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• require a prescription from your doctor if you wish to purchase this medication!

In deciding to use any medicine, the risks of taking it must be weighed against the good it will do. This is a decision you and your doctor will make. For cialis, the following should be considered:

Allergies Tell your doctor if you have ever had any unusual or allergic reaction to cialis or tadalafil. Also tell your doctor and pharmacist if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy Cialis is for use in men only. Cialis has not been studied in pregnant women +cialis has not been shown to cause birth defects or other problems in animals.

Breast-feeding Cialis is for use in men only. It is not known whether cialis passes into human breast milk.

Children Cialis is not for use in children.

Older adults This medicine has been tested in a limited number of patients 65 years of age or older and has not been shown to cause different side effects or problems in older people than it does in younger adults.

Other medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking cialis, it is especially important that your doctor and pharmacist know if you are taking any of the following:

• Erectile dysfunction medicines these medicines should not be used at the same time as tadalafil because the safety of using these medicines in combination has not been proven.

• Nitrates (medicine used to treat chest pain [e.g., nitroglycerin]) these medicines should not be used at the same time as tadalafil because they can cause very low blood pressure and serious side effects

• Alcoholic beverages drinking alcohol can cause an increased chance of some side effects.

• Alpha blockers, other than tamsulosin 0.4 mg taken once a day (medicine for high blood pressure) these medicines should not be used at the same time as tadalafil because they can cause very low blood pressure and serious side effects

• Erythromycin (e.g., Apo-erythro) or
• Itraconazole (e.g., Sporanox) or
• Ketoconazole (e.g., Nizoral) or
• Grapefruit juice or
• Ritonavir (e.g., Norvir) or
• Saquinavir (e.g., Fortovase, Invirase) These medicines or food may increase your chance of getting side effects.

• Angina (reoccurring chest pain) or
• Arrhythmia (irregular heartbeat) or
• Hypotension (low blood pressure) or
• Hypertension (high blood pressure) or
• Stroke (recent history of) or
• Heart attack (within the last 3 months) or
• Heart failure (within the last 6 months) or
• Retinal disorders (rare hereditary eye problem)
• Stroke (within the last 6 months) tadalafil has not been studied in patients with these medical conditions and should not be used

• Kidney disease (severe) cialis should be used with caution in these patients and a lower dose may be needed

• Liver disease cialis should not be used in patients with serious liver disease; in patients with less serious liver disease, tadalafil should be used with caution and a lower dose may be needed

• Abnormal penis, including curved penis and birth defects of the penis chance of problems occurring may be increased and this medicine should be used with caution in these patients

• Bleeding disorders or
• Stomach ulcers chance of problems occurring may be increased; it is not known if the medicine is safe for use in these patients

• Heart disease, underlying chance of low blood pressure occurring is greater; cialis should be used carefully in these patients

• Heart blood flow problems these conditions may cause you to be more sensitive to tadalafil

• Sickle-cell anemia (blood disorder) or
• Bone marrow cancer or
• Leukemia (blood related cancer) cialis should be used with caution in these patients as problems with prolonged erection of the penis may occur