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Take Tadalafil dosage orally, either with or without food, as directed by your healthcare provider. Tadalafil dosage should not exceed more than once a day. Swallow the tablet whole. Do not split it or crush unless advised.

Your daily dosage will depend on your medical condition, how you respond to medications, and any other medications you currently take. Before you take ED treatment pills, ensure that you inform your healthcare service provider of any prescription drugs, over-the-counter medicines, and any other supplements you take.

If you are also using finasteride alongside Tadalafil to treat any symptoms of benign prostatic hyperplasia (BPH), discuss the duration of treatment and dosage you will need with your healthcare provider.

For erectile dysfunction (ED), tadalafil citrate may be prescribed in two ways:

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Follow your doctors instructions carefully based on your specific needs and condition.

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For the best effect, take tadalafil once a day with a drink of water. Try to keep to the lowest dose of tadalafil (1mg) first thing in the morning before you take tadalafil.

If you have not told the medical professional about any other medications you're taking (if any), tell them before taking tadalafil.

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Although Cialis is a prescription-only medication, Tadalafil is a prescription-ensed medication. Many people who take Tadalafil also take generic Cialis. To help you save on price, Tadalafil is available in several other medicines you may be taking:

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  • Combining tadalafil with other ED medications may increase the risk of certain side effects.

For the best effect, take tadalafil once a day with or without food. Try to keep tadalafil to at least 1.

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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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Further Information:

For answers to frequently asked questions about drug interactions, please see Interactions. Kwikipedia's.

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References:

Cai, R. and Wilson, S. (2019). Interactions between nitrates and alpha-blockers: a review and case report. JAMAolescentshipED.30(9):e006931. https://doi.org/10.3345/ JAMA.loe.30.9.0.9.

Viokane, R. and McVary, D. (2018). Drug-drug interactions and erectile dysfunction: common and possible, respectively. Urology.34(6):873-89. https://doi.org/10.1016/j.ursudw.2018.05.026.