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A single dose of up to 0.5 g of tadalafil to a healthy person and repeated use of up to 100 mg / day. tadalafil in patients with erectile dysfunction is accompanied by side effects similar to those that occur with the use of lower drugs.

In case of overdose, standard symptomatic therapy is performed. Cialis is practically not excreted during hemodialysis. The biotransformation of Cialis is carried out with the participation of the isoenzyme CYP3A, and therefore drugs that inhibit this isoenzyme increase the value of Cmax and AUC of tadalafil.

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Despite the fact that specific studies were carried out only regarding the interaction of tadalafil with Ketoconazole and Ritonavir, it can be assumed that drugs such as Itraconazole and Erythromycin are also able to increase the activity of tadalafil.

Rifampicin, which is an inducer of CYP3A, reduces the exposure of a single dose of the drug and the value of Cmax. Most likely, the simultaneous use of other drugs from the groupspy of inducers of CYP3A, should help to reduce the plasma concentration of tadalafil. The use of Cialis in combination with antacids (Al hydroxide / Mg hydroxide) helps to reduce the rate of absorption of the active substance of the drug without changing the AUC for tadalafil.

Drugs that increase the acidity of the stomach (pH), and, in particular, the H2-blocker nizatidine, do not affect the pharmacokinetic parameters of tadalafil. The study of the safety and efficacy of using Cialis in combination with other methods of treating erectile dysfunction (including in combination with other PDE-5 inhibitors) has not been conducted, and therefore it is recommended to avoid such combinations. Tadalafil does not increase the bleeding time caused by taking ASA.

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There are reports of cases of priapism (prolonged, not associated with sexual arousal, involuntary erection) during treatment with PDE-5 inhibitors. Patients should be informed about the need to urgently consult a doctor if an erection persists for four (or more) hours. In the absence of timely assistance, such conditions lead to irreversible impotence.

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