Cialis Together Tablets

What is Cialis Together?

Cialis Together tablets contain the active substance tadalafil, which belongs to a class of medications called phosphodiesterase type 5 (PDE5) inhibitors. These medications work by enhancing blood flow to specific areas of the body, particularly the penis during sexual stimulation.

Mechanism of Action

To understand how Cialis Together works, it helps to know what happens during a normal erection. When a man is sexually aroused, his body releases chemicals that relax the smooth muscles in the penis and widen the blood vessels. This allows more blood to flow into the penis, creating an erection.

Tadalafil works by inhibiting the PDE5 enzyme, which normally breaks down a substance called cyclic guanosine monophosphate (cGMP). By blocking this enzyme, tadalafil helps maintain higher levels of cGMP, which keeps the blood vessels in the penis relaxed and allows for increased blood flow during sexual stimulation.

It's important to understand that Cialis Together will not cause an erection on its own. Sexual stimulation is still required for the medication to work. The medicine simply enhances your body's natural response to sexual stimulation.

What is Cialis Together Used For?

Cialis Together is specifically approved for the treatment of erectile dysfunction (ED) in adult men. Erectile dysfunction is defined as the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance.

Approved Indications

Cialis Together is indicated for:

• Men with erectile dysfunction who cannot achieve or maintain an erection adequate for satisfactory sexual activity
• Use prior to anticipated sexual activity
• On-demand treatment, not continuous daily use

Target Patient Populations

Cialis Together may be appropriate for adult men with erectile dysfunction due to various causes, including:

• Physical causes (vascular disease, diabetes, neurological conditions)
• Psychological causes (stress, anxiety, depression)
• Mixed causes (combination of physical and psychological factors)

Erectile dysfunction can sometimes be an early warning sign of more serious health conditions such as cardiovascular disease, diabetes, or hypertension. It's important to discuss your symptoms with a healthcare professional who can help identify any underlying causes.

Before Using Cialis Together

Before starting treatment with Cialis Together, it's essential to have a proper medical evaluation to ensure the medication is safe and appropriate for you.

Medical History Assessment Checklist

Discuss the following with your healthcare provider before taking Cialis Together:

• Any heart conditions (angina, heart failure, irregular heartbeat, previous heart attack or surgery)
• Blood pressure problems (high or low blood pressure)
• Stroke or transient ischemic attack (TIA)
• Eye problems, especially non-arteritic anterior ischemic optic neuropathy (NAION)
• Liver or kidney disease
• Blood cell disorders (sickle cell anemia, leukemia, multiple myeloma)
• Stomach ulcers or bleeding disorders
• Deformed penis (Peyronie's disease, angulation)
• History of prolonged or painful erections (priapism)
• Allergies to medications

Required Baseline Evaluations

Your doctor may recommend:

• Cardiovascular assessment to ensure sexual activity is safe for you
• Blood tests to check for diabetes, testosterone levels, or other conditions
• Discussion about your expectations from treatment
• Review of all current medications

Even if you feel healthy, erectile dysfunction may be linked to underlying health conditions that require treatment. A check-up within the first 6 months of using Cialis Together is recommended.

Cialis Together Contraindications

Certain conditions and situations make it unsafe to take Cialis Together. It's crucial to be aware of these contraindications.

Absolute Contraindications (DO NOT USE)

• Concomitant use with nitrates (glyceryl trinitrate, isosorbide mononitrate/dinitrate) or nitric oxide donors
• Use of recreational "poppers" (amyl nitrite)
• Concomitant use with guanylate cyclase stimulators (riociguat) for pulmonary hypertension
• Hypersensitivity to tadalafil or any excipients in Cialis Together
• Severe cardiovascular disease where sexual activity is not advised
• Recent heart attack (within 90 days) or stroke (within 6 months)
• Unstable angina or severe heart failure
• Non-arteritic anterior ischemic optic neuropathy (NAION) in one or both eyes
• Severe hepatic impairment
• End-stage renal disease requiring dialysis
• Women and children under 18

Relative Contraindications (Use With Caution)

• Mild to moderate hepatic impairment
• Moderate renal impairment
• Anatomical deformation of the penis
• Conditions predisposing to priapism
• Patients with left ventricular outflow obstruction
• Multiple System Atrophy
• Active peptic ulcer disease
• Bleeding disorders

Special Population Considerations

Elderly Patients

No dose adjustment is routinely needed for elderly patients, but:

• Dizziness is reported more frequently in men over 75
• Increased likelihood of concomitant medications and medical conditions
• Greater potential for decreased renal function
• Should be initiated at the lowest effective dose

Renal Impairment

• Mild impairment (CrCl 51-80 mL/min): No dose adjustment needed
• Moderate impairment (CrCl 31-50 mL/min): Maximum dose 10mg not more than once daily
• Severe impairment (CrCl <30 mL/min): Maximum dose 10mg not more than once every 48 hours
• End-stage renal disease on dialysis: Contraindicated

Hepatic Impairment

• Mild to moderate impairment (Child-Pugh Class A or B): Maximum dose 10mg not more than once daily
• Severe impairment (Child-Pugh Class C): Contraindicated

Pediatric and Adolescent Patients

Cialis Together is not indicated for use in children and adolescents under 18 years of age. Safety and effectiveness have not been established in this population.

Cialis Together and Other Medicines

Cialis Together can interact with various medications, potentially affecting how they work or increasing the risk of side effects.

High-Risk Medication Combinations

ABSOLUTELY AVOID - Dangerous Interactions:

• Nitrates (glyceryl trinitrate, isosorbide mononitrate/dinitrate) - can cause severe hypotension
• Nitric oxide donors (amyl nitrite "poppers", nicorandil, molsidomine, sodium nitroprusside)
• Guanylate cyclase stimulators (riociguat) - for pulmonary hypertension

Use With Caution - May Require Dose Adjustment:

• Alpha-blockers (alfuzosin, doxazosin, tamsulosin) - for prostate or blood pressure
• Other antihypertensives - additive blood pressure lowering effect
• Strong CYP3A4 inhibitors (ketoconazole, itraconazole, ritonavir) - may increase tadalafil levels
• Anticonvulsants (phenobarbital, phenytoin, carbamazepine) - may decrease tadalafil levels
• Antibiotics (rifampicin, erythromycin, clarithromycin) - may affect tadalafil levels
• Other ED treatments - increased risk of side effects

Timing Recommendations

• If taking alpha-blockers, Cialis Together should be taken at least 6 hours apart
• Avoid grapefruit juice as it may increase tadalafil levels
• Inform your doctor about all medications, including over-the-counter and herbal products

Pregnancy & Breastfeeding

Tadalafil is not indicated for use in women and there is no clinical data on its effects during pregnancy or breastfeeding. The medication is specifically approved only for the treatment of erectile dysfunction in adult men.

If a woman accidentally takes Cialis Together, especially during pregnancy, she should consult a healthcare professional immediately.

Driving & Machine Operation

Some men taking Cialis Together have reported dizziness during clinical studies. This may affect your ability to drive or operate machinery safely.

Precautions

• Do not drive or use machinery until you know how Cialis Together affects you
• If you experience dizziness, do not engage in activities requiring alertness
• Be particularly cautious when starting treatment or after a dose increase
• The risk of dizziness may be higher in elderly patients (over 75 years)

If you experience any visual disturbances (such as blurred vision, changes in color vision), you should avoid driving or operating dangerous machinery until these symptoms resolve completely.

Cialis Together Ingredients

Active Ingredient

• Tadalafil: 10mg per tablet

Excipients (Inactive 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

Allergen Warnings

• Lactose: Contains lactose monohydrate. If you have been diagnosed with lactose intolerance, contact your doctor before taking this medicine.
• Sodium: This medicine contains less than 1 mmol sodium (23 mg) per tablet, essentially 'sodium-free'.

How to Use Cialis Together

Proper use of Cialis Together is essential for effectiveness and safety. Follow these instructions carefully.

1. Timing: Take one tablet as needed, at least 30 minutes before anticipated sexual activity
2. Administration: Swallow the tablet whole with a glass of water
3. Frequency: Do not take more than one tablet in any 24-hour period
4. Food: Can be taken with or without food
5. Sexual Stimulation: Remember that sexual stimulation is required for the medication to work

What to Expect

• You may be able to get an erection when sexually stimulated within 30 minutes of taking the tablet
• The effect can last up to 36 hours after taking one tablet
• This medicine is intended for use prior to anticipated sexual activity, not for continuous daily use
• If you feel you need to take this medicine every day, talk to your doctor about alternative treatment options

Cialis Together Dosage Guidelines

Dose Adjustment Considerations

• The 10mg dose is the recommended starting dose for most patients
• Based on efficacy and tolerability, your doctor may increase the dose to 20mg or decrease to 5mg if appropriate formulations are available
• If you experience bothersome side effects, your doctor may recommend a lower dose
• If the 10mg dose is ineffective and well-tolerated, your doctor may consider a higher dose

Administration Instructions

Step-by-Step Guide

1. Plan for sexual activity - Cialis Together should be taken at least 30 minutes beforehand
2. Remove one tablet from the blister pack
3. Swallow the tablet whole with a glass of water - do not crush, chew, or break the tablet
4. Engage in foreplay and sexual stimulation when desired - the medication will not cause an erection without stimulation
5. Remember to relax and be patient - there is no rush
6. If not successful the first time, try again on another occasion (remember the one tablet per day limit)

Important Administration Notes

• The tablet can be taken with or without food
• Avoid consuming large amounts of alcohol before sexual activity as it may temporarily reduce your ability to get an erection
• Avoid grapefruit juice as it may affect how well Cialis Together works
• For most men, Cialis Together will work the first or second time they try it
• If it has been some time since you were able to get or keep an erection, it may take several attempts before you achieve success

Missed Dose Management

Cialis Together is taken on an as-needed basis before anticipated sexual activity, so the concept of a "missed dose" doesn't apply in the same way as with daily medications.

Guidance

• If you forget to take Cialis Together before sexual activity, you can take it when you remember, provided it's at least 30 minutes before sexual activity
• Do not take a double dose to make up for a forgotten tablet
• Remember that you should not take more than one tablet in any 24-hour period
• If you're unsure about when to take your next dose, consult your pharmacist or doctor

Overdose Information

Symptoms of Overdose

In case of overdose, expected symptoms would be consistent with the known side effects of tadalafil but more severe, possibly including:

• Severe headache
• Dizziness
• Facial flushing
• Indigestion or heartburn
• Nasal congestion
• Back pain or muscle aches
• Prolonged or painful erection (priapism)
• Severe decreases in blood pressure
• Fainting

Management

• If you suspect an overdose, seek medical attention immediately
• Contact your doctor or go to the nearest hospital emergency department
• Take the medication package with you to show the healthcare professionals
• Standard supportive measures should be adopted as needed
• Hemodialysis is not expected to significantly increase tadalafil clearance

Cialis Together Side Effects

Like all medicines, Cialis Together can cause side effects, although not everybody gets them. Most side effects are mild to moderate and usually temporary.

STOP Using and Seek IMMEDIATE Medical Help If You Experience:

• Allergic reaction (uncommon) - sudden wheeziness, difficulty breathing, dizziness, swelling of eyelids/face/lips/throat, rash
• Chest pain (uncommon) - if occurring before, during or after intercourse
• Priapism (rare) - persistent, sometimes painful erection lasting longer than 4 hours
• Sudden decrease or loss of vision (rare) - may be a sign of NAION
• Sudden decrease or loss of hearing (frequency not known)
• Stevens-Johnson Syndrome (rare) - serious skin disorder with flu-like symptoms and painful rash

Frequency-Based Side Effects

Very Common (≥1 in 10 people)

• Headache
• Back pain
• Muscle aches
• Pain in arms and legs
• Facial flushing
• Nasal congestion
• Indigestion

Common (≥1 in 100 to <1 in 10 people)

• Dizziness
• Stomach ache
• Nausea
• Vomiting
• Acid reflux
• Blurred vision
• Eye pain
• Difficulty breathing
• Blood in urine
• Prolonged erection
• Palpitations
• Fast heart rate
• High or low blood pressure
• Nose bleeds
• Tinnitus (ringing in ears)
• Swelling of hands, feet or ankles
• Fatigue

Uncommon (≥1 in 1,000 to <1 in 100 people)

• Fainting
• Seizures
• Temporary memory loss
• Swelling of eyelids
• Red eyes
• Sudden decrease or loss of hearing
• Hives
• Penile bleeding
• Blood in semen
• Increased sweating

Rare (≥1 in 10,000 to <1 in 1,000 people)

• Heart attack
• Stroke
• Partial, temporary or permanent vision loss
• Migraine
• Facial swelling
• Serious allergic reaction with facial/throat swelling
• Serious skin rashes
• Eye blood flow disorders
• Irregular heartbeats
• Angina
• Sudden cardiac death

Reporting Side Effects

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the UK Yellow Card Scheme at: www.mhra.gov.uk/yellowcard 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.

How to Store Cialis Together

Storage Instructions

• Keep this medicine out of the sight and reach of children
• Do not use after the expiry date stated on the carton and blister after 'EXP'
• The expiry date refers to the last day of that month
• Store in the original package to protect from moisture
• Do not store above 30°C

Disposal

• Do not throw away any medicines via wastewater or household waste
• Ask your pharmacist how to throw away medicines you no longer use
• Proper disposal helps protect the environment

Cialis Together Pack Information

What Cialis Together Tablets Contain

• Active substance: tadalafil 10mg per tablet
• Other ingredients: See Section 9 for complete list of excipients

Appearance and Packaging

• Light yellow film-coated tablets
• Almond-shaped
• Marked with "C 10" on one side
• Available in blister packs containing 2, 4 or 8 tablets
• Not all pack sizes may be marketed

Marketing Authorisation Holder

Manufacturer

This leaflet was last revised in February 2025.

Where to Buy Cialis Together in the UK