Contraindications
1. Do not take Tadalafil if you are a heart patient on nitrates, like nitroglyerin. Nitrates are drugs like nitroglycerin, isordil, Ismo (isosorbide mononitrate), and Transderm-Nitro, and others used primarily for treating heart pain (angina). These drugs lower the blood pressure and may precipitate angina or a heart attack in some patients.
Because Tadalafil dilates arteries throughout the body (not just in the penis), it can cause your blood pressure to drop. Tadalafil may lower blood pressure dramatically when combined with drugs like blood pressure pills like Alpha-Blockers, nitroglycerin tabs (or patches), alcohol and other drugs, such as amyl nitrate (poppers).
Physicians should consider the potential cardiac risk of sexual activity in patients with pre-existing cardiovascular disease. Physicians should advise patients who experience symptoms upon initiation of sexual activity to refrain from further sexual activity and seek immediate medical attention.
Seek medical attention immediately if you experience
- chest pain or nausea during sexual activity
- sudden vision loss
- sudden hearing loss
- priapism — a prolonged ( > 4 hr) painful erection that can damage the penis
Drinking alcohol with this medicine can cause a drop in blood pressure, leading to dizziness or fainting.
Also, avoid grapefruit while taking this medicine. Grapefruit and grapefruit juice may enhance the effect of Tadalafil and lead to unwanted side effects.
2. Do not use if you have hypersensitivity to Tadalafil.
Hypersensitivity reactions have been reported, including Stevens-Johnson syndrome, a severe form of dermatitis (allergic skin condition).
3. Do not take Tadalafil if you take Riociguat (trade name Adempas), a drug that is used to treat two forms of pulmonary hypertension.
Serious cardiovascular events, including myocardial infarction (heart attack), sudden cardiac death, stroke, chest pain, palpitations, and tachycardia, have been reported post-marketing associated with the concomitant use of Tadalafil.
Most, but not all, of these patients had pre-existing cardiovascular risk factors. Many of these events were reported to occur during or shortly after sexual activity, and a few were reported to occur shortly after the use of Tadalafil without sexual activity.
It is not clear whether these events are related directly to Tadalafil, to sexual activity, to the patient’s underlying condition.
What are the most common side effects of Tadalafil?
Among the most common side effects are headache, facial flushing (redness, tingling), stomach discomfort, back pain and muscle aches. Less common are nasal congestion, nausea, diarrhea, blurred vision, fainting and changes in color vision or hearing. The discontinuation rate in clinical trials was only 4.1%, compared to 2.8% in the placebo group.
What are the most serious side effects of Tadalafil?
Heart attack and stroke (cardiovascular side effects) are among the most serious. In rare cases, sudden loss of vision or hearing may occur.
Use Tadalafil with caution if you have a bleeding disorder or an ulcer. It may prolong bleeding. Consult with your prescribing physician about these and other drug-drug interactions.
Dosage may need to be adjusted in patients with impaired kidney or liver function. Tadalafil should be limited to 5 mg not more than once in every 72 hours in patients with or end-stage renal disease on hemodialysis.