, try taking it with a high-quality riociguat (a well-balanced dose of tadalafil) as it may decrease its blood pressure level.

  • Co-medication with prazosin or other weight-loss drugs
  • Phenobarbital, which may increase the risk of side effects
  • Protease inhibitors (used to treat infections), which cover a significant number of medications.

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