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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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  1. Cialis and aspirin (Stendra, Edrofin, generic) are European pharmaceuticalendorines which were granted approval by the European Medicines Agency (EMA) earlier this year. Thevisorygroup governing the approval process for generic pharmaceuticals.For further information, consult the EMA side effects and safety information pamphlet,,on the ECLIA website:
  2. Contact the EMA website at for more information.
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interactions

To know if you are an active participant, please check in the "Active User" section.

In the "Immunisation Schedule" section, click on the " interaction with any other medication" button. Do not use Cialis with another medication containing tadalafil as it may increase the effect of tadalafil itself.

C.

The Australian Pharmaceutical Industry, (API) is a major employer in the global pharmaceutical industry, and the company has spent over $400 million in the past 30 years to fund the company’s operations. It has a long history of being an early investment fund in the pharmaceutical industry. It has become a key player in Australian pharmaceutical operations, and was responsible for the company’s successful development and marketing of various pharmaceutical products, including Viagra, Cialis, and Levitra.

It has been a source of great pride for pharmaceutical companies. Pharmaceutical companies have worked hard to become key players in the global pharmaceutical industry, and are well placed to be a part of the business. They have been responsible for the success of the company and its efforts to develop its products. Their roles are, in many ways, to be rewarded with high levels of success, and to help in the development and marketing of new products.

There are several reasons why Australian companies are successful. Australia has been a leader in the pharmaceutical industry for over a hundred years and has been the most successful country in the world, with over 1 in 3 Australian men being involved in the pharmaceutical industry. Australia is one of the largest developing countries in the world and it has a large pharmaceutical industry and a strong pharmaceutical industry. The Pharmaceutical Companies Act of 1987 established Australia as the fifth largest developing country in the world, with more than 1 million people working in the pharmaceutical industry globally. Australian pharmaceutical companies have continued to make significant contributions to the global pharmaceutical industry, and have been responsible for many of the successful drugs and products sold in Australia.

In addition to the successful pharmaceuticals, Australian pharmaceutical companies have a rich history of success. The Pharmaceutical Companies Act of 1984 allowed the Australian government to regulate and regulate the manufacture, distribution and sale of prescription drugs, which were not regulated by the United States Food and Drug Administration (FDA). Australian pharmaceutical companies had access to a variety of drugs and products, including Viagra, Cialis, Levitra, and other prescription medicines. In addition to the success of Viagra, Cialis, and Levitra, the Australian company has also established a number of other successful pharmaceutical products, including the erectile dysfunction medication Avodart, the anti-depressant Zoloft and the painkiller Ritalin, with its first sale in November 1989.

The Pharmaceutical Companies Act of 1984 established Australia as the third largest developing country in the world, with more than 1 million people working in the pharmaceutical industry globally. The Pharmaceutical Companies Act of 1984 also required the Australian government to regulate the manufacture, distribution and sale of prescription medicines, which were not regulated by the United States Food and Drug Administration (FDA). Australia was the largest developing country in the world, and the only other country in the world that did not require this regulation.

All of the success that Australian pharmaceutical companies have had is due to the success of the Pharmaceutical Companies Act of 1984. The Pharmaceutical Companies Act of 1984 also allowed the Australian government to regulate and regulate the manufacture, distribution and sale of prescription medicines, which were not regulated by the United States Food and Drug Administration (FDA). Australia was the only other country in the world that did not require the regulation of the manufacture, distribution and sale of prescription medicines. The Pharmaceutical Companies Act also allowed the Australian government to regulate the manufacture, distribution and sale of prescription medicines, which were not regulated by the United States Food and Drug Administration (FDA). This means that, for example, the Australian company was required to submit the Australian company’s Pharmaceutical Companies Act of 1984 application form to the FDA to obtain approval for the manufacture, distribution and sale of prescription medicines. The company’s Pharmaceutical Companies Act also provided for the manufacture, distribution and sale of prescription medicines, which were not regulated by the United States Food and Drug Administration (FDA). Australia is one of the largest developing countries in the world and the only other country in the world that does not require the regulation of the manufacture, distribution and sale of prescription medicines.

The Pharmaceutical Companies Act of 1984 also allowed the Australian government to regulate the manufacture, distribution and sale of prescription medicines, which were not regulated by the United States Food and Drug Administration (FDA). This means that the Australian company was required to submit the Australian company’s Pharmaceutical Companies Act of 1984 application form to the FDA to obtain approval for the manufacture, distribution and sale of prescription medicines. Australia’s failure to do so has led to the failure of the company’s Pharmaceutical Companies Act of 1984 application form to obtain approval for the manufacture, distribution and sale of prescription medicines.

Cialis has been shown to cause some mild side effects. Talk to your health care provider if these do not go away within a few days. If you begin to experience more serious reactions, seek medical attention immediately.

Common side effects reported from Cialis use include:

  • Headache
  • Indigestion
  • Heartburn
  • Upset stomach
  • Gas
  • Nausea
  • Flushing

More severe side effects include:

  • Painful erections or erections that last longer than 4 hours
  • Sudden loss of vision
  • Sudden loss of hearing
  • Ringing in the ears
  • Chest pain
  • Shortness of breath
  • Painful urination
  • Increased urination frequency
  • Fainting
  • Dizziness
  • Skin rash
  • Hives
  • Facial swelling

If you experience any of these side effects, seek medical attention immediately. These are symptoms of a severe adverse reaction to this medication that require immediate treatment.

As with all prescription medications, inform your doctor of any medical conditions you currently manage. Tell them about any and all medications, prescription drugs, and supplements you are taking before starting treatment with Cialis. Cialis can interact with bodily substances, causing potentially serious adverse reactions.

Specifically, you should inform your health care provider of any alpha-blocker, antifungal, HIV protease inhibitor, or high blood pressure medication you are taking. Remember to mention any herbal products you use, especially St. John’s wort.

In addition, let your doctor know if you have recently had heart surgery or experience chest pain during sex. If you experience any changes in your heartbeat or chest pain during sex, contact your health care provider immediately.

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  • Cialis can cause fluid build up in the nose, throat, and lungs
  • This medication can make it harder for an individual to breathe
  • People taking Cialis may experience dizziness or fainting, which may be severe
  • Sexual performance issues can make it more difficult for an individual to have an orgasm
  • Sexual dysfunction can make it more difficult to get an erection
  • Sexual performance issues can make it more difficult to have an orgasm
  • Sexual dysfunction can make it more difficult to have an erection
  • Sexual dysfunction can make it more difficult for an individual to have an erection
  • Sexual performance problems can make it more difficult to have an erection
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  • Gastrointestinal upset
  • Back pain
  • Muscle aches

Cialis can cause potentially serious adverse reactions that need immediate treatment.

Kusch JA, Mathers JN. Effects of Cialis on the body and the nervous system. J Androl Endocrinol Metab. 2006;80(suppl):29-30.

Kusch JA, Mathers JN. Cialis: what it’s doing to men’s mental health and sexual performance. Drugs. 1998;69(suppl):22-24.

Kusch JA, Mathers JN, et al. Effects of Cialis on male sexual function in men with erectile dysfunction. Int J Impot Res. 2017;12(6):878-84. doi: 10.1016/j.

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