Do not take tadalafil if you:
- are allergic to tadalafil or any of the other ingredients of this medicine
- do not have an erection problem, as this medicine will not provide any benefit to you
- take any medicines called nitrates or nitric oxide donors (such as glyceryl trinitrate, isosorbide mononitrate, isosorbide dinitrate for the relief of chest pain or heart failure, or nicorandil, molsidomine or sodium nitroprusside), as the combination may lead to a dangerous fall in blood pressure
- take amyl nitrite, also known as "poppers", as recreational drugs, as the combination may lead to a dangerous fall in blood pressure
- have been advised by your doctor to avoid sexual activity because of a problem with your heart or blood vessels, such as recent heart attack (within the last 90 days) or stroke (within the last 6 months), unstable angina or severe cardiac failure
- have low blood pressure or uncontrolled high blood pressure
- have ever had loss of vision because of non-arteritic anterior ischemic optic neuropathy (NAION), a condition described as "stroke of the eye"
- take riociguat or other medicines belonging to a group called guanylate cyclase stimulators, used to treat pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension. If you are taking riociguat or are unsure, tell your doctor
- have a deformed penis (such as angulation, cavernosal fibrosis or Peyronie's disease)
- are a woman
- are under 18 years of age
See your doctor
It is important to have a check-up with your doctor as soon as possible within the first 6 months of using tadalafil to ensure that your erection problems are not caused by another serious health condition. Even if you feel healthy, erectile dysfunction may be an early sign of heart and blood vessel problems, diabetes, high blood pressure or depression.
Tell your doctor before taking tadalafil if you:
- get very breathless or feel any pain in the chest with light or moderate activity (e.g. walking briskly for 20 minutes or climbing two flights of stairs)
- have or have ever had any heart disease or heart surgery, e.g. valvular heart disease, cardiomyopathy or arrhythmia (irregular heart beat)
- have high blood pressure that is not controlled
- have an abnormal or impaired left lower heart chamber
- have a restriction of the blood flow from the heart, e.g. aortic stenosis
- have Multiple System Atrophy
- have ever had an erection that lasted more than 4 hours (priapism), or have any condition which can cause priapism, including sickle cell anaemia, leukaemia or multiple myeloma
- take any of the other medicines listed in the leaflet
- have any deformation of your penis
- have a serious liver problem
- have a severe kidney problem
- have undergone pelvic surgery or removal of all or part of the prostate gland in which nerves of the prostate are cut (radical non-nerve-sparing prostatectomy), as it is not known if tadalafil will be effective for you
- have known hereditary degenerative retinal disorders such as retinitis pigmentosa, as it is unknown whether tadalafil is safe for you to use
Sexual activity can put extra strain on your heart. If you have a heart problem or think you might have a heart problem, tell your pharmacist or doctor.
If you experience sudden decrease or loss of vision, or your vision is distorted or dimmed while you are taking tadalafil, stop taking tadalafil and contact your doctor immediately. If you experience decreased or sudden hearing loss, stop taking tadalafil and contact your doctor immediately.
Other medicines
Tell your pharmacist or doctor if you are taking, have recently taken or might take any other medicines, including:
- an alpha blocker such as alfuzosin, doxazosin or tamsulosin, used to treat urinary problems due to an enlarged prostate or occasionally high blood pressure
- other medicines to treat high blood pressure
- finasteride, to treat benign prostatic hyperplasia
- itraconazole or ketoconazole (fungal infections)
- rifampicin, erythromycin, clarithromycin (antibiotics)
- ritonavir or saquinavir (AIDS or HIV infection)
- phenobarbital, phenytoin and carbamazepine (anticonvulsants)
- other treatments for erectile dysfunction
- theophylline (asthma)
- cimetidine (heartburn and stomach ulcers)
Drink, alcohol and recreational drugs
Grapefruit juice may affect how well tadalafil will work and must be avoided. Drinking excessive alcohol can temporarily reduce your ability to get an erection. You are advised not to drink large amounts of alcohol before sexual activity.
Avoid the use of tadalafil with other recreational drugs (including but not limited to nitrous oxide, GHB/GBL, methamphetamines, MDMA/ecstasy, ketamine, flunitrazepam, cannabis, opioids, cocaine), as it may lead to side effects such as dizziness, decrease of blood pressure, stroke or heart attack, seizures, priapism and coma.
Driving and using machines
Some men taking tadalafil in clinical studies have reported dizziness. Check carefully how you react to the tablets before driving or using machines.
Contains lactose
If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.
Stop taking tadalafil and seek medical help immediately if you experience:
- an allergic reaction, with symptoms including sudden wheeziness, difficulty breathing or dizziness, swelling of the eyelids, face, lips or throat, or rashes (uncommon)
- chest pains (uncommon). If this occurs before, during or after intercourse, get in a semi-sitting position and try to relax. Do not use nitrates to treat chest pain
- a persistent and sometimes painful erection lasting longer than 4 hours (rare)
- sudden loss of vision, or distorted, dimmed or blurred central vision, or sudden decrease of vision
- Stevens-Johnson Syndrome, a rare, serious skin disorder causing flu-like symptoms and a painful rash that spreads and blisters
Read the full patient information leaflet before use.
