Doses

Men who need regular erectile dysfunction medication twice or more a week have the option to take low dose tadalafil either 2.5mg or 5mg tablets once daily on a continuous basis. The daily dose is low; however, tadalafil stays in the body for 36 hours and builds up to effective levels when taken daily. The dose instruction for low dose daily tadalafil 2.5mg or 5mg is for one tablet to be taken daily around the same time each day.

The recommended starting dose is 10mg, and this is usually sufficient for most men, but it can vary depending on your needs.

The 20mg dose may be prescribed if smaller doses have not been effective.

The 5mg dose is usually prescribed for men who need a small daily dose, or who have medical issues that prevent a higher amount, such as high blood pressure, diabetes, or PDE-5 inhibitor side effects.

If your dose is not strong enough, your doctor may be able to raise it until you are able to achieve a satisfactory erection.

Before our pharmacists can supply this medicine, you will need to complete a short online questionnaire, which will determine if the product is suitable for you.

Tadalafil is usually safe and trouble free for the majority of users, but there are some side effects to be aware of. If you experience these regularly speak to your doctor, but many men find they need a short period of time as their body adjusts to the new medication before continuing without problems. If you have regular side effects a smaller dose may be more suitabable.

For most patients Tadalafil is highly tolerable and side effects are infrequent or minimaland an allergic reaction is extremely unlikely, however, if you experience difficulties breathing or have chest pain , develop hives, or suddenly lose your vision, seek immediate medical help.

Priapism is a common worry, but a prolonged painful erection is very rare. Seek help if you have a continuous painful erection lasting 4 or more hours.

The most common side effects of Tadalafil include headache, flushed face and chest, indigestion, nausea and congestion. Muscle or back ache are also possible.

Less common side effects are, among others, palpitations, stomach pain, insomnia and abnormal vision.

We are unable to supply this medicine to you if you have:

•hypersensitivity to the active substance(s) or to any of the excipients or trace residuals in selected oral phosphodiesterase type-5 inhibitor (PDE5).

•are under 18 years.

•are Female.

•are a man who has severe or mild erectile dysfunction as defined by scoring outside the 8-16 point SHIM score range.

•are taking concomitantly other PDE5 inhibitors or other treatments for erectile dysfunction or concomitant use with other treatments that are contraindicated (see Product Interactions). Patients who suffer from any of the following conditions are also excluded:

• Severe renal impairment (creatinine clearance < 30 mL/min).

• Hepatic impairment •Where vasodilation or sexual activity are inadvisable (e.g. patients with severe cardiovascular disorders such as unstable angina or severe cardiac failure [New York Heart Association Class 2 or greater heart failure in the last 6 months]).

• History of non-arteritic ischaemic optic neuropathy (NAION).

• Uncontrolled blood pressure.

• Hypotension (blood pressure < 90/50 mmHg) • Hypertension (blood pressure > 170/100 mmHg). N.B. If it is suspected that you have hypertension or hypotension, it is recommended to have your blood pressure checked and consult one of our pharmacists or your doctor

• Recent history of stroke or myocardial infarction (within the last 6 months).

• Hereditary degenerative retinal disorders (including genetic disorders of retinal phosphodiesterases)

• Uncontrolled arrhythmias.

• Left ventricular outflow obstruction, e.g., aortic stenosis and idiopathic hypertrophic subaortic stenosis .

• Anatomical deformation of the penis (e.g. angulation, cavernosal fibrosis, Peyronie’s disease) .• Pre-disposition to priapism (e.g. sickle cell disease, multiple myeloma or leukaemia) .

• Bleeding disorders (such as haemophilia).

• Active peptic ulceration

Please Note - Erectile dysfunction medicines can be supplied on The NHS . If you have to any of the following conditions you may be eligible:

Multiple sclerosis, Parkinson’s disease, polio, prostate cancer, severe pelvic or spinal injury, spina bifida certain genetic conditions, such as Huntington's disease.

You can also get ED medication on the NHS if you have had any of the following treatments: pelvic surgery, surgical removal of the prostate gland (prostatectomy), dialysis for kidney failure and kidney transplant.

All erectile dysfunction medicines supplied by Numark Pharmacy are exclusively for oral administration and require sexual stimulation in order to facilitate erection

• Swallow tablets whole with water.

• The onset of action may be delayed in some ED medication when taken with food

• Combinations of sildenafil citrate, vardenafil hydrochloride, tadalafil and avanafil should not be taken in combination without a break of at least 36 hours between one medication and another .

•Lifestyle advice - Changes and risk factor modification that may be required before or accompanying treatment with a phosphodiesterase-5 (PDE-5) inhibitor, include : • regular exercise, • reduction in body mass index, • smoking cessation, • reduced alcohol consumption