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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 forC. mucosuiare listed below by brand nameHere are some examples of these interactions:
  1. Nausea and Light-headedness. If you take Cialis with nitrates, it may be intolerable to foods rich in fat. Your doctor may prescribe a lower dose to reduce this.
  2. Dizziness. If you take Cialis with an alpha-blocker, it may be contraindicated to take it cautiously.
  3. Rapid heartbeat. If you take Cialis with an antidebenoidal, it may be necessary to take it slowly, especially in high doses.
  4. Excessive saliva production. Though combination with Cialis can be dangerous, excessive use can cause symptoms like dizziness or lightheadedness.
  5. Low blood pressure. Combining this medication with low blood pressure antidepressants or blood pressure medications may cause low blood pressure.

Whether you can take Tadalafil at the same time as your other medications will depend on which medications you are taking.

You are required to complete a short medical consultation questionnaire that asks for any medications that you are prescribed from your GP and will indicate the medications that can’t be taken alongside Tadalafil.

There are several medicines which should not be taken concurrently with Tadalafil. Medicines which can have potentially serious interactions with Tadalafil include :-

• Any alpha-blocker medicines e.g. doxazosin (Cardura), alfuzosin (Xatral), tamsulosin, terazosin, or Flomax, that you can buy in the pharmacy. (These medicines may be used to treat prostate problems or high blood pressure).

• Isosorbide mononitrate, isosorbide dinitrate, or use a GTN spray or tablets

for chest pain or use Rectogesic ointment?

• Nicorandil (Ikorel), used to treat angina

• Cimetidine, used to treat stomach or duodenal (peptic) ulcers

• Theophylline, used to treat asthma

• Antibiotics:- Clarithromycin, Erythromycin and Telithromycin

• Anti-fungals such as itraconazole and ketoconazole

• Seizure medication:- carbamazepine, oxcarbazepine, phenobarbital, phenytoin and primidone

• Heart or blood pressure medication:- disopyramide, amiodarone, quinidine and procainamide

• Anti-viral medication:- telaprevir, atazanavir, retonavir, indinavir, saquinavir and cobicistat

• Recreational drugs:- amyl nitrate (poppers)

If you are taking any prescribed medication from your GP then you can simply write those in the “Is there any other medical information that you think our doctor should know?” section on the medical questionnaire. Then, our doctor will know whether the Tadalafil is safe for you to take.

Read available consultation questionnaire

What is Tadalafil?

Tadalafil is the generic version of the drugs

used to treat erectile dysfunction (ED). Tadalafil contains the same active ingredient as brand-name Cialis, and is taken with or without food in a taken orally tablet.Tadalafil taken Tadalafil

It is important that

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are taken 20 to 30 minutes before sexual activity and so that the drug can work after the intended effect has been lost.

Tadalafil can lead to side effects such as erection on sexual performance but the detailed information should not take much longer to learn.

Tadalafil may not be safe for some people due to certain medical conditions or by itself.

Tell your doctor if you have any of the following –

  • Low blood pressure
  • Osteoporosis
  • Severe liver disease
  • Coronary artery disease
  • Stroke
  • Recent heart attack
  • New or worsening angina
  • Fainting

Remember, Tadalafil may not be for you if you are taking any other medicines that you can buy without a prescription. If you are not sure, speak to your doctor or pharmacist to let them know you are not using Tadalafil.

How much Tadalafil will I take?

Tadalafil is a prescription drug, and is dispensed by a healthcare provider only. Your doctor may need to change the dose of your medication, or other medical conditions to make sure Tadalafil is right for you.

Tadalafil is taken orally in the dose and duration as directed by your doctor. Your dosage will depend on your age and your blood pressure level.

Last updated 14 September 2023

On 14 March 2023, the UK Medicines regulator approved an application to reclassify the erectile dysfunction medication Cialis. When marketed asCialis Together(tadalafil 10mg), it will be a ‘P’ (pharmacy) medication, and so available ‘over the counter’ in pharmacies – see. This follows the 2018, ‘P’ classification of (sildenafil 50mg) which has been available OTC, without a prescription, since then.

This decision is good news for men’s health …. Erectile dysfunction can be a debilitating condition, so it’s important men feel they have fast access to quality and legitimate care

Dr Laura Squire, MHRA’s Chief Officer for Healthcare, Quality and Access

Unfortunately, there is a strong black market in the UK for ED medicines, which are often unlicensed or counterfeit. UK Border Force and the MHRA seize millions of pounds of these fake products from criminals annually. This new classification of tadalafil 10mg will enable men who suffer from ED to obtain it safely from a local pharmacy.

Sanofi, the drug manufacturer, is expected to launch Cialis Together later in 2023. Cialis Together will be available to purchase in pharmacies without a prescription by men over 18 with erectile dysfunction. Cialis Together tablets will contain 10mg tadalafil and the maximum pack size will be 8 tablets. Other doses and pack sizes of Cialis and tadalafil will still be available on prescription through doctors and specially trained pharmacists. Before purchase in a pharmacy there must be an assessment with a pharmacist, who will check that Cialis Together is appropriate and safe, or whether consultation with a GP is necessary.

What does this mean for patients?

Men suffering with ED will have another treatment option with the convenience of purchasing it in their local pharmacy, including pharmacies found inside supermarkets (eg. Tesco, Asda, Sainsbury’s). The pharmacist will ask some health questions, may check blood pressure, and will advise on treatment with Cialis Together or Viagra Connect, or the need to consult a GP. Pharmacies usually have a private room for such discussions.

Cialis Together is a 10mg tadalafil product for use at least 30 minutes prior to anticipated sexual activity. Its effects can last. It is not recommended for daily use. The maximum recommended dose of Cialis Together will be one tablet in 24 hours. Prescription Cialis and tadalafil will still be available at different doses.

Dr Fox welcomes the wider access to ED medication for men that Cialis Together classified as a ‘P’ OTC medication will provide. We at Dr Fox are aware of the difficulties men have in discussing ED with their GPs and in accessing ED medication. We know that Cialis is effective and safe for most men and this change provides another option for obtaining ED treatment. Pharmacists are health professionals who are able to give ED advice but they will also know when to refer men who would benefit from a doctor’s assessment. ‘P’ medicines can also be supplied on prescription, and we will offer Cialis Together, when available, alongside our other competitively priced ED products.

Dr Claire Pugh, Dr Fox Medical Director

Categories of medicine

In the UK have 3 categories:

  • POM – Prescription only medicine:supplied by a healthcare professional following a consultation, usually on prescription.
  • P – Pharmacy medicine:supplied by a pharmacist ‘over the counter’, sometimes referred to as ‘P’ medicine or ‘PMED’.
  • GSL – General sales list medicine:available from many retail outlets ‘off the shelf’.
As with the list of things in - -, and, Cialis Together is a OTC medicine. This means that it is not prescription-only or in-store.
  • Kamagra 100mg:Cialis Together 100mg is not prescription-only, but can be purchased if a copy of the medicine,ixir, or capsule provided by your healthcare professional. The doctor or pharmacist may occasionally provide a placebo for consultation. This has not been and other prices for Cialis 10mg and other tadalafil 10mg are not.
  • Description

    Cialis (Tadalafil) is used for treating men and women with erectile dysfunction.

    Cialis (Tadalafil) is available as a brand-name medication containing the active ingredient tadalafil. This medicine is also available under the brand names Cialis and Cialis. Cialis is a prescription medicine that is prescribed only to men who have erection problems or who are having difficulty getting or maintaining an erection. Cialis is not a cure for impotence.

    Cialis is a phosphodiesterase-5 (PDE-5) inhibitor. This medicine works by helping to relax the blood vessels in your penis, allowing blood to flow into your penis when you get sexually excited. This helps to improve the length and severity of an erection.

    Dosage

    Cialis (Tadalafil) is available in a dosage of 5 mg. It is important to follow the instructions provided by your doctor or pharmacist. Take Cialis exactly as prescribed by your doctor. The dose is usually taken about 30 minutes before sexual activity. Take the tablet at the same time each day. Do not take more than one tablet in any 24-hour period unless directed by your doctor.

    Cialis (Tadalafil) should be taken 30 minutes before sexual activity. You will get an erection when you are sexually stimulated, but it will not last long. Cialis may cause dizziness, lightheadedness, and fainting. If these occur, stop taking Cialis and get medical help right away. If you take Cialis more than once a day, consult your doctor before you take it.

    Cialis (Tadalafil) should not be used in men over the age of 18 years. It is not known if Cialis (Tadalafil) is safe for use in women. If you are a woman, you should avoid the use of Cialis (Tadalafil) because it may cause birth defects. Cialis (Tadalafil) is not recommended for use by children. If you have heart disease, high blood pressure, liver disease, bleeding disorders, or a history of priapism, avoid the use of Cialis (Tadalafil) because it may increase the risk of priapism. Consult your doctor before using Cialis (Tadalafil) if you are pregnant or may become pregnant. Cialis (Tadalafil) should not be used to treat erectile dysfunction (impotence).

    Possible side effects

    The most common side effects of Cialis (Tadalafil) are headache, back pain, muscle pain, and flushing. In rare cases, Cialis (Tadalafil) may cause serious side effects such as priapism, sudden hearing loss, and hearing problems. Tell your doctor if these side effects bother you or do not go away.

    If you experience any of the following side effects or symptoms, stop taking Cialis (Tadalafil) and contact your doctor immediately:

    • blurred vision
    • blurred vision or seeing halos around lights
    • pain in the testicles
    • sensitivity to light
    • nausea
    • feeling dizzy or lightheaded
    • itching or pain in the testicles
    • stomach pain or heartburn
    • loss of appetite
    • muscle cramps or weakness

    Cialis (Tadalafil) should not be used for the treatment of erectile dysfunction (impotence).