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Erectile Dysfunction

Erection problems (impotence) are very common, particularly in men over 40.

Most men occasionally fail to get or keep an erection. This is usually due to stress, tiredness, anxiety or drinking too much alcohol, and it’s nothing to worry about.

If it happens more often, it may be caused by physical or emotional problems.

Physical causes Possible cause Treatment Narrowing of penis blood vessels, high blood pressure, high cholesterol medicine to lower blood pressure, statins to lower cholesterol Hormone problems hormone replacement – for example, testosterone Side effects of prescribed medication change to medicine following discussion with GP You may also be asked to make lifestyle changes.

Do lose weight if you’re overweight stop smoking eat a healthy diet exercise daily try to reduce stress and anxiety

Don’t cycle for a while (if you cycle more than 3 hours a week) drink more than 14 units of alcohol a week

  • Side Effects

    Possible side effects

    Like all medicines, this medicine can cause side effects, although not everybody gets them. These effects are normally mild to moderate in nature.

    If you experience any of the following side effects stop using the medicine and seek medical help immediately:

    allergic reactions including rashes (frequency uncommon). chest pain – do not use nitrates but seek immediate medical assistance (frequency uncommon). priapism, a prolonged and possibly painful erection after taking CIALIS (frequency rare). If you have such an erection, which lasts continuously for more than 4 hours you should contact a doctor immediately. sudden loss of vision (frequency rare). Other side effects have been reported:

    Common (seen in 1 to 10 in every 100 patients)

    headache, back pain, muscle aches, pain in arms and legs, facial flushing, nasal congestion, and indigestion. Uncommon (seen in 1 to 10 in every 1,000 patients)

    dizziness, stomach ache, feeling sick, being sick (vomiting), reflux, blurred vision, eye pain, difficulty in breathing, presence of blood in urine, prolonged erection, pounding heartbeat sensation, a fast heart rate, high blood pressure, low blood pressure, nose bleeds, ringing in the ears, swelling of the hands, feet or ankles and feeling tired. Rare (seen in 1 to 10 in every 10,000 patients)

    fainting, seizures and passing memory loss, swelling of the eyelids, red eyes, sudden decrease or loss of hearing, hives (itchy red welts on the surface of the skin), penile bleeding, presence of blood in semen and increased sweating. Heart attack and stroke have also been reported rarely in men taking CIALIS. Most of these men had known heart problems before taking this medicine.

    Partial, temporary, or permanent decrease or loss of vision in one or both eyes has been rarely reported.

  • taking medicines for high blood pressure – usually Rank of benefits most of these events can be reduced or avoided

    All medicines can be taken with or without food.

    medicines to lower cholesterol – often however, CIALIS does a much more serious thing, causing serious loss of vision or other visual symptoms than it should and hopes that there is a licensed medical professional to help you.

    have been taken alone or with other medicines and have experienced full and continued results for some time.

  • Disease interactions

    Most people taking CIALIS do not have any known drug-drug interactions. It is not recommended to combine this medicine with medicines that can:

    lower blood pressure medicine to lower cholesterol Hormone replacement – for example, testosterone and Fosinopril.

    A blood test is carried out before and during treatment to monitor the effect of the medicine on the individual patient.

    When this medicine is taken with blood pressure medication can be lower than when taken with the blood pressure medicine.

    Taking CIALIS with blood pressure medication can lower blood pressure while taking this medicine. This can be, by far, most dangerous. Medicines that can lower blood pressure medicine can affect or be affected by certain health conditions.

    have been taken with or without food.

  • taking antidepressants

    The most common clinical uses of CIALIS are of serum conditions for depression and anxiety (see also 'CIALIS serum use numbers' and 'CIALIS depression numbers').

    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.
    All factors, including bacteria, to help manage. (Pfizer, 2018)
  • Anti-hypertension medications (Ex. amlodipine, metoprolol, lisinopril): Cialis can interact with certain foods and beverages, potentially altering its effectiveness or increasing the risk of side effects.
  • : Although not a direct interaction, combining Cialis with high alcohol consumption might complicate its onset of action.
  • Cialis Together for Erectile Dysfunction

    Cialis Together tablets are a treatment for adult men who have erection problems (erectile dysfunction). This is when a man cannot get, or keep an erection hard enough for satisfactory sexual activity.

    Cialis Together tablets contain the active substance tadalafil. It belongs to a group of medicines called phosphodiesterase type 5 (PDE5) inhibitors. It works by relaxing the blood vessels in your penis, allowing blood flow into your penis.

    It is important to know that you will not get an erection just by taking Cialis Together tablets. This medicine works with your body’s natural function to get an erection only when you are sexually stimulated.

    Cialis Together contains the active ingredient Tadalafil. The ingredient is a phosphodiesterase type 5 inhibitor medicine that temporarily improves blood flow to the penis by relaxing the blood vessels in and around the area.

    The Cialis Together medication is available over-the-counter and begins to work about 30 to 60 minutes after taking it. The effects are expected to last up to 36 hours. Cialis Together comes in 10mg tablets and should only be taken when needed.

    The active substance Tadalafil is also useful in treating other conditions along with erectile dysfunction. Please consult a Doctor, a Pharmacist or relevant product literature for more information.

    Is Cialis Together right for me?

    If you suffer from erectile dysfunction (impotence) Cialis Together may be an effective treatment. However, it may not be suitable for you if you have the following:

    • If you are allergic to any of the ingredients in Cialis Together
    • If you have severe heart, liver or kidney problems
    • If you have blood pressure concerns
    • If you have non-arteritic anterior ischemic optic neuropathy
    • If you are taking riociguat
    • If you have other penis-related issues (deformation or painful erections)
    Always read the enclosed leaflet carefully to ensure safe use, it contains information on taking Cialis Together and answers any questions you may have about use.

    Cialis Together is not suitable for people with the following health concerns:

    • If you have heart problems
    • If you have vision problems
    • If you are taking any other medicine

    For more information, consult your doctor or talk to a healthcare professional before taking this medicine.

    For further details, consult your doctor or consult your doctor.

    Read the patient information leaflet that comes with your medicine called

    Read the patient information leaflet that comes with your medicine

    This leaflet provides important questions to ask your doctor or pharmacist before taking Cialis Together medicine The medicine for erectile dysfunction is Cialis Together. You should read the answers to I question 1 and answer the medicineHow much does it cost? Cialis Together is available in 10mg tablets. The answers to I questions 2 and 3 are free and available in the medicine.medicine.ie article. Cialis Together is a phosphodiesterase-5 (PDE-5) inhibitor. It is a type of medicine called a PDE-5 inhibitor. This medicine works by relaxing the blood vessels in your penis, allowing blood to flow into your penis. Cialis Together works by helping the blood vessels in your penis to relax. Take Cialis Together about 1 to 3 hours before sexual activity. Cialis Together should be taken with a-filler, without regard to meals. You should avoid taking Cialis Together, with a-filler, without regard to meals as it can cause a low in the blood pressure. Avoid eating high-fat meals before taking Cialis Together, while taking this medicine. Also, do not take Cialis Together, with a-filler or without regard to meals without taking it. Avoid drinking alcohol while taking this medicine. Drink at least 3 liters/20 minutes before having sex.

    How much does Cialis Together cost?

    The cost of Cialis Together medicine is described in the product information leaflet. In this price section the product is supplied in a 10mg dose. Cialis Together medicine is available in a number of strengths, including 10mg, 20mg, 40mg, 60mg, 80mg, 100mg, 120mg andaltruively.

    The most common side effect is headache and a bit of a runny nose. If you experience any of these side effects, speak to your doctor immediately.

    If you experience any of the following, your doctor may need to adjust your dosage to increase the chance of experiencing more serious side effects, such as erectile dysfunction or decreased libido.

    Common side effects of tadalafil (Cialis) include headache, flushing, indigestion, nasal congestion, dizziness, and indigestion. If you experience any side effects that do not improve or worsen, talk to your doctor immediately.

    If you experience any of the following, your doctor may need to adjust your dosage to decrease the risk of experiencing these side effects. Talk to your doctor immediately if you experience severe headache, flushing, indigestion, nasal congestion, dizziness, and indigestion.

    If you experience any of the following, your doctor may need to adjust your dosage to decrease the chance of experiencing these side effects. Talk to your doctor immediately if you experience severe headaches, nasal congestion, indigestion, nasal congestion, dizziness, and indigestion.

    The most common side effects of tadalafil (Cialis) are headaches and indigestion.

    If you experience any of the following side effects, speak to your doctor immediately.

    If you experience any of the following side effects, talk to your doctor immediately.

    Cialis()has been available in pharmacies in South Africa since its launch. As a non-prescription version, it is a much cheaper option than the branded version, and has also been available in Australia and in a few other countries.

    As a non-prescription version, it is a much cheaper option than the branded version, and has also been available in a few other countries.

    The price ofin South Africa is around $1,500 per month. For a lower cost version of the medication, the price is only $1,800 per month.

    The cost ofin South Africa varies depending on the pharmacy, but it is usually around $30 for a monthly supply of 2.5 mg tablets. It is available in the form of 50 mg tablets, which is why it has to be taken three times a day. It is not available in a branded version of Cialis, which is why it is available in a different dosage form. The cost for this version is around $10.