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What should I tell my health care provider before I take this medicine?They need to know if you have any of these conditions:anatomical deformity of the penis, Peyronie's disease, or ever had an erection that lasted more than 4 hours bleeding disorder diabetes frequent heartburn or gastroesophageal reflux disease (GERD) heart disease, angina, a history of heart attack, irregular heart beats, or other heart problems high or low blood pressure high cholesterol HIV infection kidney disease or require dialysis liver disease sickle cell disease stroke stomach or intestinal ulcers eye or vision problems or a rare genetic eye disease called retinitis pigmentosa an unusual or allergic reaction to tadalafil, other medicines, foods, dyes, or preservatives pregnant or trying to get pregnant breast-feeding How should this medicine be used?Take tadalafil tablets by mouth. Follow the directions on the prescription label. The dose is usually taken 30 minutes to 1 hour before sexual activity. You should not take this dose more than once per day. The pill needs to be put under the tongue till it dissolves. If you have kidney or liver problems or are taking certain medications, your prescriber may limit your dose of tadalafil. Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed. At this time, this medicine is not for use in children. What if I miss a dose? This does not apply. What drug(s) may interact with Tadalafil?Do not take tadalafil if you are taking the following medications:nitroglycerin-type drugs for the heart or chest pain such as amyl nitrite, isosorbide dinitrate, isosorbide mononitrate, nitroglycerin, even if these are only taken occasionallyTadalafil may also interact with the following medications:alpha blockers, such as alfuzosin (UroXatral reg;), doxazosin (Cardura reg;), prazosin (Minipress reg;), or terazosin (Hytrin reg;), used to treat high blood pressure or an enlarged prostate. bosentan certain antibiotics such as clarithromycin, erythromycin, troleandomycin certain drugs used for seizures such as carbamazepine, phenytoin, and phenobarbital cimetidine cisapride diltiazem grapefruit juice medicines for fungal infections (fluconazole, itraconazole, ketoconazole, voriconazole) mibefradil nicardipine certain medicines for the treatment of HIV infection or AIDS quinidine rifabutin, rifampin or rifapentine some drugs for treating depression, anxiety or other mood problems (examples: fluoxetine, fluvoxamine, nefazodone) verapamil Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines. What side effects may I notice from receiving Tadalafil?Side effects that you should report to your prescriber or health care professional as soon as possible:changes in hearing such as loss of hearing or ringing in ears changes in vision such as loss of vision, blurred vision, eyes being more sensitive to light, or trouble telling the difference between blue and green objects or objects having a blue color tinge to them chest pain or palpitations difficulty breathing, shortness of breath dizziness eyelid swelling prolonged erection (lasting longer than 4 hours) skin rash, itching Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):back pain flushing headache indigestion muscle aches stuffy or runny nose What should I watch for while taking Tadalafil? If you notice any changes in your vision while taking this drug, notify your prescriber or health care professional as soon as possible. Stop using tadalafil right away if you have a loss of sight in one or both eyes. Contact your healthcare provider immediately. Contact your physician immediately if the erection lasts longer than 4 hours or if it becomes painful. This may be a sign of priapism and must be treated immediately to prevent permanent damage. If you experience symptoms of nausea, dizziness, chest pain or arm pain upon initiation of sexual activity after tadalafil use, you should refrain from further activity and should discuss the episode with your prescriber or health care professional as soon as possible. Do not drink alcohol to excess (examples, 5 glasses of wine or 5 shots of whiskey) when taking tadalafil. When taken in excess, alcohol can increase your chances of getting a headache or getting dizzy, increasing your heart rate or lowering your blood pressure. Do not change the dose of your medication. Please call your prescriber or health care professional to determine if your dose needs to be reevaluated. Using tadalafil does not protect you or your partner against HIV infection (the virus that causes AIDS) or other sexually transmitted diseases. Where can I keep my medicine?Keep out of the reach of children in a container that small children cannot open. 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