Do not take extra medicine to make up the missed dose.Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.Drinking alcohol with this medicine can cause a drop in blood pressure, leading to dizziness or fainting.Grapefruit and grapefruit juice may interact with tadalafil and lead to unwanted side effects. Analyses of observational data suggest an increased risk of acute NAION in men with erectile dysfunction following exposure to tadalafil or other PDE5 inhibitors. adverse effects, nor should it be construed to indicate )There is no relevant use of Tadalafil in the paediatric population with regard to the treatment of erectile dysfunction.The safety and efficacy of tadalafil in the paediatric population has not yet been established. When tadalafil was administered with lower doses of alcohol (0.6 g/kg), hypotension was not observed and dizziness occurred with similar frequency to alcohol alone. Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicinal product.Interaction studies were conducted with 10 mg and/or 20 mg tadalafil, as indicated below. In clinical studies, riociguat has been shown to augment the hypotensive effects of PDE5 inhibitors. In the pregnant rat the AUC for calculated free drug at this dose was approximately 18-times the human AUC at a 20 mg dose.There was no impairment of fertility in male and female rats. Tell your doctor if you are pregnant or plan to become pregnant.It is not known whether tadalafil passes into breast milk or if it could affect the nursing baby. If you take it this way, you may attempt sexual activity at any time between your doses.If you are taking tadalafil once daily for BPH, or for ED, or for both, take it regularly to get the most benefit from it. 3. Properly discard this product when it is expired or no longer needed. The clinical relevance of this finding is uncertain.Alcohol concentrations (mean maximum blood concentration 0.08 %) were not affected by co-administration with tadalafil (10 mg or 20 mg). (See sections 4.4 and 5.2. In a rat prenatal and postnatal development study, the no observed effect dose was 30 mg/kg/day. (4) Clinical non-MedDRA term to include reports of abnormal/excessive menstrual bleeding conditions such as menorrhagia, metrorrhagia, menometrorrhagia, or vaginal hemorrhage. In another clinical pharmacology study, tadalafil (20 mg) was studied in combination with up to 4 classes of antihypertensives. Results were generally consistent in subgroups according to age, gender, PAH aetiology and baseline WHO functional class and 6MWD. No dose adjustment is warranted.In healthy female and male subjects following single and multiple-doses of tadalafil, no clinically relevant differences in exposure were observed. Tadalafil relaxes muscles of the blood vessels and increases blood flow to particular areas of the body.Tadalafil under the name of Cialis is used to treat Do not take tadalafil if you are also using a nitrate drug for chest pain or heart problems, including nitroglycerin, isosorbide dinitrate, isosorbide mononitrate, and some recreational drugs such as "poppers". There was no statistically significant effect of tadalafil on levonorgestrel which suggests the effect of ethinylestradiol is due to inhibition of gut sulphation by tadalafil. Another brand of tadalafil is Adcirca, which is used to treat pulmonary arterial hypertension and improve exercise capacity in men and women. Healthcare professionals are asked to report any suspected adverse reactions via Yellow Card Scheme Website: www.mhra.gov.uk/yellowcard.Single doses of up to 500 mg have been given to healthy subjects, and multiple daily doses up to 100 mg have been given to patients. See section 4.2 for information on paediatric use.Tadalafil is readily absorbed after oral administration and the mean maximum observed plasma concentration (CThe rate and extent of absorption of tadalafil are not influenced by food, thus Tadalafil may be taken with or without food. 4.5 Interaction with other medicinal products and other forms of interaction6.6 Special precautions for disposal and other handling9. Although this effect is minor and was of no clinical significance in this study, it should be considered when co-administering these medicinal products.At steady-state, tadalafil (40 mg once per day) increased ethinylestradiol exposure (AUC) by 26 % and Cmax by 70 % relative to oral contraceptive administered with placebo.