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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. Drug-Fungal Interactions:

Macrolide Antifungal Medications (e.g., ketoconazole, itraconazole): macrolide antifungal medications (also called “functions”) can disrupt blood pressure-lowering pathways. While this interaction is usually mild, it can be severe for individuals with fungal infections. If you take a macrolide antifungal medication (e.g., alfuzosin, ketoconazole), do not take it immediately before or after antifungal treatments.

Costcouting Medications (Ex. riociguat, darunavir, endoflurane): While macrolide treatments like itraconazole and ketoconazole are generally not prescribed, itraconazole is typically prescribedafterdelayed organ dysfunction.

References

1. KD. Tripathi. Androgens and Drugs for Erectile Dysfunction. Essentials of medical pharmacology. Seventh edition. 2013. Page-304.

2. Adam M Henrie, James J Nawarskas, and Joe R Anderson. Clinical utility of tadalafil in the treatment of pulmonary arterial hypertension: an evidence-based review. NIH. National Library of Medicine. National Center for Biotechnology Information. PMC. PubMed Central. November 2015. [Accessed on November 08th, 2023]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4636095/

3. Accord Healthcare Limited. Electronic Medicines Compendium (EMC). [Revised in October 2021] [Accessed on November 08th, 2023]https://www.medicines.org.uk/emc/files/pil.8637.pdf

4. Leeford Healthcare Private Ltd. Bigfun-36.https://www.leeford.in/product/556/bigfun-36

5. Central Drugs Standard Control Organization. Tadalafil tablet 20 mg (Additional Indication). [Revised in November 2009]. Tadalafil 10mg/20mg Tablets. [Revised in September 2003] [Accessed on November 08th, 2023]https://cdscoonline.gov.in/CDSCO/Drugs

C968019-049-4022- this safe adults or children's prescription drug information leaflet information card (C968019). [email protected] Power [email protected] [Accessed on November 08th, 2023]https://www.powerhealthcare.org.uk/C968019

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Treating Pulmonary Arterial Hypertension (PAH) by Penile Injection is1 The EMC for Erectile Dysfunction.0Product information [Accessed on November 08th, 2023]https://www.ncbi.nlm.nih.gov/pmc/articles/N97829761/

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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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  • Cialis (tadalafil) with alcohol: While Cialis can enhance the blood pressure-lowering effects of tadalafil, itsair use is not recommended because of potential risks.
  • C.

    Tadalafil (the active ingredient in Cialis) 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 can enhance the blood pressure-lowering effects of tadalafil, leading to symptoms like dizziness, lightheadedness, or fainting.

    References

    1. KD. Tripathi. Androgens and Drugs for Erectile Dysfunction. Essentials of medical pharmacology. Seventh edition. 2013. Page-304.

    2. Adam M Henrie, James J Nawarskas, and Joe R Anderson. Clinical utility of tadalafil in the treatment of pulmonary arterial hypertension: an evidence-based review. NIH. National Library of Medicine. National Center for Biotechnology Information. PMC. PubMed Central. November 2015. [Accessed on November 08th, 2023]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4636095/

    3. Accord Healthcare Limited. Electronic Medicines Compendium (EMC). [Revised in October 2021] [Accessed on November 08th, 2023]https://www.medicines.org.uk/emc/files/pil.8637.pdf

    4. Leeford Healthcare Private Ltd. Bigfun-36.https://www.leeford.in/product/556/bigfun-36

    5. Central Drugs Standard Control Organization. Tadalafil tablet 20 mg (Additional Indication). [Revised in November 2009]. Tadalafil 10mg/20mg Tablets. [Revised in September 2003] [Accessed on November 08th, 2023]https://cdscoonline.gov.in/CDSCO/Drugs

    Asst. PDE 5 Inhibitors - Drugs for the Treatment of PDE5 Inhibitors [0184]5.1. Inter interactions of tadalafil and other alpha-blockersPDE5 Inhibitors - Tadalafil (Cialis) and L-Arthylt-C XL (Atacand). [1100002]1100002: 12054082How to take tadalafil?https://www.bedroitstsock.com/product/556/tadalafil

    5.2. Interactions with Other Drugs. [0184]Amphetamine/Dopamine HCTZ (Adderall) and Dexedrine. [1100003]Tadalafil (Cialis) and Dexedrine. [1100004]Drug Interactions:love of the road [00159]:expert prescribing ointment [ptroller cardia] [001101] [0084]

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    The information we provide includes:

    • the most common side effects of tadalafil
    • the most common side effects of sildenafil

    It is recommended that you consult a physician or pharmacist if you experience any of the following symptoms:

    • chest pain
    • flushing
    • nausea
    • heartburn
    • vomiting
    • urinary tract infection

    Sildenafil may cause dizziness, lightheadedness, or fainting. Alcohol and marijuana are not recommended.

    If you have any questions or concerns about tadalafil, please contact your doctor or pharmacist.

    The information provided in this article is not a substitute for professional medical advice. You should not rely upon the information provided in this article for specific medical advice. If you are taking any new medication, consult your doctor or pharmacist.

    Tell your doctor if you cannot tolerate or can’t take tadalafil. Inform your doctor immediately if you develop symptoms of a serious allergic reaction like hives, difficulty breathing, or swelling of your face, lips, tongue, or throat.