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If you take tadalafil for pulmonary arterial hypertension, do not take Cialis® or other PDE5 inhibitors, including sildenafil (Revatio® or Viagra®) or vardenafil (Levitra®). If you take too much tadalafil or take it together with these medicines, the chance for side effects will be higher. Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco. Cialis relaxes muscles of the blood vessels and increases blood flow to particular areas of the body. So if you drink alcohol while taking this medication, it’s recommended that you don’t drink too much.

If you’re healthy—especially if you’ve seen a doctor routinely—and young, and you have erectile dysfunction, I think there’s a place for [platforms] like Hims. I think it opens the door to treatment for patients who are really, really skittish about seeing somebody in person, but [their ED] needs to be handled. That said, experts say it’s usually safe to use a PDE5 inhibitor like tadalafil to treat ED without also enrolling in therapy. The medicines aren’t addictive in a chemical sense, but it’s important to be aware of the risk of psychological dependence—believing you can’t get an erection without taking medicine first. "Men care a lot about their penis working," says Fenwa Milhouse, a board-certified urologist and CEO of Down There Urology.

That being said, orgasm may be able to be reached more than once, but an unwanted erection can persist and cause problems when the user is not sexually aroused. This common effect will at times change one’s idea of recreational use, as those who do not have ED, but take the drug for the purpose of prolonging intercourse, may be inconvenienced by the ongoing blood flow. Notably, Cialis has fewer side effects than other medications used to treat erectile dysfunction.

Heart attack and stroke have also been reported rarely in men taking CIALIS. Most of these men had known heart problems before taking this medicine. CIALIS may still be effective up to 36 hours after taking the tablet. Always take this medicine exactly as your doctor has told you. In most cases, back pain caused by Cialis should go away on its own after a few hours or days. Also, if you drink alcohol, talk with your doctor about how much, if any, may be safe for you to have while taking Cialis.

It is also true, however, that men with untreated ED may feel anxious, depressed, or stressed about their condition. If you are experiencing negative mental health symptoms due to ED, also consider trying one of the best online therapy services to help you cope. The most concerning drug interaction tadalafil has is with nitrates.

Single doses up to 500 mg have given to healthy subjects, and multiple daily doses up to 100 mg have been given to patients. In cases of overdose, standard supportive measures should be adopted as required. Hemodialysis contributes negligibly to tadalafil elimination. Based on the data from 3 studies in adult males, tadalafil decreased sperm concentrations in the study of 10 mg tadalafil for 6 months and the study of 20 mg tadalafil for 9 months. This effect was not seen in the study of 20mg tadalafil taken for 6 months.

This medication may be prescribed for other uses