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Fairways Exploration & Production, LLC

"Our lives are impacted every day by the use of hydrocarbons such as oil and natural gas. These energy sources heat our homes, fuel our vehicles, and power our factories, offices and schools. They are used to make everyday items like plastics. Fairways is actively pursuing the discovery and development of new frontiers to support our nation's growing demand for energy. High-Impact Exploration is Fairways business."

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Certificate of Insurance

Does my company need a certificate of insurance on file with Fairways?
  • Yes, all companies doing business with Fairways need a certificate of insurance on file. The certificate of insurance needs to be on file prior to any work commencing.
  • Please contact Miss Stephanie Musetto for any questions regarding Master Service Agreements and Insurance Certificates at smusetto@fairwaysresources.com or (832) 255-1528.

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Does my company need a Master Service Agreement (MSA) on file with Fairways?
  • Yes, any company doing more than $250,000 per year in gross sales with Fairways must have an MSA onfile. In order to be considered for a project, an MSA must be executed by both companies.
  • Please contact Miss Stephanie Musetto for any questions regarding Master Service Agreements and Insurance Certificates at smusetto@fairwaysresources.com or (832) 255-1528.
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Please Note: We do not accept ads for generic Viagra on this page.

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Where Are The Best Places to Buy Cialis Online?

Just like Viagra, people always ask me “Where is the best place to buy Cialis online?” Before writing this page, we investigated the top websites that sell Cialis online. We keep this information up-to-date, so all shoppers should find the Cialis costs to be current. After doing research we found out that convenience, privacy, and Authentic Medications are the reason shoppers chose some websites over others.

Who Does CoreyNahman.com Recommend?

Stay away from the bootlegs. If you are looking for genuine, brand-name Cialis Online manufactured by Eli Lilly, I recommend AccessRx.com. They have been in business since 1998. They are located in the USA in Tempe Arizona. They offer overnight shipping, and they keep their Cialis cost reasonable.

They have a 24 hour telephone number for customer service. They even have licensed physicians and pharmacists on staff to answer your medical questions.

Their prices are higher than the generics but you are assured of getting brand-name, American, FDA-Approved Cialis (and other medications) delivered to your door in a couple of days without having to go to a doctor and provide a co-pay.

If you plan to buy Cialis online, definitely check out AccessRx before you make a decision.

Who is Buying Cialis Online

More and more people are choosing to buy Cialis online. In 2003 worldwide Cialis sales were $203.3 million. According to Eli Lilly, in 2008 worldwide Cialis sales jumped to $1.44 billion. a 700% increase since it was launched in the United States!

Cialis’ popularity is catching up to Viagra (which sold $1.934 billion worldwide in 2008). This is the first time Cialis is within $500 million in sales to Viagra worldwide. In 2008 daily Cialis was launched. which should boost Cialis sales even further towards reaching Viagra.

Since so many people are buying Cialis, it is a tempting pill for unscrupulous online merchants to bootleg or make counterfeit copies of, with the eye on making a quick dollar.

Q: Is there a generic Cialis?
A: No

There is no such thing as an FDA approved generic Cialis. The Cialis patent is good until at least 2015 (source = Eli Lilly 2009 annual report, p 50). This means that Lilly has a legal monopoly on all versions of Cialis.

If you see a website advertising generic Cialis for sale, that means it is an unapproved, unauthorized bootleg version or an outright counterfeit pill. As mentioned earlier, the cost of Cialis that is authentic and approved by the FDA is more than illegal “generic” Cialis.

Q: What if I tried generic Cialis and it worked?
A: If you buy “generic” Cialis online, it may work. BUT.

you have no way of telling for sure what the active ingredient is or how much is present. You might be paying for a 20 mg dose but only getting 7mg or 8mg. Or you might be getting a dangerously high dose without knowing it.

The tablets may contain tadalafil (the active ingredient in Cialis) but they may contain something like silendafil (the active ingredient in Viagra or vardenafil the active ingredient in Levitra). It’s a crapshoot.

The only way to tell for sure would be for you to send the pills out to a pharmaceutical laboratory for a chemical analysis, but unless you are a scientist or a CSI expert this is not a realistic option. When you buy Cialis online that is sold as “generic,” you become your own guinea pig and you hope for the best. Although the your Cialis cost will be higher for the authentic version, you will have peace of mind knowing that the medication is safe and effective.

Q: If it’s not legitimate, why do they sell it?
A: The number of people sell fake Cialis online, outnumber the agencies that regulate this type of thing and the government can’t keep up.

The government considers generic Cialis to be an illegal substance. They are concerned about public health and safety issues, particularly since many non-regulated internet pharmacies sell you pharmaceuticals without a doctor’s prescription.

They don’t go after the people who buy generic Cialis online but postal authorities will interdict it at the border whenever possible. Every once in a while they go after the major players and shut down their operations.

The sellers are usually charged with mail fraud and or conspiracy to introduce misbranded drugs into interstate commerce in violation of the Federal Food, Drug, and Cosmetic Act .

Q: Where is the best place to buy Cialis Online?
A: There is no one best place to buy Cialis online but there are red flags for spotting scam Cialis sellers:

– The Cialis price should be realistic. You get what you pay for. Genuine, FDA approved Cialis should cost at least $38 per pill. If you are seeing offers for $3.00 or $4.00 per dose it is a guarantee that you are not getting the real thing.

– Google the operation that is selling the Cialis online. Do a little detective work. If they are selling shady products, or they have ripped people off in the past there is a good chance that someone has complained about them on a message board or in a blog. Google their phone number, their address, the name of the website, etc. You would be surprised to see what turns up.

– Lots of pharmacies selling Cialis online pretend to be American or Canadian but are actually located in developing nations, particularly India, Mexico and the Caribbean Basin. You want to screen out these non-North American operations.

The online pharmacy should have a physical address (not a just P.O. box) in the Unites Stated or Canada and a working telephone number. Call the number and test it out. Speak with a customer service representative. Ask a few questions such as, “what is your shipping policy? What is your return policy? What is the name of your supervising pharmacist? What is your pharmacy license number”. They should answer your questions courteously in perfect English. If they sound fishy on the phone stay away.

– Their ad should purport to sell “genuine Cialis”, “FDA approved Cialis” or “Brand Name Cialis”.

– If the ad says generic Cialis, chewable Cialis, Cialis strips, liquid or gelcaps this is a big red flag since as we have discussed above there is no such thing as generic Cialis. Generic Cialis or Cialis in any formulation other than tablets mean bootlegged product or a product that contains no active ingredient.

– A prescription should be required. If they are a reputable outfit, You should be required to do one of the following:
(A) Have one of their doctors examine you via a questionnaire or an online examination.
(B) Mail or fax them a prescription.
(C) Have them call your doctor to get a telephone prescription.

If the ad says. "No Prescription Needed", that’s a bad sign. That means that you are probably dealing with an offshore internet pharmacy that sells anything to anyone. Just because a person has a website and a computer does not mean they should be trusted to sell Cialis online. Use good judgment when you buy Cialis online.

Who this site recommends & why we recommend them:

If you are looking for the authentic Brand Name Cialis, I recommend AccessRx.com. They do not sell generic Cialis, which is good considering that it is illegal and dangerous to your health. AccessRx.com has been serving customers conveniently and safely since 1998. They are located in the USA in Tempe Arizona. Their customer service representatives are available 6-days a week and they have licensed physicians and pharmacists on staff to answer your medical questions.

AccessRx.com does have higher prices than generics but you are 100% assured that you will be getting the brand-name American, FDA-Approved Cialis delivered to your door conveniently in a couple of days without having to visit your own doctor.

1/10/08: A New Way To Take Cialis; Every Single Day!

Beginning in January of 2008, Lilly began marketing Cialis in a different manner. Cialis became approved for every day low-dose administration as an option for men with erectile dysfunction who engage in sex frequently (more than twice per week) so that men can engage in sex any time between doses rather than waiting for a pill to kick in.

Cialis for every-day-administration is given in a lower dose – 2.5mg to start (as opposed to the 10mg or 20mg that occasional users take). If the 2.5mg per day is inadequate, the dose can be doubled to 5mg per day. Your Cialis cost for a week’s worth of low dose therapy is comparable for what a man would pay if he takes two tablets per week. The cost of Cialis, unfortunately, has increased to more than $25 per pill, but that’s still better than risking your health by taking illegal “generic” Cialis.

Cialis is available 2.5mg, 5mg, 10mg and 20mg tablets.

If you are going to take Cialis the traditional way, every once in a while in anticipation of having sex, the recommended dose is 10mg taken prior to anticipated sexual activity without regard to food. In those patients in whom 10mg does not produce an adequate effect, 20mg might be tried.

It can be taken from 30 minutes to 12 hours prior to sexual activity. The efficacy of tadalafil may persist up to 24 hours post-dose. The maximum recommended dose of the 10mg or 20mg tablets is one pill per day.

How Does Cialis Work?

When an erection goes limp, you have PDE5 to thank.
Specialized penis tissue produces a substance called cyclic guanosine monophosphate (cGMP) in response to sexual stimulation. The more cGMP available, the more Durable the erection. Cialis inhibits the PDE5 enzyme, preserving cGMP levels, therefore aiding erection viability and durability.

Cialis is a member of a family of drugs known as PDE5 enzyme inhibitors.

Cialis is known as the “36 hour pill” or the “weekend pill” because unlike other similar drugs, Cialis has a long duration of action.

Cialis blocks an enzyme that causes an erection to go flaccid. Although Cialis is similar to Levitra and Viagra, its dose, onset of action, and duration of action is unique.

Cialis is a member of a family of drugs called PDE5 Inhibitors. Cialis is now marketed in approximately 40 countries and is available by prescription in pharmacies on five continents.

Cialis was developed by Icos, a small biotech company located in Washington State. Icos formed a 50/50 joint venture with Eli Lilly & company. Eventually, Lilly bought out Icos.

The BIG Discovery: cyclic guanosine monophosphate (cGMP)

When a man gets sexually stimulated, a chain reaction occurs in the tissue of the penis that results in elevated levels of a substance called cyclic guanosine monophosphate (cGMP).

As long as there are sufficient levels of cGMP, the penis can remain erect. The more cGMP, the more robust and durable the erection.

If you inhibit the degradation of cGMP it stays around in the penis longer, producing a more durable erection.

Cialis is that it preserves the elevated levels of cGMP that are created when a man is sexually stimulated for a stronger, more durable erection.

Cialis blocks the enzyme phosphodiesterase-5 (PDE5) which is responsible for the neutralization of cGMP. Cialis (tadalafil) is a highly selective inhibitor of PDE5. (PDE5 is not the only phosphodiesterase involved in the erectile physiology but it appears to be the most important one).

The nice thing about Cialis is that it won’t cause erections at inappropriate times because it only blocks degradation of cGMP produced in reaction to sexual stimulation, such as thinking about something sexy. If you are not being sexually stimulated, there is no cGMP to protect, so the drug remains in the background.

How Does Cialis Compare To Viagra and Levitra?

One huge difference is that Cialis is used to tread erectile dysfunction as though it is a chronic condition. As stated above, only Cialis is approved by the FDA to be taken once-per-day whether or not you are going to engage in sex. Viagra, on the other hand, is only taken just before sex. Here is a complete table that shows the difference between Viagra, Cialis, and Levitra.

Cialis Versus Viagra
Cialis Versus Viagra From Forbes magazine 12/03/03; M. Herper; side by side comparison of various characteristics of Cialis and Viagra in slide show format.

Cialis Versus Viagra Versus Levitra (2004 Media Report)
Viagra Faces Stiff Competition On Airwaves � Viagra focuses on depicting happy men in their ads. Levitra uses a woman’s testimonial and sports star Mike Ditka. Cialis, which is more subtle and longer-lasting, focuses on the relationship. [ WFTV.com]
Editor’s Note: Above report offers comparison between Cialis, Viagra and Levitra in terms of advertising.

Absorption, Onset, Bioavailability

Cialis is readily absorbed from the bloodstream. It is about 16% bioavailable. Tadalafil is about 94% bound to plasma protein. Maximum plasma concentration of Tadalafil was achieved 2 hours post dose. The Cialis label states that It can be taken from 30 minutes to 12 hours prior to sexual activity. Efficacy of tadalafil may persist up to 24 hours post-dose.

Metabolism, Half Life, Excretion

Cialis is mostly metabolized in the liver by an enzyme known as CYP3A4 and to a lesser extent CYPC2. Tadalafil breakdown products are excreted in the feces (61%) and in the urine (36%). Cialis’ mean half life is 17.5 hours in healthy men.

If you are going to take any of the PDE5 inhibitors such as Cialis, it is very important that your doctor be aware if you have a liver condition (such as cirrhosis) or kidney condition ( such as if you are on dialysis) because you may need a special dosage adjustment.

Likewise, if you try to buy Cialis online, please make sure that the person authorizing your prescription knows the true status of your liver function and your kidney function.

Non-Sexual Uses Of Cialis (tadalafil):

Benign Prostate Enlargement:
Recent information published in scientific journals indicate that Cialis may be useful for treating lower urinary tract symptoms associated with benign enlargement of the prostate. Of the doses studied, the 5 mg Cialis dose seemed to be the most appropriate dose.
See Also: J Urol. 2008 Aug 21. (abstract). CONCLUSIONS: Once daily tadalafil demonstrated clinically meaningful and statistically significant efficacy and it was well tolerated in men with benign prostatic hyperplasia lower urinary tract symptoms.
See Also: Impotence Drug Eases Prostate Problems. new research, funded by Eli Lilly, the company that owns the rights to the drug tadalafil, shows a daily dose of the drug may help ease some of the urinary symptoms related to an enlarged prostate. [WebMD]

Altitude Sickness
Because of Cialis’ effect on the cardiovascular system, researchers are looking into if it is beneficial to administer Cialis it to people who are susceptible to high altitude sickness. Early data indicates it has a moderate beneficial effect:
See Also: Am J Physiol Heart Circ Physiol. 2008 Apr;294(4):H1651-7. Epub 2008 Feb 29. Evidence supportive of impaired myocardial blood flow reserve at high altitude in subjects developing high-altitude pulmonary edema.
See Also: Ann Intern Med. 2006 Oct 3;145(7):497-506. Both tadalafil and dexamethasone may reduce the incidence of high-altitude pulmonary edema: a randomized trial �[ Annals of Internal Medicine; Abstract]
See Also: Stroke. 2005 Mar;36(3):557-60. Epub 2005 Feb 3. Effects of high altitude exposure on cerebral hemodynamics in normal subjects �[Stroke; Abstract]

Cialis Price Check. 10 top sites that sell Cialis; simple comparison shopping.

Cialis.com. Brand new website; prescribing information, patient information, safety information, FAQ, etc.

Cialis Prescribing Information. Dose, mechanism of action, side effects, precautions, warnings; patient information; very technical, don’t get scared when you come to the section on warnings and side effects. [ This is the information that doctors will use when they are considering prescribing Cialis]

Cialis Side Effects & Drug Interactions. 2,800 word report regarding side effects and drug interactions taken from Cialis’ official FDA label; includes seven charts and graphs.

Cialis Recall Information – up to date information regarding possible Cialis recalls if appropriate.*
* There has never been a Cialis recall so this page should be blank.

FDA Cialis Page. Cialis talk paper, Cialis label, Cialis approval letter, Questions and answers for Cialis, Cialis consumer drug information sheet.

Cialis Talk Paper [FDA]. from FDA’s official website; explains how Cialis is different from other erectile dysfunction drugs, starting dose, metabolism, possible drug interactions, contraindications.

Cialis Questions & Answers [FDA]. what is Cialis used for, how does it work, how is it different from similar drugs, how do you take cialis, common doses, etc. Similar to the drugtore flyer you get when you pick up a prescription at the drugstore.

Cialis Scientific Papers (from the National Library of medicine) automated Medline search; a listing of scientific papers in abstract form regarding Cialis.

Cialis News (from Google) recently published news regarding Cialis.

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Prescription Drugs

Cialis

CIALIS 5MG TABLET

How does this medication work? What will it do for me?

Tadalafil belongs to a group of medications called phosphodiesterase type 5 inhibitors. It is used to treat erectile dysfunction (male impotence). It helps to achieve and maintain an erection sufficient for sexual activity to occur. It does this by allowing a greater flow of blood into the penis when a man taking the medication is sexually aroused. It works only with sexual stimulation and does not increase sexual desire.

Tadalafil is also used to treat symptoms of benign prostatic hyperplasia (BPH) in men with enlarged prostates. It helps to relieve symptoms such as the frequent need to urinate, painful urination, or the sensation of not completely emptying the bladder. It does this by relaxing muscles in the prostate and bladder. Tadalafil may be used to treat men who experience both erectile dysfunction and BPH.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

How should I use this medication?

For the treatment of erectile dysfunction:

The usual recommended dose is 20 mg taken as needed, at least 30 minutes before sexual activity. This medication has been shown to be effective within 30 minutes of taking the tablet, and last up to 36 hours later. As the amount of time tadalafil takes to work varies from person to person, starting sexual activity at different times after taking the tablet will determine the optimal time for sexual activity. The maximum recommended amount of medication to take is one tablet a day.

The usual recommended dose is 5 mg per day, taken at about the same time each day and regardless of when sexual activity is planned. The daily dose may be lowered by your doctor if necessary.

Tadalafil may be taken with or without food.

For the treatment of benign prostatic hyperplasia (BPH) or erectile dysfunction with BPH:

The usual recommended dose is 5 mg once daily, at about the same time each day. It may be taken with or without food.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that this medication be taken exactly as prescribed by your doctor. Do not take higher doses of this medication than prescribed by your doctor. Contact your doctor if you take a greater dose of tadalafil than prescribed.

Store this medication at room temperature (between 15°C and 30°C) and keep it out of the reach and sight of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

What form(s) does this medication come in?

2.5 mg (for once-a-day use)
Each yellow-orange, almond-shaped, film-coated tablet, marked on one side with "C2½", contains tadalafil 2.5 mg. Nonmedicinal ingredients: croscarmellose sodium, hydroxypropyl cellulose, hydroxypropyl methylcellulose, iron oxide, lactose monohydrate, magnesium stearate, microcrystalline cellulose, sodium lauryl sulfate, talc, titanium dioxide, and triacetin.

5 mg (for once-a-day use)
Each yellow, almond-shaped, film-coated tablet, marked on one side with "C5", contains tadalafil 5 mg. Nonmedicinal ingredients: croscarmellose sodium, hydroxypropyl cellulose, hydroxypropyl methylcellulose, iron oxide, lactose monohydrate, magnesium stearate, microcrystalline cellulose, sodium lauryl sulfate, talc, titanium dioxide, and triacetin.

10 mg (for "on-demand" dosing)
Each yellow, almond-shaped, film-coated tablet, marked on one side with "C10", contains tadalafil 10 mg. Nonmedicinal ingredients: croscarmellose sodium, hydroxypropyl cellulose, hydroxypropyl methylcellulose, iron oxide, lactose monohydrate, magnesium stearate, microcrystalline cellulose, sodium lauryl sulfate, talc, titanium dioxide, and triacetin.

20 mg (for "on-demand" dosing)
Each yellow, almond-shaped, film-coated tablet, marked on one side with "C20", contains tadalafil 20 mg. Nonmedicinal ingredients: croscarmellose sodium, hydroxypropyl cellulose, hydroxypropyl methylcellulose, iron oxide, lactose monohydrate, magnesium stearate, microcrystalline cellulose, sodium lauryl sulfate, talc, titanium dioxide, and triacetin.

Who should NOT take this medication?

Do not take tadalafil if you:

  • are allergic to tadalafil or any ingredients of this medication
  • have had vision loss caused by an eye condition called nonarteritic anterior ischemic optic neuropathy (NAION)
  • are taking the medication riociguat
  • are taking (or have taken in the past 48 hours) any type of nitrate medication in any form (oral, sublingual [under the tongue], skin patch, or spray). Nitrate medications include nitroglycerin and related medicines that are used for the relief of chest pain or angina. They also include amyl nitrite "poppers." Use of these medications with tadalafil could cause a sudden severe drop in blood pressure that could lead to dizziness, fainting, heart attack, or stroke.

Nitrates are found in medications that are used to treat angina (chest pain). If you are not sure if you are taking nitrates, ask your doctor or pharmacist. Nitrates must NOT be taken by anyone who is using tadalafil because they can cause your blood pressure to drop very low. This may cause dizziness, fainting, heart attack, or stroke.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • back pain
  • facial flushing
  • headache
  • indigestion or stomach discomfort following meals
  • muscle ache
  • nasal congestion

Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • dizziness
  • eye pain
  • high blood pressure
  • red eyes
  • swollen eyelids

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • an allergic reaction (e.g. rash; itching; shortness of breath; swollen face, lips, or throat)
  • chest pains, an irregular heartbeat, or shortness of breath when starting sexual activity (if you have a heart condition)
  • hearing loss
  • prolonged (longer than 4 hours), painful, or inappropriate erection of penis
  • temporary memory loss
  • vision changes, including partial or total loss of vision

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Alcohol: Consumption of alcohol may decrease the ability to achieve an erection and may also temporarily decrease blood pressure, causing dizziness and fainting.

Blood pressure: Tell your doctor if you are taking medications to treat high blood pressure. The combination of these medications with tadalafil may add to the blood-pressure-lowering effect of these medications. This may lead to dizziness or fainting.

Grapefruit juice: Grapefruit juice can increase the amount of tadalafil in your blood. Do not drink grapefruit juice when taking this medication.

Hearing problems: Rarely, people taking tadalafil have experienced a sudden decrease or loss of hearing. If this occurs, you should seek medical attention immediately.

Heart conditions: Speak to your doctor before taking any medication for erectile dysfunction if you:

  • have, or have had, heart disease
  • have had a heart attack
  • have had a stroke
  • have angina (chest pain as a result of poor blood flow to the heart muscle)
  • have experienced chest pain during sexual activity
  • have uncontrolled irregular heart rhythm
  • have very low blood pressure
  • have uncontrolled high blood pressure

If you experience chest pains, dizziness, or nausea during sex, stop the exertion, and inform your doctor as soon as you can.

Kidney function: Kidney disease or reduced kidney function may cause this medication to build up in the body, causing side effects. Lower doses of this medication should be used if you have impaired kidney function. Daily use of "on-demand" medication is not recommended. It should not be used more than 3 times per week. Once-a-day use with 5 mg dosing or less may be considered for some people with mild-to-moderate kidney problems.

Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. Men with poor liver function may need lower doses of this medication. Daily use of this medication is not recommended. It should not be used more frequently than 3 times per week. Once-a-day use with 5 mg dosing or less may be considered for some patients with liver problems.

Nitrate-containing medications: Tadalafil should never be taken with any medications that contain nitrates. Blood pressure may drop to life-threatening levels if tadalafil is taken with any nitrate-containing medication (e.g. nitroglycerin tablets, spray, or patches) or any other nitrates (e.g. isosorbide dinitrate or amyl nitrite "poppers"). Dizziness, fainting spells, heart attack, or stroke may be experienced.

If use of a nitrate-containing medication is considered medically necessary, 48 hours must pass after the last dose of tadalafil before taking a nitrate, and only under close medical supervision.

Penis deformation: As with other medications for erectile dysfunction, men with an anatomical deformation of the penis such as angulation, cavernosal fibrosis, or Peyronie’s disease should be closely monitored by their doctors if they take this medication. If you have any of these conditions, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Prolonged erection (priapism): If an erection lasts longer than 4 hours (a rare occurrence), seek immediate medical assistance. If this condition is not treated quickly, tissue damage and permanent loss of the ability to have an erection could result.

Tell your doctor if you have any of the following conditions, as they may increase your risk of a prolonged erection: sickle cell anemia, multiple myeloma, or leukemia.

Prostate problems: If you are taking other medications to treat BPH called alpha blockers (e.g. doxazosin), let your doctor know. The combination of alpha blockers with tadalafil is not recommended for treatment of BPH. People who are taking tadalafil for erectile dysfunction may be able to continue taking alpha blockers. Talk to your doctor for more information.

Vision problems: If you experience a sudden loss of vision in one or both eyes, or other vision-related problems, contact your doctor immediately. Vision loss may be partial or complete. While in some cases the condition may improve over time, it can be permanent in other cases. This is a rare condition that more likely to occur if you have heart disease, high blood pressure, high cholesterol, diabetes, or eye problems, if you are more than 50 years old, or if you smoke.

Pregnancy and breast-feeding: Tadalafil is not intended for use by women.

Children and adolescents: Tadalafil is not intended for use by children or adolescents under 18 years old.

What other drugs could interact with this medication?

There may be an interaction between tadalafil and any of the following:

  • abiraterone
  • alcohol
  • alpha-blockers (e.g. alfuzosin, doxazosin, terazosin)
  • alprostadil
  • alpha agonists (e.g. clonidine, methyldopa)
  • amiodarone
  • angiotensin-converting enzyme inhibitors (ACEIs; captopril, enalapril, ramipril)
  • angiotensin receptor blockers (ARBs; e.g. candasartan, irbesartan, losartan)
  • antacids (magnesium hydroxide, aluminum hydroxide)
  • aprepitant
  • "azole" antifungals (e.g. itraconazole, ketoconazole, voriconazole)
  • beta-adrenergic blockers (e.g. atenolol, propranolol, sotalol)
  • bicalutamide
  • boceprevir
  • bosentan
  • calcium channel blockers (e.g. amlodipine, diltiazem, nifedipine, verapamil)
  • carbamazepine
  • clonidine
  • conivaptan
  • cyclosporine
  • desipramine
  • diuretics (water pills; e.g. furosemide, hydrochlorothiazide, triamterene)
  • enzalutamide
  • HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g. delaviridine, efavirenz, etravirine, nevirapine)
  • HIV protease inhibitors (e.g. atazanavir, indinavir, ritonavir, saquinavir)
  • grapefruit juice
  • imatinib
  • ivacaftor
  • lomitapide
  • macrolide antibiotics (e.g. clarithromycin, erythromycin)
  • metronidazole
  • nitrates (e.g. nitroglycerin, isosorbide mononitrate, isosorbide dinitrate, or amyl nitrite "poppers")
  • norfloxacin
  • other medications for erectile dysfunction (e.g. sildenafil, vardenafil)
  • oxcarbazepine
  • phenobarbital
  • phenytoin
  • primidone
  • rifabutin
  • rifampin
  • riociguat
  • sertraline
  • simeprevir
  • stiripentol
  • tamsulosin
  • telaprevir
  • tetracycline
  • tipranavir

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material © 1996-2016 MediResource Inc. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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