Cialis (Tadalafil)

Cialis tablets are used to treat erectile dysfunction. They work by blocking PDE5, an enzyme which narrows blood vessel walls, responsible for reduced erection. If this chemical is blocked, the blood vessels in the penis are able to open wider, increasing the blood flow to the penis. This means that men who are unable to achieve or maintain an erection are able to engage in satisfactory sexual intercourse. Cialis tablets contain the active ingredient tadalafil and it starts working in 30 to 60 minutes.

There are various online services providing Cialis tablets. However, many of them are illegal and may be dispensing unlicensed or fake versions of Cialis, which may not work or could even be harmful. Before you buy Cialis online, you should check whether the website you are using has been approved by the General Medical Council as well as the Care Quality Commission. If you can buy Cialis without a prescription, you are likely to be ordering from a fraudulent business. Legitimate online doctor services like ZAVA offer the opportunity to obtain a prescription online and will ask you to fill in a medical questionnaire.

You should only take Cialis 10mg or 20mg tablets if you expect to have sex on the same day. These dosages are not usually suitable for daily consumption. If you would like to use Cialis every day, please consult your doctor. You will need to undergo a medical check-up to ascertain whether you could safely be prescribed a daily dose of 2.5mg or 5mg to help you achieve erections regularly.

In Ireland, Cialis is only available on prescription. This means that the tablets have to be dispensed from a licensed doctor or pharmacist. You can go to your GP to discuss taking Tadalafil tablets or you can obtain a prescription for an erectile dysfunction treatment from us online. Our team of UK-based online doctors use a questionnaire-based assessment to check which treatment is best for you. If you order a consultation before 4pm, your prescription will be sent out on the same day.

You shouldn’t take Cialis if your blood pressure isn’t under control, or if you have low blood pressure. Cialis can dangerously decrease your blood pressure. Make sure to check with your doctor first before taking Cialis if you have a history of low blood pressure or heart attacks.

Some blood pressure medications may cause erectile dysfunction. If you’re taking blood pressure medicine, and find that you’re having problems with your erections, talk to your doctor about changing your medication. Most men decide that they can live with their erectile dysfunction in order to keep their blood pressure at a safe level.

Tadalafil tablets like Cialis should be taken with extreme caution by anyone who may be at risk of getting prolonged erections. This includes patients who have any of the following conditions:

• sickle cell anaemia
• multiple myeloma
• leukaemia
• a history of recurrent prolonged erections
• decreased kidney function
• decreased liver function
• cardiovascular disease (involving the heart and blood vessels)
• Peyronie's disease, severe scarring, curvature or abnormality of the penis
• anyone taking medication for high blood pressure

Cialis should not be used by:

• women
• anyone under the age of 18
• anyone advised against sexual activity on health grounds
• anyone taking any form of nitrate medication (GTN sprays)

The same applies to patients with any of the following conditions:

• angina
• serious heart disease or recent heart attack or stroke
• low or high blood pressure
• eye conditions i.e. NAION
• kidney failure or severely decreased function
• rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-glucose malabsorption

These are all serious contraindications, so if any of the above applies to you, speak to your doctor before taking Cialis.

Cialis can cause dizziness and affect spatial awareness. Do not drive, operate machinery or engage in any activity that requires intense concentration after taking Cialis tablets, until you are confident that it won't affect your performance. Avoid taking alcohol when on Cialis as this may cause a drop in blood pressure and feelings of dizziness.

Avoid drinking grapefruit juice when using Cialis, as it may increase the amount of medicine in your blood, resulting in more pronounced side effects. Consult a doctor if your erection lasts longer than 4 hours (called priapism). Delayed treatment of this condition can result in irreversible damage. Consult a doctor if you experience a sudden, partial or total loss of vision in one or both eyes.

If you have never taken Cialis before, you should start with a 10mg dose, to see whether this dosage is effective for you. We recommend you allow one hour for the tablet to work if it is the first time you are using Cialis. If you feel that the effect was too strong or too weak, you can adjust the dosage accordingly the next time you take a tablet. Do not exceed the maximum dosage of 20mg.

Every Cialis tablet contains the active ingredient tadalafil. Depending on the dosage, each pill may contain 10 or 20mg of tadalafil, as well as the additional non-active ingredients, lactose monohydrate, magnesium stearate, triacetin, iron oxide yellow (E172), croscarmellose sodium, hydroxypropylcellulose, microcrystalline cellulose, sodium laurilsulfate, titanium dioxide (E171), talc and hypromellose.

• blurred vision/ eye pain
• abdominal pain
• increased heart rate or palpitations
• increase in blood pressure (hypertension)
• decrease in blood pressure (hypotension)
• rash
• sweating
• chest pain
• prolonged erections (priapism)

• swelling of the face or eyelids
• nosebleeds
• temporary loss of memory
• hives
• seizures
• sudden decrease or loss of hearing
• heart attack, stroke or mini-stroke (mostly in men with pre-existing risk factors)

If you experience any serious side effects when taking Cialis, consult your doctor immediately.

It is important you tell your doctor or pharmacist about any other medicines you are currently taking (including non-prescription and herbal medicines) before you start taking Cialis tablets. Cialis must not be taken with any form of nitrate medication as it can create a severe or even deadly drop in blood pressure. This includes:

• glyceryl trinitrate, isosorbide mononitrate/ dinitrate. This is used specifically for angina or heart failure
• nicorandil

You should also avoid certain illicit drugs, like amyl nitrite ('poppers'), while using Cialis.

It is also not advisable to take Tadalafil if you are using any of the following medication:

• antibiotics such as erythromycin, clarithromycin or rifampicin
• antifungals such as ketoconazole or itraconazole
• antivirals such as amprenavir, ritonavir or saquinavir

This list is not exhaustive. Please read the patient leaflet for more details, and speak to your doctor if you have any questions.