Effective treatment for erection difficulties

To safely take Cialis® Together, here are some important things you should know:

• Follow dosing directions. Do not take more than directed (1 tablet a day). It is not recommended for continuous daily use. Talk to your doctor if you feel you need to take this medicine every day.
• Do not cut or split tablet
  If you need emergency medical care for any reason, tell a doctor you took Cialis® Together
• Do not take any medicines that interact with Cialis® Together
  Tell your pharmacist if your health has changed since your last consultation
• Men from 18 years of age
• Swallow the tablet whole with water at least 30 minutes before sexual activity as needed
• Engage in foreplay when you are ready for an erection
• Do not take more than 1 tablet a day
• There are a range of circumstances when use of Cialis® Together may not be suitable. Please read carefully the patient information leaflet. Please also discuss with your pharmacist to ensure Cialis® Together is right for you.
  

Don't use

• Under 18 years of age, without erectile dysfunction and women
• If you are intersex, or identify as trans or non-binary, please speak with a healthcare professional as this product may not be suitable for you.

Active substance:

• Tadalafil – each tablet contains 10mg

Other ingredients:

• Tablet core: lactose monohydrate, croscarmellose sodium, hydroxypropylcellulose, microcrystalline cellulose, sodium laurilsulfate, magnesium stearate
• Film-coat: lactose monohydrate, hypromellose, triacetin, titanium dioxide (E171), iron oxide yellow (E172), talc

​​​​​​​​​​​​​​Cialis® Together tablets contain lactose. If you have an intolerance to some sugars, contact your doctor before taking this medicine.

Like all medicines, this medicine can cause side effects. They are normally mild to moderate in nature, and most men won't get any of them. However,

if you experience sudden wheeziness, difficulty breathing or dizziness, swelling of the eyelids, face, lips or throat, rashes, chest pains, painful erection lasting longer than 4 hours, sudden decrease or loss of vision, or flu-like symptoms with painful rash that spreads and blisters, seek medical help immediately. To find out more, read the patient information leaflet.

You can also report side effects directly via the Yellow Card Scheme at:
https://yellowcard.mhra.gov.uk/ or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.

It is important to have a check-up with your doctor as soon as possible within the first 6 months of using Cialis® Together tablets to ensure that your erection problems are not caused by another serious health condition. Even if you feel healthy, your erection problems may be linked to other serious health conditions. Erectile dysfunction may be an early sign of:

• Heart and blood vessel problems
• Diabetes
• High blood pressure
• Depression

You should discuss your symptoms and these conditions with your doctor if you have not already done so.

Do NOT take if you:

• Do not have an erection problem, as this medicine will not provide any benefit to you
  Are allergic to tadalafil or any of the other ingredients in this medicine
• Take any medicines called nitrates or nitric oxide donors (often used for the relief of chest pain or heart failure) as the combination may lead to a dangerous fall in blood pressure
• Take amyl nitrite also known as “poppers” as recreational drugs, as the combination may lead to a dangerous fall in blood pressure
  Have been advised by your doctor to avoid sexual activity because of a problem with your heart or blood vessels
• Have low blood pressureor uncontrolled high blood pressure
  Have ever had sudden vision defect or loss
• Take riociguat or other medicines belonging to a group called guanylate cyclase stimulators (used to treat pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension)
• Have a deformed penis
• Are a woman
• Are under 18 years of age

Cialis® Together tablets with drink and alcohol:
Grapefruit juice may affect how well Cialis® Together tablets will work and must be avoided. Drinking excessive alcohol can temporarily reduce your ability to get an erection. To get the maximum benefit from your medicine, you are advised not to drink large amounts of alcohol before sexual activity. Talk to your pharmacist or doctor for further information.

Recreational drugs:
Do not take amyl nitrite (also known as “poppers”) as recreational drugs, as the combination may lead to a dangerous fall in blood pressure.

Avoid the use of Cialis® Together with other recreational drugs (including but not limited to nitrous oxide, GHB/GBL, methamphetamines, MDMA/ecstasy, ketamine, flunitrazepam, cannabis, opioids, cocaine, etc.), as it may lead to side effects such as dizziness, decrease of blood pressure, stroke or heart attack, seizures, priapism, and coma.

Cardiovascular risk factors:

• Before taking Cialis® Together tablets, in order to ensure this medicine issuitable for you and that you are fit enough to have sex, tell your doctor if you:
  Get very breathless or feel any pain in the chest with light or moderate activity (e.g. walking briskly for 20 minutes or climbing two flights of stairs).
• Your doctor may need to check whether your heart can take the additional strain of having sex
  Have or have ever had any heart disease or heart surgery e.g. valvular heart disease (damaged or diseased heart valve), cardiomyopathy (disease of the heart muscle), arrhythmia (irregular heart beat)
• Have high blood pressure that is not controlled
• Have an abnormal or impaired left lower heart chamber
• Have a restriction of the blood flow from the heart e.g. aortic stenosis
• Have Multiple System Atrophy ( a rare condition causing severe loss of control of blood pressure due to shrinkage of muscle or nerve t issue)

Other risk factors

Talk to your doctor before taking Cialis® Together if you:

• Have ever had an erection that lasted more than 4 hours (called priapism) or have any condition that can cause priapism, which includes sickle cell anaemia (an abnormality of red blood cells), leukaemia (cancer of blood cells), or multiple myeloma (cancer of bone marrow)
• Take any medicines listed in patient information leaflet. Please see www.medicines.org.uk
• Have any deformation of your penis
• Have a serious liver problem
• Have a severe kidney problem

Speak to your doctor if you have:

• Undergone pelvic surgery or removal of all or part of the prostate gland in which nerves of the prostate are cut (radical non-nerve-sparing prostatectomy) as it is not known if Cialis® Together tablets will be effective for you
  
• Known hereditary degenerative retinal disorders such as retinitis pigmentosa (a genetic disorder that causes loss of vision) as it is unknown whether tadalafil is safe for you to use

STOP using and SEEK medical help immediately if you experience:

• An allergic reaction: this occurs uncommonly. Symptoms include sudden wheeziness, difficulty breathing or dizziness, swelling of the eyelids, face, lips or throat, rashes
• Chest pains: this occurs uncommonly. If this occurs before, during or after intercourse, get in a semi-sitting position and try to relax. DO NOT use nitrates to treat chest pain. Seek immediate medical help
• Persistent and sometimes painful erection lasting longer than 4 hours: this occurs rarely
• A sudden decrease or loss of vision: this occurs rarely
  Stevens-Johnson Syndrome (SJS), which is a rare, serious disorder of the skin causing flu-like symptoms and a painful rash that spreads and blisters

It is best to ask your pharmacist if Cialis® Together could interact with other medicines you are taking. Do not take Cialis®Together with nitrate medicines or other ED medicines. And avoid sexual enhancement products when taking Cialis®Together.

For more information please read carefully the patient information leaflet or discuss with your pharmacist to ensure the product is suitable for you.