Cialis 20mg film-coated tablets Singapore 犀利士 西力士 希爱力他达拉非片 20mg 美国礼来犀利士*4s

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
• If you get any side effects talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

What is in this leaflet:

1. What CIALIS is and what it is used for
2. What you need to know before you take CIALIS
3. How to take CIALIS
4. Possible side effects
5 How to store CIALIS
6. Contents of the pack and other information

Do not take CIALIS if you:

• are allergic to tadalafil or any of the other ingredients of this medicine (listed in section 6).
• are taking any form of organic nitrate or nitric oxide donors such as amyl nitrite. This is a group of medicines (“nitrates”) used in the treatment of angina pectoris (“chest pain”). CIALIS has been shown to increase the effects of these medicines. If you are taking any form of nitrate or are unsure tell your doctor.
• have serious heart disease or recently had a heart attack within the last 90 days.
• recently had a stroke within the last 6 months.
• have low blood pressure or uncontrolled high blood pressure.
• ever had loss of vision because of non-arteritic anterior ischemic optic neuropathy (NAION), a condition described as “stroke of the eye”.
• are taking riociguat. This drug is used to treat pulmonary arterial hypertension (i.e., high blood pressure in the lungs) and chronic thromboembolic pulmonary hypertension (i.e., high blood pressure in the lungs secondary to blood clots). PDE5 inhibitors, such as CIALIS, have been shown to increase the hypotensive effects of this medicine. If you are taking riociguat or are unsure tell your doctor.

Warnings and precautions

Talk to your doctor before taking CIALIS.

Be aware that sexual activity carries a possible risk to patients with heart disease because it puts an extra strain on your heart. If you have a heart problem you should tell your doctor.

Before taking the tablets, tell your doctor if you have:

• sickle cell anaemia (an abnormality of red blood cells).
• multiple myeloma (cancer of the bone marrow).
• leukaemia (cancer of the blood cells).
• any deformation of your penis.
• a serious liver problem.
• a severe kidney problem.

It is not known if CIALIS is effective in patients who have had:

• pelvic surgery.
• removal of all or part of the prostate gland in which nerves of the prostate are cut (radical non-nerve-sparing prostatectomy).

If you experience sudden decrease or loss of vision, stop taking CIALIS and contact your doctor immediately.

Decreased or sudden hearing loss has been noted in some patients taking tadalafil. Although it is not known if the event is directly related to tadalafil, if you experience decreased or sudden hearing loss, stop taking CIALIS and contact your doctor immediately.

CIALIS is not intended for use by women.

Children and adolescents

CIALIS is not intended for use by children and adolescents under the age of 18.

Other medicines and CIALIS

Tell your doctor if you are taking, have recently taken or might take any other medicines

Do not take CIALIS if you are already taking nitrates.

Some medicines may be affected by CIALIS or they may affect how well CIALIS will work. Tell your doctor or pharmacist if you are already taking:

• an alpha blocker (used to treat high blood pressure or urinary symptoms associated with benign prostatic hyperplasia).
• other medicines to treat high blood pressure.
• riociguat.
• a 5- alpha reductase inhibitor (used to treat benign prostatic hyperplasia).
• medicines such as ketoconazole tablets (to treat fungal infections) and protease inhibitors for treatment of AIDS or HIV infection.
• phenobarbital, phenytoin and carbamazepine (anticonvulsant medicines).
• rifampicin, erythromycin , clarithromycin or itraconazole.
• other treatments for erectile dysfunction.

CIALIS with drink and alcohol

Information on the effect of alcohol is in section 3. Grapefruit juice may affect how well CIALIS will work and should be taken with caution. Talk to your doctor for further information.

Fertility

When dogs were treated there was reduced sperm development in the testes. A reduction in sperm was seen in some men. These effects are unlikely to lead to a lack of fertility.

Driving and using machines

Some men taking CIALIS in clinical studies have reported dizziness. Check carefully how you react to the tablets before driving or using machines.

CIALIS contains lactose

If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.

CIALIS contains sodium

This medicine contains less than 1 mmol sodium (23 mg) per tablet, that is to say essentially ‘sodium-free’.

If you take more CIALIS than you should

Contact your doctor. You may experience side effects described in section 4.

If you experience any of the following side effects stop using the medicine and seek medical help immediately:

• allergic reactions including rashes (frequency uncommon).
• chest pain – do not use nitrates but seek immediate medical assistance (frequency uncommon).
• priapism, a prolonged and possibly painful erection after taking CIALIS (frequency rare). If you have such an erection, which lasts continuously for more than 4 hours you should contact a doctor immediately.
• sudden loss of vision (frequency rare).

Other side effects have been reported:

Common (seen in 1 to 10 in every 100 patients)

• headache, back pain, muscle aches, pain in arms and legs, facial flushing, nasal congestion, and indigestion.

Uncommon (seen in 1 to 10 in every 1,000 patients)

• dizziness, stomach ache, feeling sick, being sick (vomiting), reflux, blurred vision, eye pain, difficulty in breathing, presence of blood in urine, prolonged erection, pounding heartbeat sensation, a fast heart rate, high blood pressure, low blood pressure, nose bleeds, ringing in the ears, swelling of the hands, feet or ankles and feeling tired.

Rare (seen in 1 to 10 in every 10,000 patients)

• fainting, seizures and passing memory loss, swelling of the eyelids, red eyes, sudden decrease or loss of hearing, hives (itchy red welts on the surface of the skin), penile bleeding, presence of blood in semen and increased sweating.

Heart attack and stroke have also been reported rarely in men taking CIALIS. Most of these men had known heart problems before taking this medicine.

Partial, temporary, or permanent decrease or loss of vision in one or both eyes has been rarely reported.

Some additional rare side effects have been reported in men taking CIALIS that were not seen in clinical trials. These include:

• migraine, swelling of the face, serious allergic reaction which causes swelling of the face or throat, serious skin rashes, some disorders affecting blood flow to the eyes, irregular heartbeats, angina and sudden cardiac death.

The side effect dizziness has been reported more frequently in men over 75 years of age taking CIALIS. Diarrhoea has been reported more frequently in men over 65 years of age taking CIALIS.

Reporting of 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 national reporting system。

Cialis是一种治疗性 功能障碍的药物。 临床证明，药效可长达36小时，30分钟起效。由于cialis的药效可延续性，不需要担心几小时内失效。你和你的伴侣可以好好放松并且享受。

【药品名称】希爱力 他达拉非片
【通用名称】他达拉非片
【规格】20毫克×1片/盒
【功能主治】治疗男性勃起功能障碍，需要性刺激以使本品生效。他达拉非不能用于女性。
【用法用量】口服，用于成年男性：本品的推荐剂量为10mg，在进行性生活之前服用,不受进食的影响，如果服用10mg效果不显著，可以服用20mg。可至少在性生活前30分钟服用，最大服药频率为每日一次，最好不要连续每日服用他达拉非，因为尚未确定长期服用的安全性。同时，因为他达拉非的作用经常持续超过一天，用于老年男性:老年人无须调整剂量。用于肾功能不全的男性：对于轻至中度肾功能不全的患者无须调整剂量。对于重度肾功能不全的患者，最大的推荐剂量为10mg。
【不良反应】眼睑肿胀或者描述为眼痛和结膜充血是非常少见的副反应。报告显示由他达拉非所引起的副反应是短暂的、轻微的或者是中度的。这些副反应是数据只对年龄在75以下的病人适用。
【注意事项】在考虑给予药物治疗之前,应当先询问病史和对患者进行体检。以诊断是否患有男性勃起功能障碍和确定可能的未知病因，因为心血管病的发病几率与性行为有一定程度的相关，所以医生在对男性勃起功能障碍患者进行治疗以前，包括他达拉非，应当考虑患者的心血管健康状况。由于他达拉非具有使血管扩张的特性,所以会导致血压轻度的、短暂的降低，这种特性可能增强硝酸盐的降压效果。严重的心血管疾病，包括心肌梗塞、不稳定型心绞痛、室性心律失常、休克、短暂性缺血性发作等曾经在他达拉非的临床试验中观察到。
【禁忌】临床研究表明他达拉非可以增强硝酸盐类药物的降压作用。这被认为硝酸盐类药物和他达拉非共同作用于一氧化氮/cGMP通路的结果。因此，正在服用任何形式的硝酸盐类药物的患者禁止服用本品。性生活会给心脏病患者带来潜在的心脏风险。因此，勃起功能障碍的治疗药物，包括他达拉非在内，不应用于建议不宜进行性生活的心脏病患者。对已患有心脏病的患者，医生应考虑性生活潜在的心脏风险。
【生产企业】美国礼来 Eli Lilly Company Ltd
【批准文号】 H20140853