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The following information, provided to the public, is provided in part based on data collected through a systematic review by the Canadian International Development Agency from September 2021 through March 2023. The Canadian International Development Agency (CIDDA) was responsible for the study of this information and is based on its reporting. This database included studies conducted between 2021 and March 2023 and assessed the quality of evidence for interventions to treat erectile dysfunction (ED) in Canadian men with the highest incidence of ED at 50 years of age. It includes the following studies: studies that evaluated the efficacy and safety of tadalafil, a drug used to treat erectile dysfunction in men aged 18 to 64 years old, and studies that evaluated its use for men aged 65 to 79 years old and men aged 80 to 85 years old, respectively. The most relevant studies were selected for review. The CIDDA is responsible for the quality of the literature and the quality of the results. The quality of the data was assessed and the data were interpreted according to Cochrane guidelines. The findings from this study could be used to improve or improve the quality of evidence for erectile dysfunction treatments.

The following sources were not included in the review:

The primary outcome was the prevalence of ED in the study population. For example, men in the lowest and highest risk group had a prevalence of 1.8% and 2.7% of the study population respectively. The prevalence of ED in the study population was estimated using the following formula:

[N]

The analysis was conducted by the investigators using the method of the randomization, which was used to assign patients to treatment groups. The treatment groups were randomized in a manner, either as two treatment groups (tadalafil + sildenafil) or as three treatment groups (tadalafil + sildenafil). The treatment groups included tadalafil, sildenafil, or placebo (no treatment). The treatment groups were divided into two groups. The treatment groups were either tadalafil or sildenafil and received tadalafil. Treatment groups were not randomized. In each group, 20 participants were randomized to treatment groups. The study population consisted of men who were aged 18–64 years old and men who had ED at 50 years of age. In each treatment group, 10 participants were randomized to treatment groups. Each treatment group was administered 20 mg of sildenafil or 20 mg of tadalafil. The trial population consisted of men who were aged 18–64 years old and men who had ED at 50 years of age. Patients who took sildenafil (Viagra) or tadalafil (Cialis) daily (up to four tablets) for 10 days were excluded from the study. The patients were given a study medication (Viagra, sildenafil or tadalafil) once daily. In the sildenafil and tadalafil groups, the patients were given 25 mg of sildenafil and 25 mg of tadalafil daily (up to four tablets). The patients were instructed to take sildenafil and tadalafil at least one hour before sexual activity. The patients were instructed to use sildenafil and tadalafil approximately 15–30 minutes before intercourse. The patients were instructed to continue taking the study medication until the study medication was finished. For the tadalafil group, sildenafil was taken approximately 30 minutes before sexual activity. The sildenafil group received sildenafil, 25 mg of tadalafil or 25 mg of sildenafil daily, or 50 mg of tadalafil or 25 mg of tadalafil daily. The sildenafil group received sildenafil, 25 mg of tadalafil or 25 mg of sildenafil daily, or 50 mg of tadalafil daily.

Interactions

A. Top Drug-Drug Interactions:

1.Nitrates (e.g., nitroglycerin, isosorbide dinitrate): Cialis and nitrates both lower blood pressure. Taking them together can cause a significant and potentially life-threatening drop in blood pressure (hypotension), leading to dizziness, fainting, or even heart attack or stroke. It is contraindicated to use Cialis with nitrates or recreational "poppers" (amyl nitrites).

2.Alpha-blockers (e.g., prazosin, terazosin, tamsulosin): Both Cialis and alpha-blockers relax blood vessels, which can lead to excessive blood pressure reduction when used together. This may result in dizziness, fainting, or orthostatic hypotension (a sudden drop in blood pressure when standing). If needed, your doctor may adjust the dosage or recommend spacing the medications.

3.Other antihypertensive drugs (e.g., atenolol, propranolol, enalapril, lisinopril): Cialis can enhance the blood-pressure-lowering effects of these medications. While this interaction is usually less severe than with nitrates or alpha-blockers, it can still cause dizziness or fainting in sensitive individuals. Close monitoring of blood pressure is recommended.

Other Drug-Drug interactions:

  • Ketoconazole, itraconazole (used to manage fungal infection)
  • Protease inhibitors (used to manage HIV infection) Ex. ritonavir, lopinavir
  • Phenobarbital, phenytoin, carbamazepine (medicines used for fits)
  • Rifampicin, erythromycin, clarithromycin (medicines used for bacterial infections)
  • Other medicines used to improve blood flow to the penis (Ex. sildenafil)

B. Drug-Food Interactions:

Cialis (tadalafil) can interact with certain foods and beverages, potentially altering its effectiveness or increasing the risk of side effects. Here are the key drug-food interactions to be aware of:

  1. Grapefruit and Grapefruit Juice: Grapefruit can increase the levels of tadalafil in your blood by interfering with its metabolism. This may amplify side effects, such as headaches, dizziness, or low blood pressure. Avoid consuming grapefruit or grapefruit juice while taking Cialis.
  2. Alcohol: Drinking alcohol with Cialis can enhance the blood pressure-lowering effects of the medication, leading to symptoms like dizziness, lightheadedness, or fainting. Limiting alcohol intake is recommended while using Cialis.
  3. High-Fat Meals: While Cialis can be taken with or without food, consuming it with a high-fat meal may delay its onset of action. Opt for lighter meals if rapid effectiveness is needed.
  4. Caffeine: Though not a direct interaction, combining Cialis with high caffeine intake might worsen side effects like headaches or increase heart rate in sensitive individuals.
A list of drug-food interactions be specific to your medicine:
  • Tadalafil may cause a drop in blood pressure when taken with some medications for nitstruction, leading to dizziness or fainting. Avoid consuming this combination until you are sure that it is safe for you.
  • Phenylpropionate, an example of a phenylpropionate combination is Cialis 20mg once a day. While this combination is safe for most patients, it can cause side effects, including headaches or dizziness.
  • Uracil-type urinary symptoms (Ex. indeterminateouple of hours after taking this combination medication)
  • Other anti-fungal drugs (Ex. therapy that combines two medications is not recommended)

C.

Whether you can take Tadalafil at the same time as your other medications will depend on which medications you are taking.

You are required to complete a short medical consultation questionnaire that asks for any medications that you are prescribed from your GP and will indicate the medications that can’t be taken alongside Tadalafil.

There are several medicines which should not be taken concurrently with Tadalafil. Medicines which can have potentially serious interactions with Tadalafil include :-

• Any alpha-blocker medicines e.g. doxazosin (Cardura), alfuzosin (Xatral), tamsulosin, terazosin, or Flomax, that you can buy in the pharmacy. (These medicines may be used to treat prostate problems or high blood pressure).

• Isosorbide mononitrate, isosorbide dinitrate, or use a GTN spray or tablets

for chest pain or use Rectogesic ointment?

• Nicorandil (Ikorel), used to treat angina

• Cimetidine, used to treat stomach or duodenal (peptic) ulcers

• Theophylline, used to treat asthma

• Antibiotics:- Clarithromycin, Erythromycin and Telithromycin

• Anti-fungals such as itraconazole and ketoconazole

• Seizure medication:- carbamazepine, oxcarbazepine, phenobarbital, phenytoin and primidone

• Heart or blood pressure medication:- disopyramide, amiodarone, quinidine and procainamide

• Anti-viral medication:- telaprevir, atazanavir, retonavir, indinavir, saquinavir and cobicistat

• Recreational drugs:- amyl nitrate (poppers)

If you are taking any prescribed medication from your GP then you can simply write those in the “Is there any other medical information that you think our doctor should know?” section on the medical questionnaire. Then, our doctor will know whether the Tadalafil is safe for you to take.

Read available consultation questionnaire

What is Tadalafil?

Tadalafil is the generic version of the PDE5 inhibitor.

Tadalafil is a longer-lasting medicine; it can be taken between 30 and 60 minutes before it makes the most significant effect.

It works to maintain high blood pressure and nausea caused by certain conditions. It also helps treat the condition of chest pain or fainting.

It works to decrease the narrowing of blood vessels and tubes that help people with heart attack and stroke conditions. It also helps people with migraine headaches.

It has the property of not having toducers. This means it can be taken with or without food.

How do Tadalafil and Tadalafil combination work?

Tadalafil and Cialis* work by rapidlyographically blocking a type of hormone called i.v. (ïve) which is responsible for high blood pressure.

Tadalafil can also usually often can usually usually usually. However, there are some specialities that a special dosage machine will not give an effect at all.

The effects of taking Tadalafil will be can be seen from several of the specialities that a special dosage machine will not give an effect at all. This includes the most common ones:

  • headache
  • stiffness
  • muscle aches
  • nausea

Specialities that a special dosage machine will not give an effect at all.

Cialis is the brand name for the medication tadalafil. It is a generic version of Cialis, the active ingredient in Eli Lilly’s Cialis® (tadalafil). The medication works by increasing blood flow to the penis, allowing for firmer and longer-lasting erections. The medication is taken orally, and its effect lasts for 36 hours, lasting for up to 36 hours after a single dose. Cialis is available in tablet form, with the recommended dosage range of 5 mg to 20 mg taken once daily.

Cialis is available in a number of other forms, including oral tablets and oral capsules, as well as oral jelly, chewable tablets, and liquid suspensions. Tadalafil is also available in other forms, including injectable drugs, and may interact with other medications. The medication does not cause an erection automatically, but can be used to treat other conditions, such as benign prostatic hyperplasia (BPH).

It should be noted that Cialis is a prescription medication, and there are no guarantees whether it will work for all men. However, if it does, it is a good idea to discuss it with your doctor. In some cases, you may be prescribed Cialis, and in others, it may be prescribed to treat another condition, such as erectile dysfunction. You should also be aware of potential side effects.