Cialis: warnings and precautions

The use of Cialis in women is not indicated.

The use of Cialis is contraindicated in subjects who show hypersensitivity to the active substance or to one of the excipients . Tadalafil increases the hypotensive effects of nitrates . Reptile dysfunction _

it is a relatively common disorder and the risk factors are similar to those of coronary artery disease. Hence, several men suffering from erectile dysfunction often are already being treated (or may require treatment, particularly if they increase physical activity) with angina medications (such as nitrates). The association between nitrates and type 5 phosphodiesterase inhibitors can cause marked hypotension. Therefore, taking type 5 phosphodiesterase inhibitors is contraindicated in patients taking nitrates. Therefore, in a patient who has been prescribed any dosage of tadalafil (2.5 mg to 20 mg), and in whom the administration of nitrate is considered medically necessary for a life-threatening situation, they must pass at least 48 hours after the last dose of Tadalafil before considering nitrate administration. In such circumstances, nitrates should only be administered under close medical supervision with appropriate monitoring of the haemodynamic situation. In any case, ask your doctor for information

on the possible possibility of taking tadalafil if you are undergoing hypotensive treatment, even with drugs other than nitrates. 

The administration Concomitant with doxazosin (4 and 8 mg daily) and tadalafil (5 mg daily and 20 mg single dose) significantly increases the hypotensive effect of alpha-blockers. This effect lasts for at least twelve hours and can be associated with symptoms including syncope. Therefore, the combination of tadalafil with doxazosin is not recommended . 

These effects were not reported in interaction studies with alfuzosin and tamsulosin in a limited number of healthy volunteers. However , caution is recommended when tadalafil is used in patients treated with any alpha blocker and especially in elderly patients. Treatments should be started at the lowest dosage and progressively adjusted.

시알리스 구매 should not be used in men with heart disease for whom sexual activity is inadvisable. Physicians should consider the potential cardiac risk associated with sexual activity in patients with pre-existing cardiovascular disease.

Some groups of patients with cardiovascular disease were not included in clinical trials with tadalafil; therefore, the use of this type of drug is contraindicated in:

•     Patients who have had myocardial infarction within the past 90 days;
•     Patients with unstable angina or who have had episodes of angina during sexual intercourse;
•     Patients who have had Class 2 or greater heart failure in the past 6 months according to the New York Heart Association classification;
•     Patients with uncontrolled arrhythmias , hypotension (<90/50 mm Hg) or uncontrolled hypertension;
•     Patients who have had a stroke within the past 6 months.

시알리스 구매 is also contraindicated in patients who have lost sight in one eye due to non-arteritic anterior ischemic optic neuropathy (NAION), regardless of whether or not this event is related to previous use of a PDE5 inhibitor.

Co-administration of PDE5 inhibitors, including tadalafil, with guanylate cyclase stimulants, such as riociguat, is contraindicated as it may lead to symptomatic hypotension .

Before considering drug treatment, a medical history and physical examination should be donein order to diagnose erectile dysfunction and determine the underlying causes of the disease.

Because there is a degree of cardiac risk associated with sexual activity, doctors will need to evaluate the cardiovascular condition of patients before starting any treatment for erectile dysfunction. Evaluation

of erectile dysfunction should include a determination of the potential underlying causes of the condition and the identification of appropriate treatment following an appropriate medical evaluation. It is not known whether tadalafil is effective in patients who have undergone pelvic surgery or radical non-retaining prostatectomy. vascular-nerve bundles .

Image representing a person who is having a heart attack warnings

Serious cardiovascular events including myocardial infarction, sudden cardiac death, unstable angina pectoris, ventricular arrhythmia, stroke, transient ischemic attacks, chest pain, palpitations and tachycardia have been reported post- marketing and / or in clinical trials . Most patients in whom these events have been reported had pre-existing cardiovascular risk factors. However, it is not possible to definitively determine whether these events are directly related to these risk factors, tadalafil, sexual activity, or a combination of these or other factors.

In patients receiving concomitant antihypertensive medicinal products , tadalafil may induce a reduction in blood pressure. When daily treatment with tadalafil is initiated, appropriate clinical evaluation should be performed for possible dose adjustment of antihypertensive therapy. Visual disturbances and cases of NAION have been reported in association with the use of tadalafil and other PDE5 inhibitors. Analyzes of observational data

suggest an increased risk of acute NAION in men with erectile dysfunction after exposure to tadalafil or other PDE5 inhibitors. As this may be relevant for all patients exposed to tadalafil, the patient should be advised that in the event of sudden vision problems, he should stop taking 시알리스 구매 and consult a doctor immediately . Cases of sudden hearing loss have been reported

after using tadalafil. Although other risk factors (such as age, diabetes, hypertension and a previous history of hearing loss) were present in some cases, patients should be advised to stop taking tadalafil and seek immediate medical attention if of sudden decrease or loss of hearing.

Due to the increased exposure to tadalafil, limited clinical experience and the lack of ability to influence clearance by dialysis, once-daily administration of Cialis is not recommended in patients with severe renal impairment . There is limited clinical data on

safety of tadalafil given as a single dose in patients with severe hepatic impairment (Child-Pugh class C). Once daily dosing has not been evaluated in patients with hepatic insufficiency. If Cialis is prescribed, a careful case-by-case assessment of the benefit-risk ratio should be made by the prescribing physician.

Patients who have and reactions that last 4 hours or more (priapism) should be advised to seek immediate medical attention .. If priapism is not treated immediately, it can cause damage to penile tissue and a permanent loss of potency.

Cialis should be used with caution in patients with anatomical deformations of the penis (e.g. angulation, cavernous fibrosis or Peyronie's disease) or in patients with conditions that may predispose to priapism (such as sickle cell anemia, multiple myeloma or leukemia) . Cialis tablets contain lactose. Patients with rare hereditary problems of galactose intolerance , the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine.