Drug interactions may change the way your medications work or increase your risk of serious side effects. This document does not cover all possible drug interactions. Keep a list of all products you use (including prescription/over-the-counter and herbal products) and share it with your doctor and pharmacist. Do not start, stop or change the dosage of any medication without your doctor's approval.
One product that may interact with Tadalafil is Riociguat.
When used with nitrates, tadalafil can cause a severe drop in blood pressure, which can lead to dizziness, fainting and rarely a heart attack or stroke. Do not use any of the following drugs with tadalafil or within 48 hours after your last dose: certain drugs used to treat chest pain/angina (nitrates, e.g. nitroglycerin, isosorbitol), recreational drugs called "poppers" containing amyl or butyl nitrite.
If you are also taking alpha-blocker medications (such as doxazosin, tamsulosin) to treat enlarged prostate /BPH or high blood pressure, your blood pressure may be too low to cause dizziness or fainting. Your doctor may start treating or adjusting your alpha-blocker medication with a lower dose of tadalafil to minimize your risk of hypotension.
Other medications may affect the clearance of tadalafil from your body, which may affect its effects. Examples include azole antifungals (e.g., itraconazole, ketoconazole), macrolides (e.g., clarithromycin, erythromycin), HIV protease inhibitors (e.g., fosanavir, ritonavir), hepatitis C virus protease inhibitors (e.g., plavir, terrapivir), and rifamequine.
Do not take this drug with any other product containing tadalafil or other similar drugs (e.g. sildenafil, vardenafil) used to treat erectile dysfunction - ED or pulmonary hypertension.
Missed dose
If you take this medication regularly and you miss your dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take the next dose regularly. Do not double the dose to catch up.
storage
Store at room temperature, away from light, and keep dry. Don't store in the bathroom. Keep all medications away from children and pets.
Do not flush medication down the toilet or down the drain unless instructed. Discard this product properly when it is expired or no longer needed. Check with your pharmacist or local waste company.
