Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Cialis (Tadalafil).

Alcohol: Consumption of alcohol may decrease the ability to achieve an erection and may also temporarily decrease blood pressure, causing dizziness and fainting.

Blood pressure: Tell your doctor if you are taking medications to treat high blood pressure. The combination of these medications with Cialis (Tadalafil) may add to the blood-pressure-lowering effect of these medications. This may lead to dizziness or fainting.

Grapefruit juice: Grapefruit juice can increase the amount of Cialis (Tadalafil) in your blood. Do not drink grapefruit juice when taking Cialis (Tadalafil).

Hearing problems: Rarely, people taking Cialis (Tadalafil) have experienced a sudden decrease or loss of hearing. If this occurs, you should seek medical attention immediately.

Heart conditions: Speak to your doctor before taking any medication for erectile dysfunction if you:

• have or have had heart disease
• have had a heart attack
• have had a stroke
• have angina (chest pain as a result of poor blood flow to the heart muscle)
• have experienced chest pain during sexual activity
• have uncontrolled irregular heart rhythm
• have very Low Blood Pressure
• have uncontrolled high blood pressure

If you experience chest pains, dizziness, or nausea during sex, stop the exertion, and inform your doctor as soon as you can.

Kidney function: Kidney Disease or reduced kidney function may cause Cialis (Tadalafil) to build up in the body, causing side effects. Lower doses of Cialis (Tadalafil) should be used if you have impaired kidney function. Daily use of "on-demand" medication is not recommended. It should not be used more than 3 times per week. Once-a-day use with 5 mg dosing or less may be considered for some people with mild-to-moderate kidney problems.

Liver function: Liver disease or reduced liver function may cause Cialis (Tadalafil) to build up in the body, causing side effects. Men with poor liver function may need lower doses of Cialis (Tadalafil). Daily use of Cialis (Tadalafil) is not recommended. It should not be used more frequently than 3 times per week. Once-a-day use with 5 mg dosing or less may be considered for some patients with liver problems.

Nitrate-containing medications: Cialis (Tadalafil) should never be taken with any medications that contain nitrates. Blood pressure may drop to life-threatening levels if Cialis (Tadalafil) is taken with any nitrate-containing medication (e.g., nitroglycerin tablets, spray, or patches) or any other nitrates (e.g., isosorbide dinitrate or amyl nitrite "poppers"). Dizziness, fainting spells, heart attack, or stroke may be experienced.

If use of a nitrate-containing medication is considered medically necessary, 48 hours must pass after the last dose of Cialis (Tadalafil) before taking a nitrate, and only under close medical supervision.

Penis deformation: As with other medications for erectile dysfunction, men with an anatomical deformation of the penis such as angulation, cavernosal fibrosis, or Peyronie's disease should be closely monitored by their doctors if they take Cialis (Tadalafil). If you have any of these conditions, discuss with your doctor how Cialis (Tadalafil) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Cialis (Tadalafil), and whether any special monitoring is needed.

Prolonged erection (priapism): If an erection lasts longer than 4 hours (a rare occurrence), seek immediate medical assistance. If this condition is not treated quickly, tissue damage and permanent loss of the ability to have an erection could result.

Tell your doctor if you have any of the following conditions, as they may increase your risk of a prolonged erection: sickle cell Anemia, Multiple Myeloma, or Leukemia.

Prostate problems: If you are taking other medications to treat BPH called alpha blockers (e.g., Doxazosin), let your doctor know. The combination of alpha blockers with Cialis (Tadalafil) is not recommended for treatment of BPH. People who are taking Cialis (Tadalafil) for erectile dysfunction may be able to continue taking alpha blockers. Talk to your doctor for more information.

Vision problems: If you experience a sudden loss of vision in one or both eyes, or other vision-related problems, contact your doctor immediately. Vision loss may be partial or complete. While in some cases the condition may improve over time, it can be permanent in other cases. This is a rare condition that more likely to occur if you have heart disease, high blood pressure, High Cholesterol, Diabetes, or eye problems, if you are more than 50 years old, or if you smoke.

Pregnancy and breast-feeding: Cialis (Tadalafil) is not intended for use by women.

Children and adolescents: Cialis (Tadalafil) is not intended for use by children or adolescents under 18 years old.

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Apo Tadalafil Pah.

Blood conditions: Before taking Apo Tadalafil Pah, tell your doctor if you have sickle cell Anemia or Leukemia.

Blood pressure: Tell your doctor if you are taking medications to treat high blood pressure, as the combination of these medications with tadalafil may add to the blood-pressure-lowering effect of these medications.

Dehydration: If you lose a large amount of body fluids (dehydration) through excessive sweating; from not drinking enough fluids; or from being sick with a fever, vomiting, or diarrhea, contact your doctor. Dehydration can make you more likely to experience low blood pressure while you are taking Apo Tadalafil Pah.

Grapefruit juice: Grapefruit juice can increase the amount of tadalafil in your bloodstream. Talk to your doctor about drinking grapefruit juice when taking Apo Tadalafil Pah.

Hearing changes: If you experience a decrease or loss of hearing while taking Apo Tadalafil Pah, seek immediate medical attention.

Heart problems: If you have heart disease or other heart problems, you may be more likely to experience low blood pressure while taking Apo Tadalafil Pah and should discuss with your doctor how Apo Tadalafil Pah may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Apo Tadalafil Pah, and whether any special monitoring is needed.

Kidney function: If you have decreased kidney function, you may require a lower dose of Apo Tadalafil Pah. Talk to your doctor. If you have severely reduced kidney function, you should not take Apo Tadalafil Pah.

Liver function: If you have decreased liver function, you may require a lower dose of Apo Tadalafil Pah. Talk to your doctor. People with severely reduced liver function should not take Apo Tadalafil Pah.

Lung problems: Tadalafil is not recommended for people with a form of high blood pressure in the lungs called pulmonary veno-occlusive disease. If you have pulmonary veno-occlusive disease or experience sudden cough, shortness of breath, chest pain, or rapid breathing, talk to your doctor before taking Apo Tadalafil Pah.

Nitrate-containing medications: Never take tadalafil with any medications that contain nitrates. Your blood pressure may suddenly drop to life-threatening levels if you take it with any nitrate-containing medication (e.g., nitroglycerin tablets, spray, or patches) or any other nitrates (e.g., isosorbide dinitrate or amyl nitrite "poppers"). You may experience dizziness, fainting spells, Heart Attack, or Stroke.

Penis deformation: If you have a deformation of the penis such as angulation, cavernosal fibrosis, or Peyronie's disease, discuss with your doctor how Apo Tadalafil Pah may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Apo Tadalafil Pah, and whether any special monitoring is needed.

Prolonged erection: Before taking Apo Tadalafil Pah, tell your doctor if you have ever had an erection that lasted longer than 4 hours.

Vision problems: If you have or have had a temporary decrease or permanent loss of vision in one or both eyes, including a condition called non-arteritic anterior ischemic optic Neuropathy (NAION), or if you have a condition called retinitis pigmentosa, tell your doctor before taking Apo Tadalafil Pah.

Apo Tadalafil Pah can cause partial or complete vision loss that may be temporary or permanent. If you experience a sudden loss of vision in one or both eyes or other vision related problems, tell your doctor immediately. If you do experience vision changes, do not drive or operate machinery until your vision returns to normal.

Pregnancy: Apo Tadalafil Pah should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Apo Tadalafil Pah, contact your doctor immediately.

Breast-feeding: It is not known if tadalafil passes into breast milk. If you are a breast-feeding mother and are taking Apo Tadalafil Pah, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of Apo Tadalafil Pah have not been established for children with pulmonary hypertension.