When to Seek Emergency Care
Call 911 or seek immediate medical attention if you experience:
⚠️
Priapism
An erection lasting more than 4 hours. This is a medical emergency that can cause
permanent damage if not treated immediately.
👁️
Vision Loss
Sudden decrease or loss of vision in one or both eyes. This could be a sign of a
serious eye problem called NAION.
👂
Hearing Loss
Sudden decrease or loss of hearing, possibly with ringing in the ears or dizziness.
💔
Chest Pain
Chest pain, irregular heartbeat, or severe dizziness during or after sexual activity.
Absolute Contraindications
DO NOT take these medications if you:
- Take nitrates (nitroglycerin, isosorbide mononitrate, isosorbide dinitrate) for chest pain
- Take riociguat (Adempas) for pulmonary hypertension
- Are allergic to tadalafil, sildenafil, or any ingredients in these medications
- Have been advised by your doctor to avoid sexual activity due to heart problems
- Have severe liver disease
- Have severe kidney disease requiring dialysis
- Have recently had a stroke or heart attack (within the last 6 months)
Important Medical Conditions
Tell your doctor if you have or have had:
Cardiovascular
- Heart disease or heart rhythm problems
- Heart attack or stroke
- Angina (chest pain)
- High or low blood pressure
- Heart failure
Blood & Circulation
- Sickle cell anemia
- Multiple myeloma
- Leukemia
- Bleeding disorders
- Blood clotting problems
Organ Function
- Liver disease
- Kidney disease
- Stomach ulcers
- Pulmonary veno-occlusive disease
Eye & Ear
- Retinitis pigmentosa
- NAION (eye stroke)
- Vision or hearing loss
- Other eye problems
Penile Conditions
- Peyronie's disease
- Penile curvature or deformity
- Previous priapism
Drug Interactions
These medications can interact with many other drugs. Always inform your healthcare
provider about ALL medications you're taking, including:
Dangerous Interactions
🚫
Never combine with:
- Nitrates (nitroglycerin, isosorbide)
- Riociguat (Adempas)
- Other PDE5 inhibitors
- Recreational drugs called "poppers" (amyl nitrite)
Medications Requiring Caution
- Alpha-blockers: Used for prostate problems or high blood pressure
(doxazosin, tamsulosin)
- Blood pressure medications: May cause excessive blood pressure lowering
- Antifungals: Ketoconazole, itraconazole
- Antibiotics: Clarithromycin, erythromycin
- HIV medications: Protease inhibitors
- Hepatitis C medications: Some antivirals
Lifestyle Considerations
Alcohol
🍷
Limit alcohol consumption. Excessive alcohol can:
- Reduce the medication's effectiveness
- Increase risk of side effects (dizziness, low blood pressure)
- Make it harder to achieve an erection
Grapefruit
Grapefruit and grapefruit juice can increase the levels of these medications in your blood,
potentially increasing side effects. Avoid grapefruit products while taking these medications.
Driving and Operating Machinery
These medications can cause dizziness or vision changes. Be cautious when driving or operating
machinery until you know how the medication affects you.
Pregnancy and Breastfeeding
These medications are not intended for use by women. If you are pregnant, planning to become
pregnant, or breastfeeding, do not take these medications without explicit medical guidance.