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Instructions: Not recommended in this age group

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Tadalafil is contraindicated in conditions like Myocardial infarction,Hypotension,Unstable angina,Brief reversal of non-depolarising neuromuscular blockade,Diagnosis of dual block,Acute psychosis,Uncontrolled hypertension.

The severe or irreversible adverse effects of Tadalafil, which give rise to further complications include Priapism.The symptomatic adverse reactions produced by Tadalafil are more or less tolerable and if they become severe, they can be treated symptomatically, these include Dizziness, Headache, Vomiting, Myalgia, Dyspepsia, Flushing, Nasal congestion, Hypersensitivity reactions, Redness of eye, Visual disturbances, Back pain, Raised intra-ocular pressure.

Tadalafil is primarily indicated in conditions like Erectile dysfunction.

Tadalafil is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAfatinibmay increase the level of afatinibuse alternative or reduced doseAlcoholConcurrent use can increase the potential for orthostatic signs and symptoms, including increase in heart rate, decrease in standing blood pressure, dizziness, and headache. Aluminium Hydroxide and OxideSimultaneous administration of an antacid aluminium hydroxide and oxide and tadalafil reduced the apparent rate of absorption of tadalafil without altering exposure (AUC) to tadalafil.Amlodipine (Besylate)Small reductions in blood pressure may occur following coadministration of tadalafil and Amlodipine (Besylate).Dapoxetine HCl should prescrided with cautionKetoconazoleKetoconazole (400 mg daily), a selective and potent inhibitor of CYP3A4, increased tadalafil 20 mg single-dose exposure (AUC) by 312% and Cmax by 22%, relative to the values for tadalafil 20 mg alone.Magnesium Oxides and HydroxidesSimultaneous administration of an antacid magnesium hydroxide and tadalafil reduced the apparent rate of absorption of tadalafil without altering exposure (AUC) to tadalafil.NicorandilConcurrent use can cause a dangerous drop in blood pressure, therefore this combination should be avoided.NitrendipineBlood pressure-lowering effects may be additiveNitroglycerinTadalafil may exaggerate the blood pressure lowering effects of nitroglycerin and may cause excessive blood pressure reduction.Patients taking nitrates should not receive Tadalafil.Riociguatcause hypotensioncontraindicatedRitonavirRitonavir (500 mg or 600 mg twice daily at steady state), an inhibitor of CYP3A4, CYP2C9, CYP2C19, and CYP2D6, increased tadalafil 20-mg single-dose exposure (AUC) by 32% with a 30% reduction in Cmax, relative to the values for tadalafil 20 mg alone. VORICONAZOLEVoriconazole may increase the serum concentration of tadalafil by decreasing its metabolism. Concomitant therapy should be avoided These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.

Abnormal LFTs

Drug should not be given to patients suffering from Kidney dysfunction, and patients suffering from Liver Malfunction.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.

It should be used with caution in cardiovascular disease, anatomical deformation of the penis (e.g. angulation, cavernosal fibrosis, peyronie`s disease), and in those with a predisposition to prolonged erection (e.g. in sickle-celll disease, multiple myeloma, or leukemia).