Who should not take Cialis?
Cialis (tadalafil) must not be taken with any form of nitrate medication, as this combination can produce a severe drop in blood pressure that can cause dizziness, fainting, or even a heart attack. Nitrate medications include the following:
- nicorandil
- glyceryl trinitrate, isosorbide mononitrate, isosorbide dinitrate, used for angina or heart failure.
- amyl nitrate (also known as 'poppers').
If Cialis is taken by people who are taking medicines for high blood pressure (antihypertensives), the combination may potentially cause an extra drop in blood pressure. This is unlikely to be significant, but you should be aware that if it does occur it may make you feel dizzy.
The use of Cialis with other treatments for erectile dysfunction is not recommended, as the safety of such combinations has not yet been established.
The following medicines may increase the blood level of tadalafil, which could increase the risk of side effects:
- The antifungal medicines ketoconazole and itraconazole.
- The antibiotic medicines clarithromycin and erythromycin.
- The HIV protease inhibitors ritonavir and saquinavir.
Tell your doctor if you are taking any of these as you may need a lower tadalafil dose. Grapefruit juice taken with tadalafil may also cause an increase in the blood level of tadalafil.
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