Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Tadalafil.

Alcohol: Consumption of alcohol may decrease the ability to achieve an erection and may also temporarily decrease blood pressure, causing dizziness and fainting.

Blood pressure: Tell your doctor if you are taking medications to treat high blood pressure. The combination of these medications with tadalafil may add to the blood-pressure-lowering effect of these medications. This may lead to dizziness or fainting.

Grapefruit juice: Grapefruit juice can increase the amount of tadalafil in your blood. Do not drink grapefruit juice when taking Tadalafil.

Hearing problems: Rarely, people taking tadalafil have experienced a sudden decrease or loss of hearing. If this occurs, you should seek medical attention immediately.

Heart conditions: Speak to your doctor before taking any medication for erectile dysfunction if you:

• have or have had heart disease
• have had a heart attack
• have had a stroke
• have angina (chest pain as a result of poor blood flow to the heart muscle)
• have experienced chest pain during sexual activity
• have uncontrolled irregular heart rhythm
• have very Low Blood Pressure
• have uncontrolled high blood pressure

If you experience chest pains, dizziness, or nausea during sex, stop the exertion, and inform your doctor as soon as you can.

Kidney function: Kidney Disease or reduced kidney function may cause Tadalafil to build up in the body, causing side effects. Lower doses of Tadalafil should be used if you have impaired kidney function. Daily use of "on-demand" medication is not recommended. It should not be used more than 3 times per week. Once-a-day use with 5 mg dosing or less may be considered for some people with mild-to-moderate kidney problems.

Liver function: Liver disease or reduced liver function may cause Tadalafil to build up in the body, causing side effects. Men with poor liver function may need lower doses of Tadalafil. Daily use of Tadalafil is not recommended. It should not be used more frequently than 3 times per week. Once-a-day use with 5 mg dosing or less may be considered for some patients with liver problems.

Nitrate-containing medications: Tadalafil should never be taken with any medications that contain nitrates. Blood pressure may drop to life-threatening levels if tadalafil is taken with any nitrate-containing medication (e.g., nitroglycerin tablets, spray, or patches) or any other nitrates (e.g., isosorbide dinitrate or amyl nitrite "poppers"). Dizziness, fainting spells, heart attack, or stroke may be experienced.

If use of a nitrate-containing medication is considered medically necessary, 48 hours must pass after the last dose of tadalafil before taking a nitrate, and only under close medical supervision.

Penis deformation: As with other medications for erectile dysfunction, men with an anatomical deformation of the penis such as angulation, cavernosal fibrosis, or Peyronie's disease should be closely monitored by their doctors if they take Tadalafil. If you have any of these conditions, discuss with your doctor how Tadalafil may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Tadalafil, and whether any special monitoring is needed.

Prolonged erection (priapism): If an erection lasts longer than 4 hours (a rare occurrence), seek immediate medical assistance. If this condition is not treated quickly, tissue damage and permanent loss of the ability to have an erection could result.

Tell your doctor if you have any of the following conditions, as they may increase your risk of a prolonged erection: sickle cell Anemia, Multiple Myeloma, or Leukemia.

Prostate problems: If you are taking other medications to treat BPH called alpha blockers (e.g., Doxazosin), let your doctor know. The combination of alpha blockers with tadalafil is not recommended for treatment of BPH. People who are taking tadalafil for erectile dysfunction may be able to continue taking alpha blockers. Talk to your doctor for more information.

Vision problems: If you experience a sudden loss of vision in one or both eyes, or other vision-related problems, contact your doctor immediately. Vision loss may be partial or complete. While in some cases the condition may improve over time, it can be permanent in other cases. This is a rare condition that more likely to occur if you have heart disease, high blood pressure, High Cholesterol, Diabetes, or eye problems, if you are more than 50 years old, or if you smoke.

Pregnancy and breast-feeding: Tadalafil is not intended for use by women.

Children and adolescents: Tadalafil is not intended for use by children or adolescents under 18 years old.