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Cialis is a phosphodiesterase inhibitor. It works by helping to increase blood flow into the penis during sexual stimulation. This helps you to achieve and maintain an erection. Before using Cialis: Some medical conditions may interact with Cialis . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you: * if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement * if you have allergies to medicines, foods, or other substances * if you have a deformed penis (eg, Peyronie disease, cavernosal fibrosis), blood problems (eg, sickle cell anemia, leukemia, multiple myeloma), or any other condition that may increase the risk of a prolonged erection (priapism) * if you have a history of certain eye problems (eg, retinitis pigmentosa, sudden vision loss, optic neuropathy, macular degeneration) * if you have a history of liver or kidney problems, dialysis, high or low blood pressure, ulcers, bleeding problems, heart problems (eg, heart failure, irregular heartbeat, aortic stenosis, angina), or blood vessel problems * if you have a history of heart attack, stroke, or life-threatening irregular heartbeat Some MEDICINES MAY INTERACT with Cialis . Tell your health care provider if you are taking any other medicines, especially any of the following: * Alpha-blockers (eg, doxazosin), medicines for high blood pressure, nitrates (eg, isosorbide, nitroglycerin), or nitroprusside because severe low blood pressure with dizziness, lightheadedness, and fainting may occur * Azole antifungals (eg, itraconazole), HIV protease inhibitors (eg, ritonavir), macrolide antibiotics (eg, erythromycin), or telithromycin because they may increase the risk of Cialis 's side effects * Rifampin because it may decrease Cialis 's effectiveness This may not be a complete list of all interactions that may occur. Ask your health care provider if Cialis may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine. How to use Cialis: Use Cialis as directed by your doctor. Check the label on the medicine for exact dosing instructions. * An extra patient leaflet is available with Cialis . Talk to your pharmacist if you have questions about this information. * Take Cialis by mouth with or without food. * For use as needed: Take Cialis at least 30 minutes before sexual activity, as directed by your doctor. Cialis may work for up to 36 hours after you take it. * For daily use: Take Cialis regularly at about the same time each day. * Talk with your doctor if you have questions about how you should take Cialis . * Check with your doctor before you eat grapefruit or drink grapefruit juice while you are taking Cialis . * For use as needed: If you miss a dose of Cialis and you still intend to engage in sexual activity, take it as soon as you remember. Continue to take it as directed by your doctor. For daily use: If you miss a dose of Cialis , take it as soon as possible. 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