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If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor. It is important that this medication be taken exactly as prescribed by your doctor. Do not take higher doses of this medication than prescribed by your doctor. Contact your doctor if you take a greater dose of tadalafil than prescribed. Do not dispose of medications in wastewater e. Ask your pharmacist how to dispose of medications that are no longer needed or have expired. Nitrates are found in medications that are used to treat angina chest pain. If you are not sure if you are taking nitrates, ask your doctor or pharmacist. Nitrates must NOT be taken by anyone who is using tadalafil because they can cause your blood pressure to drop very low. This may cause dizziness, fainting, heart attack, or stroke. Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor. Many of these side effects can be managed, and some may go away on their own over time. Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects. Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention. Stop taking the medication and seek immediate medical attention if any of the following occur:. Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication. Before you begin using 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. Alcohol: Consumption of alcohol may decrease the ability to achieve an erection and may also temporarily decrease blood pressure, causing dizziness and fainting. Blood pressure: Tell your doctor if you are taking medications to treat high blood pressure. The combination of these medications with tadalafil may add to the blood-pressure-lowering effect of these medications. This may lead to dizziness or fainting. Grapefruit juice: Grapefruit juice can increase the amount of tadalafil in your blood. Do not drink grapefruit juice when taking this medication. Hearing problems: Rarely, people taking tadalafil have experienced a sudden decrease or loss of hearing. If this occurs, you should seek medical attention immediately. Heart conditions: Speak to your doctor before taking any medication for erectile dysfunction if you:. If you experience chest pains, dizziness, or nausea during sex, stop the exertion, and inform your doctor as soon as you can. Kidney function: Kidney disease or reduced kidney function may cause this medication to build up in the body, causing side effects. Lower doses of this medication should be used if you have impaired kidney function. Daily use of "on-demand" medication is not recommended. It should not be used more than 3 times per week. Once-a-day use with 5 mg dosing or less may be considered for some people with mild-to-moderate kidney problems. Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. Men with poor liver function may need lower doses of this medication. Daily use of this medication is not recommended. It should not be used more frequently than 3 times per week. Once-a-day use with 5 mg dosing or less may be considered for some patients with liver problems. Nitrate-containing medications: Tadalafil should never be taken with any medications that contain nitrates. Blood pressure may drop to life-threatening levels if tadalafil is taken with any nitrate-containing medication e. Dizziness, fainting spells, heart attack, or stroke may be experienced. If use of a nitrate-containing medication is considered medically necessary, 48 hours must pass after the last dose of tadalafil before taking a nitrate, and only under close medical supervision. Penis deformation: As with other medications for erectile dysfunction, men with an anatomical deformation of the penis such as angulation, cavernosal fibrosis, or Peyronie's disease should be closely monitored by their doctors if they take this medication. If you have any of these conditions, 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 priapism : If an erection lasts longer than 4 hours a rare occurrence , seek immediate medical assistance. If this condition is not treated quickly, tissue damage and permanent loss of the ability to have an erection could result. Tell your doctor if you have any of the following conditions, as they may increase your risk of a prolonged erection: sickle cell anemia, multiple myeloma, or leukemia. Prostate problems: If you are taking other medications to treat BPH called alpha blockers e. The combination of alpha blockers with tadalafil is not recommended for treatment of BPH. People who are taking tadalafil for erectile dysfunction may be able to continue taking alpha blockers. Talk to your doctor for more information. Vision problems: If you experience a sudden loss of vision in one or both eyes, or other vision-related problems, contact your doctor immediately. Vision loss may be partial or complete. While in some cases the condition may improve over time, it can be permanent in other cases. This is a rare condition that more likely to occur if you have heart disease, high blood pressure, high cholesterol, diabetes, or eye problems, if you are more than 50 years old, or if you smoke. Children and adolescents: Tadalafil is not intended for use by children or adolescents under 18 years old. If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:. An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed. Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter non-prescription , and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them. All material copyright MediResource Inc. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www. About this Medication. 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