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Risk and Benefit - Generics No APO
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Risk and Benefit - Generics No APO

Advice for patients who have been prescribed sildenafil or tadalafil

  • You acknowledge that any medication dispensed by our pharmacy partner in accordance with a prescription provided by a health care provider will NOT be shipped in child-resistant packaging, and that you must KEEP OUT OF REACH FROM CHILDREN/DO NOT LEAVE IN AN AREA ACCESIBLE TO UNATTENDED CHILDREN. 
  • THIS IS A CUSTOM PRESCRIPTION MEDICATION AND SHOULD BE SAFELY SECURED OUT OF REACH OF ANYONE OTHER THAN YOU.
  • STORAGE: FILL In with appropriate storage 
  • Medication is only intended for use for men 18 years and older.
  • The recommended dose will be different for each individual. We will work with you to adjust the strengths to find the one that works best for you.
  • The length of time that the medication will last may vary from person to person. However, most men find that the effects of sildenafil last for 4-5 hours, the effects of tadalafil last for 24-36 hours after taking the medication.
  • The maximum recommended dosing frequency is one dose in every 24 hours. 
  • For prodcts that contain greater than 10mg of tadalafil, it should be noted that tadalafil can stay in the blood stream for up to 36 hours, and this should be taken into consideration.
  • Medications containing any nitrates (such as nitroglycerin, isosorbide mononitrate or isosorbide dinitrate), nitrites or alkyl nitrites (also known as “poppers”), as well as guanylate cyclase (GC) stimulators (such as riociguat), must NOT be used at the same time as this combination may lead to a dangerous drop in blood pressure and/or syncope (fainting).
  • 5-HT3 (serotonin) antagonist medications used for the treatment of nausea or irritable bowel syndrome (IBS) (e.g. ondansetron (Zofran), granisetron (Kytril), dolasetron (Anzemet), palonosetron (Aloxi), alosetron (Lotronex), etc.) must NOT be used at the same time, as this combination may lead to a dangerous drop in blood pressure and/or syncope (fainting).
  • You should NOT take if you have a known allergy (hypersensitivity) to sildenafil and/or tadalafil.
  • You should NOT take if sexual activity is inadvisable due to your cardiovascular status.
  • AVOID grapefruit, grapefruit juice and excessive alcohol consumption when taking.
  • Use caution when taking with alpha-blockers or anti-hypertensive medications, as this may lead to a drop in blood pressure and/or syncope (fainting).
  • Use caution when taking with strong CYP inhibitors (such as ritonavir, saquinavir, ketoconazole, itraconazole, erythromycin), as metabolism is decreased, and this may lead to a prolonged erection, a drop in blood pressure and/or syncope (fainting). 
  • Use caution when taking if you are predisposed to priapiasm (a prolonged erection).
  • Use caution when taking if you have renal (kidney) or hepatic (liver) impairment, active peptic ulcers, or a bleeding disorder.
  • Use caution when taking if you have been diagnosed with long QT syndrome or a prolonged QT interval, or if you take medications that prolong the QT interval. These medications may prolong the QT interval and cause torsades de pointes (a fatal heart arrhythmia) and sudden death.
  • Use caution when taking if you have been diagnosed with a major psychotic disorder, have a history of psychosis, or take antipsychotic medication.
  • Use caution when taking if you have been diagnosed with or treated for Parkinson's disease.
  • WARNINGS: medications may cause drowsiness or daytime sleepiness (be mindful if driving or operating heavy machinery). Medications may also affect impulse control and cause compulsive behaviors. Withdrawal-emergent hyperpyrexia and confusion may occur with rapid dose reduction or withdrawal.
  • You should tell your doctor that you are taking sildenafil/tadalafil, especially if you are started on any new medications.
  • COMMON SIDE EFFECTS include: headache, flushing, rash, abnormal vision, cyanopsia (blue-tinted vision), dyspepsia (indigestion), oral mucosal irritation, nasal congestion, dizziness, nausea, vomiting, back pain and myalgia (muscle aches). NOTE: If any of these become a concern, please contact your doctor or call the 1-800 telephone number on your prescription label to speak one of our pharmacists.
  • You should STOP TAKING medications and seek IMMEDIATE medical attention if you experience any of the following SERIOUS side effects: 
    • Chest pain (nitrates must NOT be used to treat chest pain).
    • Palpitations (an abnormal beating of the heart).
    • Syncope (fainting).
    • Hallucinations or psychotic behavior.
    • An erection lasting longer than 4 hours.
    • A sudden decrease or loss of hearing or vision.
    • An allergic reaction (symptoms include sudden onset of wheezing; difficulty breathing; dizziness; swelling of the eyelids, face, lips, tongue or throat; hives).
    • Serious skin reactions such as Stevens-Johnson Syndrome (SJS) or Toxic Epidermal Necrolysis (TEN) (symptoms may include a skin rash; severe blistering, peeling, pain and swelling of the skin; blistering of the mouth, genitals and around the eyes; a fever).
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