WARNINGS AND INFORMATION
If you take any medicines that contain nitrates - either regularly or as needed - you should never take Cialis.

If you take Cialis with any nitrate medicine or recreational drug containing nitrates, your blood pressure could suddenly drop to an unsafe level. You could get dizzy, faint, or even have a heart attack or stroke. Nitrates are found in many prescription medicines that are used to treat angina (chest pain due to heart disease) such as: nitroglycerin (sprays, ointments, skin patches or pastes, and tablets that are swallowed or dissolved in the mouth), isosorbide mononitrate and isosorbide dinitrate (tablets that are swallowed, chewed, or dissolved in the mouth). Nitrates are also found in recreational drugs such as amyl nitrate or nitrite ("poppers"). If you are not sure if any of your medicines contain nitrates, or if you do not understand what nitrates are, ask your doctor or pharmacist.

HOW DOES CIALIS WORK?
When sexual stimulation begins nitric oxide (NO) is released into the spongy tissue of the penis. NO then activates an enzyme that increases the production of cyclic guanosine monophosphate (cGMP) the substance that relaxes the spongy tissue of the penis and facilitates an influx of blood.
As specific enzymes slowly degrade cGMP the penis will slowly loose its ability to sustain an erection. Cialis works by inhibiting those enzymes that degrade cGMP, thereby enhancing ones ability to obtain and sustain an erection. Cialis enables many men with erectile dysfunction to respond to sexual stimulation. When a man is sexually excited, Cialis helps the penis fill with enough blood to cause an erection. After sex is over, the erection goes away.

OTHER INFORMATION
This medicine can help many men when it is used as prescribed by their doctors. However, Cialis is not for everyone. It is intended for use only by men who have a condition called erectile dysfunction. Cialis must never be used by men who are taking medicines that contain nitrates of any kind, at any time. This includes nitroglycerin. If you take Cialis with any nitrate medicine your blood pressure could suddenly drop to an unsafe or life threatening level.

What Is Cialis?
Cialis is a pill used to treat erectile dysfunction (impotence) in men. It can help many men who have erectile dysfunction get and keep an erection when they become sexually excited (stimulated).

You will not get an erection just by taking this medicine. Cialis helps a man with erectile dysfunction get an erection only when he is sexually excited.

How Sex Affects the Body
When a man is sexually excited, the penis rapidly fills with more blood than usual. The penis then expands and hardens. This is called an erection. After the man is done having sex, this extra blood flows out of the penis back into the body. The erection goes away. If an erection lasts for a long time (more than 6 hours), it can permanently damage your penis. You should call a doctor immediately if you ever have a prolonged erection that lasts more than 4 hours.

Some conditions and medicines interfere with this natural erection process.
The penis cannot fill with enough blood. The man cannot have an erection.
This is called erectile dysfunction if it becomes a frequent problem.

During sex, your heart works harder. Therefore sexual activity may not be advisable for people who have heart problems. Before you start any treatment for erectile dysfunction, ask your doctor if your heart is healthy enough to handle the extra strain of having sex. If you have chest pains, dizziness or nausea during sex, stop having sex and immediately tell your doctor you have had this problem.

Cialis Is Not for Everyone
As noted above (How Sex Affects the Body), ask your doctor if your heart is healthy enough for sexual activity.

If you take any medicines that contain nitrates either regularly or as needed you should never take Cialis. If you take Cialis with any nitrate medicine or recreational drug containing nitrates, your blood pressure could suddenly drop to an unsafe level. You could get dizzy, faint, or even have a heart attack or stroke. Nitrates are found in many prescription medicines that are used to treat angina (chest pain due to heart disease) such as:

nitroglycerin (sprays, ointments, skin patches or pastes, and tablets that are swallowed or dissolved in the mouth) isosorbide mononitrate and isosorbide dinitrate (tablets that are swallowed, chewed, or dissolved in the mouth) Nitrates are also found in recreational drugs such as amyl nitrate or nitrite ("poppers"). If you are not sure if any of your medicines contain nitrates, or if you do not understand what nitrates are, ask your doctor or pharmacist.

Cialis is only for patients with erectile dysfunction. Cialis is not for newborns, children, or women. Do not let anyone else take your Cialis. Cialis must be used only under a doctor's supervision.

What Cialis Does Not Do
Cialis does not cure erectile dysfunction. It is a treatment for erectile dysfunction.
Cialis does not protect you or your partner from getting sexually transmitted diseases, including HIV the virus that causes AIDS.
Cialis is not a hormone or an aphrodisiac.

What To Tell Your Doctor Before You Begin Using Cialis
Only your doctor can decide if Cialis is right for you. Cialis can cause mild, temporary lowering of your blood pressure. You will need to have a thorough medical exam to diagnose your erectile dysfunction and to find out if you can safely take Cialis alone or with your other medicines. Your doctor should determine if your heart is healthy enough to handle the extra strain of having sex.

Be sure to tell your doctor if you:

	Have ever had any heart problems (e.g., angina, chest pain, heart failure, irregular heart beats, heart attack or narrowing of the aortic valve)
	Have ever had a stroke have low or high blood pressure have a rare inherited eye disease called retinitis pigmentosa have ever had any kidney problems have ever had any liver problems are galactose intolerat (galatose not lactose)
	Have problems with galactose absorption have ever had any blood problems, including sickle cell anemia or leukemia are allergic to sildenafil or any of the other ingredients of Cialis tablets have a deformed penis, Peyronie's disease, or ever had an erection that lasted more than 4 hours have stomach ulcers or any types of bleeding problems are taking any other medicines

Cialis and Other Medicines
Some medicines can change the way Cialis works. Tell your doctor about any medicines you are taking. Do not start or stop taking any medicines before checking with your doctor or pharmacist. This includes prescription and nonprescription medicines or remedies:

Remember, Cialis should never be used with medicines that contain nitrates (see Cialis Is Not for Everyone). Cialis should not be used with any other medical treatments that cause erections. These treatments include pills, medicines that are injected or inserted into the penis, implants or vacuum pumps.

Finding the Right Dose for You
Cialis comes in different doses (10 mg, 20 mg). In most cases the recommended dose is 10mg, in some cases 20 mg might be tries. If you buy 20mg pills but only need 10mg make sure to split the pill in two. If you do not get the results you expect, talk with your doctor. You and your doctor can determine the dose that works best for you.

Do not take more Cialis than your doctor prescribes.
If you think you need a larger dose of Cialis, check with your doctor.
Cialis should not be taken more than once a day and should not be taken daily.
If you are older than age 65, or have liver or kidney problems do not take more than 10mg dose of Cialis.

How To Take Cialis
Beginning in about 30 minutes and for up to 36 hours, Cialis can help you get an erection if you are sexually excited. If you take Cialis after a high-fat meal (such as a cheeseburger and french fries), the medicine may take a little longer to start working. Cialis can help you get an erection when you are sexually excited. You will not get an erection just by taking the pill.

Storing Cialis
Keep Cialis out of the reach of children. Keep Cialis in its original container.