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CIALIS is contraindicated in patients with a known serious hypersensitivity to tadalafil (CIALIS orADCIRCA). Hypersensitivity reactions have been reported, including Stevens-Johnson syndrome and exfoliative dermatitis [see ADVERSE REACTIONS] . In another rat prenatal and postnatal development study at doses of 60, 200, and 1000 mg/kg, a reduction in postnatal survival of pups was observed. The no observed effect level (NOEL) for maternal toxicity was200 mg/kg/day and for developmental toxicity was 30 mg/kg/day.

You should not take more than 20mg of tadalafil within a 24 hour period. This is because 20mg is the highest licensed dose to treat ED. Taking more than 20mg can increase the likelihood of experiencing serious side effects, such as a drop in blood pressure, which can cause headache and dizziness. It can also increase the chances of experiencing other potentially harmful side effects such as priapism. Most alternative ED tablets belong to the same class of drugs, known as PDE5 inhibitors.

The inhibition of phosphoresce type 5 (PDE5) enhances erectile function by increasing the amount of cGMP.Tadalafil inhibits PDE5. Because sexual stimulation is required to initiate the local release of nitric oxide, the inhibition of PDE5 by tadalafil has no effect in the absence of sexual stimulation. If clinically approved, this depends on your personal preference and how frequently you have sex.

Individuals who take these alpha-blockers should be on a stable dose of the alpha-blocker before tadalafil is started. In such situations, tadalafil should be started at the lowest dose. If the patient is already taking tadalafil, the alpha-blocker should be started at the lowest dose. Combining tadalafil with alpha-blockers for treatment of BPH is not recommended.

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