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The safety and warning information for tadalafil (Adcirca) is provided to ensure your well-being while using this medication. Please review the following points carefully and discuss any concerns with your healthcare provider.

• Low Blood Pressure: Tadalafil (Adcirca) may cause temporary drops in blood pressure, particularly in individuals with specific heart conditions or those on blood pressure medications. This can lead to dizziness and an increased risk of falls. Exercise caution when rising from sitting or lying positions. Avoid using tadalafil (Adcirca) within 48 hours of nitrate medications for chest pain to prevent dangerous blood pressure drops. Alcohol consumption can also lower blood pressure, so it should be avoided. Contact your healthcare provider if dizziness or lightheadedness persists. Relevant risk factors include taking alpha-blockers, medications for high blood pressure or chest pain, and alcohol consumption.

• Prolonged or Painful Erection (Priapism): Rare cases of priapism, an erection lasting more than 4 hours, have been reported with the use of PDE-5 inhibitors like tadalafil (Adcirca). This condition can cause permanent damage to the penis if not promptly addressed. Seek immediate medical attention for erections exceeding 4 hours or if pain is experienced during an erection. Increased risks are associated with conditions such as sickle cell anemia, multiple myeloma, leukemia, and certain penile disorders.

• Vision Changes: Sudden changes in vision may occur, potentially leading to permanent eye damage. Emergency medical help or consultation with your prescriber is advised if vision changes arise. Those with a "crowded" optic disc are at higher risk. Inform your healthcare provider of your complete medical history before starting tadalafil (Adcirca). Risk factors include being over 50, high blood sugar, high blood pressure, heart disease, high cholesterol, smoking, and a history of eye problems.

• Hearing Loss: Some users of tadalafil have reported hearing loss, occasionally accompanied by tinnitus and dizziness. Immediate medical attention is required if changes in hearing are noticed in one or both ears.

• Avoidance of Other PDE-5 Inhibitors: Do not combine tadalafil (Adcirca) with other PDE-5 inhibitors, such as sildenafil (Viagra), vardenafil (Levitra), or avanafil (Stendra), as this may cause unsafe blood pressure drops and increased side effects.

• Risks with Certain Heart Problems: Tadalafil (Adcirca) is not recommended for individuals with pulmonary vascular occlusive disease (PVOD), a rare condition affecting blood flow between the lungs and heart. Although unstudied in PVOD patients, tadalafil (Adcirca) could worsen this condition. Seek medical assistance if you experience extreme fatigue or difficulty breathing.

Contraindications:

• Do not use tadalafil (Adcirca) if you are taking nitrates or guanylate cyclase stimulators, such as riociguat (Adempas), as these combinations can pose severe health risks. Consult your healthcare provider if you fall into these categories.

While taking this medication, you might experience some common side effects, which are generally mild. These include headaches, muscle pain, runny nose or sore throat, flushing, respiratory infections like colds or bronchitis, pain in the hands and feet, nausea, back pain, upset stomach, and a stuffy nose. If these side effects persist or worsen, it is advisable to consult your healthcare provider for further guidance.

However, there are some other side effects that, although less common, have been reported by some users. These include hearing loss, visual changes, migraines, seizures, and memory problems. It is important to monitor these symptoms and contact your healthcare provider, especially if they become severe.

Rare but serious side effects warrant immediate medical attention. These include sudden vision changes or loss in one or both eyes, sudden hearing loss, ringing in the ears, dizziness, or an erection lasting more than four hours, which can cause permanent damage if untreated. Additionally, symptoms of low blood pressure such as dizziness, lightheadedness, nausea, or fainting, as well as signs of fluid buildup in the lungs like trouble breathing, chest pain, or a bluish tint to the skin, should be addressed urgently by a medical professional.

In very rare cases, a severe allergic reaction can occur, characterized by a rash, itching, swelling especially of the face, tongue, or throat, severe dizziness, and trouble breathing. Should these symptoms appear, seeking medical help immediately is crucial. Remember, this is not an exhaustive list of possible side effects, and any unusual symptoms should be discussed with your healthcare provider.

Tadalafil, known for treating erectile dysfunction and pulmonary hypertension, can interact with several medications and supplements. It's crucial to inform your doctor and pharmacist about all the medications and supplements you are currently taking.

Certain drugs, particularly nitrates like Nitroglycerin, isosorbide dinitrate, and recreational substances like "poppers" containing amyl or butyl nitrite, should not be used with tadalafil. This combination can significantly lower your blood pressure, leading to dizziness, fainting, or even severe heart issues such as a heart attack or stroke.

Additionally, if you are on alpha blockers like Doxazosin or Tamsulosin, used for treating an enlarged prostate or high blood pressure, using them alongside tadalafil may lower your blood pressure excessively, causing dizziness or fainting. Your doctor might adjust your treatment to avoid this risk.

Tadalafil's effectiveness can be influenced by other medications that affect its removal from the body. These include azole antifungals (e.g., Itraconazole, Ketoconazole), macrolide antibiotics (e.g., Clarithromycin, Erythromycin), HIV protease inhibitors (e.g., lopinavir, Ritonavir), and Rifampin.

Lastly, avoid using other erectile dysfunction or pulmonary hypertension medications, such as Sildenafil or Vardenafil, alongside tadalafil. Always consult your healthcare provider to ensure safe use of tadalafil with other treatments.