Medically reviewed by: Thomas Fischer (Pharmacist). This article has been written according to strict guidelines and medical standards.
Medically reviewed by: Thomas Fischer (Pharmacist)
Imagine using Cialis (Tadalafil) to improve your lifestyle to end up having to deal with something that can be far worse than your original problem. That is the reality of interactions and contraindications. Bear in mind that in general, using prescribed medication is reasonably safe. Cialis Interactions and contraindications seldom happen.
It is vital that you share your history of drug use and known medical conditions with your doctor. This information is extremely important to your doctor when he prescribes medication. It will help you to avoid potential interactions and contraindications of Cialis (Tadalafil).
Are Interactions And Contraindications The Same?
Most people believe that side effects and adverse effects are one and the same thing. Likewise, they think interactions and contraindications are on and the same. The reality is that these four terms are very different from each other.
Below is a short definition of each:
- Side effect: An undesirable secondary impact that arises due to the treatment of prescription medication, regardless of the amount or dosage.
- Adverse effect: An unintended occurrence that arises from the correct use of prescription medication.
- Interactions: Undesirable reactions that occur through the combination of two or more drugs. Particular foods, beverages, or supplements can also cause this. Interactions may change how a drug works, and it may also cause undesired side effects.
- Contraindications: A specific factor or condition in a person that justifies withholding certain medical procedures, medications, or surgery because it may be harmful to the patient.
Without providing a complete background of your conditions and drug usage to your physician, you increase your chances of experiencing interactions or contraindications.
Did you know?
Cialis - Known Interactions With Other Drugs
Cialis has Tadalafil as its active ingredient. It is classified as a phosphodiesterase type 5 (PDE5) inhibitor. This product’s primary use includes treatment for pulmonary arterial Hyperpiesis (PAH), impotence (ED), and benign prostatic hyperplasia (BPH).
A variety of drugs, food, supplements, and beverages may interact with Cialis. Interactions have the potential to alter the desired effects of a drug. It can also result in severe and unwanted side effects. The result of an interaction ranges from mild to severe.
Cialis may interact with the following:
- Drugs designed to treat Pulmonary Arterial Hyperpiesis (PAH), such as Riociguat.
- Nitrate use may be the cause of sudden hypotension, and this reaction may lead to strokes, fainting, heart attack, and heart dizziness. Nitrates used in drugs include isosorbide, nitroglycerin, butyl nitrite, and amyl. It is an ingredient in medications used in treating angina (chest pain). It is also an ingredient found in recreational drugs such as ‘poppers.’
- Alpha-blockers are used for the treatment of BPH and hyperpiesis. This combined use may result in your blood pressure dropping too low, which can lead to fainting and dizziness.
Certain medications affect the elimination of Cialis from your system. This reaction may alter how the active ingredient works. These medications include:
- Macrolide antibiotics (erythromycin, clarithromycin)
- A variety of HIV drugs (fosamprenavir, ritonavir)
- Antifungals (ketoconazole, itraconazole)
- Hepatitis C protease inhibitors (telaprevir, boceprevir)
- Rifampin (used to prevent tuberculosis (TB))
- Other sexual dysfunction medicine such as vardenafil and sildenafil
- Tizanidine (short-acting muscle relaxer)
- Vasodilators and certain antihypertensive drugs (used to treat hypertension).
Grapefruit and its juice are also known to interact with Cialis. It might increase tadalafil levels in your system. The result is that you could experience side effects faster than if you hadn’t consumed it.
Minimal alcohol use is acceptable, excessive alcohol intake while using Cialis is not. It may be the cause of hypotension, fainting, dizziness, headaches, and heart palpitations (s. also Cialis & Alcohol – Are There Compatibility Issues?).
The above isn’t a comprehensive list of Cialis interactions. For a complete list of items that can interact with this drug, speak to your pharmacist or doctor.
Cialis - Absolute Contraindications
Contraindications may cause severe side effects in people that use Cialis. Your doctor can prevent this with enough information about your health. People that have known allergies and other severe reactions to the medication or any part of the pill shouldn’t use Cialis. Due to both drugs having vasodilatory effects, the combined use of Alpha-blockers and Cialis might lead to a sudden and severe drop in blood pressure. Thus you should avoid this combination.
Using Cialis by people who are receiving nitrite or nitrate treatment is not advised. The drug may increase the hypotensive (lowering blood pressure) effect of nitrites.
Patients with renal impairment, renal failure, and dialysis-dependency should not use Cialis. It may lead to increased levels of tadalafil in the system. This increase is attributed to the inability of the body to excrete the drug effectively.
Men with severe hepatic disease (damage to the liver) must refrain from using Cialis.
For people with a history of heart conditions, vigorous sexual intercourse may bring on a cardiac arrest. For this reason, men that suffer from the following must avoid using Cialis:
- Angina (severe chest pain)
- Cardiac arrhythmias (heart rhythm problems)
- Coronary artery disease (a type of heart disease)
- Heart failure
- Hypertension
- Myocardial infarction (heart attack)
- Stroke
- Veno-occlusive disease (VOD) (blocked small blood vessels in the liver).
In rare cases, Cialis may cause priapism (prolonged, painful erections lasting more than 4 hours). Untreated, priapism may cause permanent erectile tissue damage. If this occurs, you should seek immediate medical help.
People with penile abnormalities must use Cialis with caution. The same applies to people that suffer from other conditions that may cause priapism. These conditions include:
- Leukemia (blood or bone marrow cancer)
- Myeloma (plasma cell cancer)
- Polycythemia (increased hemoglobin concentration in the blood)
- Sickle cell disease (disorders of hemoglobin)
- Angulation (abnormal bend or curve)
- Cavernosal fibrosis (the formation of fibrous tissue in the penis)
- Peyronie’s disease (a non-cancerous condition caused by fibrous scar tissue)
Use Cialis with caution if you have or are suffering from non-arteritic anterior ischemic optic neuropathy (NAION). The same applies to visual impairment and retinitis impairment. The use of this medication may cause blurred or a sudden loss of vision.
Cialis consumption may obstruct esophageal motility. It can also reduce the strength of the lower esophageal sphincter. Use Tadalafil with caution if you suffer from a hiatal hernia related to gastroesophageal reflux disease (GERD).
Before taking Cialis, patients who suffer from hematological or peptic ulcer disease must do a risk-benefit assessment. Also, administering it to prostate cancer patients is not advisable.
Our tip: How to buy Cialis with online prescription
What To Consider When Using Cialis For High Blood Pressure?
High blood pressure is one of the leading causes of impotence. It may also reduce sexual desire and interfere with ejaculation. Traditional medications used to treat hyperpiesis often have similar effects. Certain high blood pressure drugs can cause sexual dysfunction. These drugs include:
- Diuretics (water pills) - Can affect penile blood flow resulting in erectile dysfunction. Water pills diminish zinc in your system, which produces testosterone (sex hormone). This effect can affect your sex drive.
- Beta-blockers - May result in sexual dysfunction.
In general, it is safe to combine Cialis with high blood pressure medication. Cialis is a PDE5 inhibitor medication that acts as a vasodilator. Its uses include the treatment of ED, BPH, and PAH.
Pulmonary Arterial Hyperpies is hypertension that narrows, blocks, or destroys lung based blood vessels. Often prescribed, Cialis is an efficient dual treatment for both ED and PAH. Men who suffer from uncontrolled blood pressure or those that use alpha-blockers must not consume Cialis.
Operating Heavy Machinery and Driving - What Are The Implications When Using Cialis?
Cialis carries a warning notice that states, “Do not drive or operate heavy machinery while on this medication.” There are good reasons for this warning.
Cialis acts as a vasodilator (medication that lowers blood pressure). Combined with other vasodilators it may cause an increase in its effect. The result of this is a sudden severe drop in blood pressure, causing dizziness and fainting. Side effects of Cialis (Tadalafil) include:
- Dizziness and fainting
- Sudden hearing loss
- Abrupt impaired or loss of vision
The side effects decrease your motor skills and ability to function. If this happens while you are operating heavy machinery or driving, it can cause an accident. This accident may be the cause of severe injury and possible death for either yourself or someone else.
United States law states, “If you are inebriated to the point where your ability to operate a vehicle safely by any foreign substance, you could be charged and found guilty of driving under the influence.”. What this law means is that if you use a drug that impairs your ability to drive, then you are driving under the influence. You are also liable for any damage or personal harm caused while driving under the influence.
Cialis Pregnancy Notice
There is no adequate information about drug-associated risks in pregnant women available using Cialis. Limited testing in pregnant women has not shown any harmful effects on the fetus. Animal studies in which pregnant animals received Cialis treatment showed no sign of an escalation in fetal damage. Procreation studies conducted in animals treated with tadalafil have demonstrated no risk to the fetus. Although drug studies in animals might be indicative of human response, it is not always accurate.
While testing on animals, the evidence proved that Cialis passed into the milk of breastfeeding rats. Many drugs find their way into breast milk in breastfeeding women. For this reason, a risk to the breastfed human child is not impossible.
Cialis should not be given to anyone under the age of 18, so for this reason, breastfeeding women should avoid taking this medication.
Cialis Usage - Warnings & Precautions
Ensure that your doctor does a proper and thorough evaluation of your ED or BPH condition. This evaluation will reveal the possible underlying causes of your ED or BPH, allowing your doctor to prescribe the best possible treatment option.
This evaluation will allow your doctor to avoid interactions and contraindications. Interactions and contraindications may result in severe and permanent damage. Speak to your doctor or pharmacist, or study the leaflet accompanying the medication. This information will educate you as to the potential risks which might trigger them and how to avoid them.
The use of Cialis is not suitable for children and women. Tadalafil is also not recommended for use by breastfeeding women. Women must only use this medication if it is absolutely necessary to do so. While using Cialis, you should avoid heavy machinery, driving, and doing hazardous tasks.
Cialis use must not exceed the prescribed amount. In large enough doses, you can overdose from Tadalafil. A lot of the side effects of Cialis are not severe and can not cause permanent damage. These side effects diminish with prolonged use or lowering the dose of the drug.
If you experience severe side effects or unknown side effects, then you should cease taking the medication and seek immediate emergency medical care.
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Article Sources
- Questions and Answers for Cialis (tadalafil). In: U.S. Food and Drug Administration. URL: https://www.fda.gov/
- Parker-Pope, Tara (August 28, 2009). “The Cost of Treating Erectile Dysfunction“. New York Times.
- CIALIS- tadalafil tablet, film coated. Eli Lilly and Company. URL: https://uspl.lilly.com/
- A Study of Tadalafil and Sildenafil in Men With Erectile Dysfunction in China. Information provided by (Responsible Party): Eli Lilly and Company. URL: https://clinicaltrials.gov/ct2/show/NCT01352507
- Porst, Hartmut et al. Efficacy of tadalafil for the treatment of erectile dysfunction at 24 and 36 hours after dosing: a randomized controlled trial. In: Urology Volume 62, 07/2003. Elsevier Inc.
- Brock, Gerald et al. Efficacy and Safety of Tadalafil for the Treatment of Erectile Dysfunction: Results of Integrated Analyses. In: The Journal of Urology Volume 168, 10/2002. Elsevier Inc.
- Eli Lilly and Company Limited (2017). Cialis 20mg film-coated tablets. EMC. [online] Available at: https://www.medicines.org.uk/emc/files/pil.7430.pdf [accessed 20th July, 2020].
- Moncada, I., Bethencourt, F, R and Lledó-García et al., (2014). Effects of Tadalafil Once Daily or On Demand Versus Placebo on Time to Recovery of Erectile Function in Patients After Bilateral Nerve-Sparing Radical Prostatectomy. World J Urol: 33, pp 1031-1038.