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Physicians should inform their patients that concomitant use of CIALIS with alpha-adrenergic antagonists (other than 0.4 mg once-daily tamsulosin) is contraindicated because coadministration can lead to significant reductions in blood pressure. Physicians should discuss with patients the potential for CIALIS to augment the blood-pressure-lowering effect of other anti-hypertensive medications. Patients should be made aware that both alcohol and CIALIS, a PDE5 inhibitor, act as mild vasodilators. When mild vasodilators are taken in combination, blood-pressure-lowering effects of each individual compound may be increased. Therefore, physicians should inform patients that substantial consumption of alcohol (e. g., 5 units or greater) in combination with CIALIS can increase the potential for orthostatic signs and symptoms, including increase in heart rate, decrease in standing blood pressure, dizziness, and headache. Physicians should consider the potential cardiac risk of sexual activity in patients with preexisting cardiovascular disease. Text Continues Below
Patients who experience symptoms upon initiation of sexual activity should be advised to refrain from further sexual activity and seek immediate medical attention. There have been rare reports of prolonged erections greater than 4 hours and priapism (painful erections greater than 6 hours in duration) for this class of compounds. Priapism, if not treated promptly, can result in irreversible damage to the erectile tissue. Patients who have an erection lasting greater than 4 hours, whether painful or not, should seek emergency medical attention. The use of CIALIS offers no protection against sexually transmitted diseases. Counseling of patients about the protective measures necessary to guard against sexually transmitted diseases, including Human Immunodeficiency Virus (HIV) should be considered. Patients should read the patient leaflet entitled "INFORMATION FOR THE PATIENT" before starting therapy with CIALIS and each time the prescription is renewed or refilled.
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