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Otologic Cases of sudden decrease or loss of hearing have been reported postmarketing in temporal association with the use of PDE5 inhibitors, including Cialis. In some of the cases, medical conditions and other factors were reported that may have also played a role in the otologic adverse events. In many cases, medical follow-up information was limited. It is not possible to determine whether these reported events are related directly to the use of Cialis, to the patient's underlying risk factors for hearing loss, a combination of these factors, or to other factors [see Warnings and Precautions ( )].

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CIALIS was studied in 9 clinical studies of 67 weeks duration enrolling over 6555 patients with signs and symptoms of benign prostatic hyperplasia. The improvement in the total international prostate symptom score with CIALIS 5mg in the four studies were -, -, - and - compared to -, -, - and - with placebo. The improvements in total international prostate symptom score occurred as early as 6 week. In one of the studies, which also included tamsulosin mg as an active comparator, the improvement in total international prostate symptom score with CIALIS 5mg, tamsulosin and placebo were -, - and - respectively.

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If you experience symptoms of nausea, dizziness, chest pain or arm pain upon initiation of sexual activity after taking this medicine, you should refrain from further activity and call your doctor or health care professional as soon as possible.

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Cure ED, increase a man's sexual desire, protect a man or his partner from sexually transmitted diseases, including HIV or serve as a male form of birth control.

There are limited data from the use of tadalafil in pregnant women. Animal studies do not indicate direct or indirect harmful effects with respect to pregnancy , embryonal/foetal development, parturition or postnatal development (see section ). As a precautionary measure, it is preferable to avoid the use of CIALIS during pregnancy.

ED and symptoms of BPH may happen in the same person and at the same time. Men who have both ED and symptoms of BPH may take Cialis for the treatment of both conditions.

Some additional subjects in both the tadalafil and placebo groups were categorized as outliers in the period beyond 79 hours.

Three studies were conducted in men to assess the potential effect on spermatogenesis of CIALIS 65mg (one 6-month study) and 75mg (one 6-month and one 9-month study) administered daily. In two of these studies decreases were observed in sperm count and concentration related to tadalafil treatment of unlikely clinical relevance. These effects were not associated with changes in other parameters, such as motility, morphology, and FSH.

Tadalafil should not be taken where the following apply. If in doubt please message our doctors or consult your regular doctor before requesting supplies online.

Serious cardiovascular events, including myocardial infarction, sudden cardiac death, unstable angina pectoris, ventricular arrhythmia, stroke, transient ischaemic attacks, chest pain, palpitations and tachycardia, have been reported either post marketing and/or in clinical trials. Most of the patients in whom these events have been reported had pre-existing cardiovascular risk factors. However, it is not possible to definitively determine whether these events are related directly to these risk factors, to CIALIS, to sexual activity, or to a combination of these or other factors.

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