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Dosing and Drug Interactions

• Viagra
• Cialis
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  • Dosing and Drug Interactions
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• Levitra

DOSING:
For a majority individuals the recommended beginning dose of Cialis is 10 mg per day. Depending on the response or side effects the dose may be increased to 20 mg or decreased to 5 mg a day. The effect of Cialis can have a lasting effect of up to 36 hours. Individuals who are taking medications that increase the blood levels of Cialis should not exceed a total dose of 10 mg in 72 hour period. Cialis may be taken with or without food as food will have no affect.

DRUG INTERACTIONS: The breakdown and elimination of Cialis from the body may be decreased by erythromycin, ketoconazole (Nizoral), itraconazole (Sporanox), indinavir (Crixivan) and ritonavir (Norvir). These drugs can lead to an increase in the levels of Cialis in the blood. If these drugs are being used at the same time as Cialis, the dose of Cialis should be reduced in order to avoid side effects from high levels of Cialis. 
Cialis exaggerates the increases in heart rate and lowering of blood pressure caused by nitrates, e.g. nitroglycerin, isosorbide dinitrate (Isordil), isosorbide mononitrate (Imdur, Ismo, Monoket), nitroglycerin (Nitro-Dur, Transderm-Nitro) that are used primarily for treating heart pain (angina). In patients who take nitrates for angina, Cialis could cause heart pain or possibly even a heart attack by exaggerating the increase in heart rate and the lowering of blood pressure. 
CIALIS SHOULD NOT BE USED WITH NITRATES.
Cialis also exaggerates the blood pressure lowering effects of some alpha-blocking drugs e.g., terazosin (Hytrin) that primarily are used for treating high blood pressure or enlargement of the prostate. Individuals who take these alpha-blockers should be on a stable dose of the alpha-blocker before Cialis is started. In these situations Cialis should be begun at the lowest dose. If the patient is already taking Cialis, the alpha-blocker should be started at the lowest dose. Cialis and alcohol both lower blood pressure. Do not combine Cialis with alcohol as this may cause excessive drops in blood pressure and cause dizziness, headaches, and increased heart rate.