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There was no evidence of favourable clinical effect of the combination in the population studied. Concomitant use of riociguat with PDE5 inhibitors, including tadalafil, is contraindicated (see section 4.3). There is limited clinical data on the safety of single-dose administration of CIALIS in patients with severe hepatic insufficiency (Child-Pugh Class C). Once-a-day administration has not been evaluated in patients with hepatic insufficiency. Tadalafil has been shown to be highly effective in ED treatment.

This is high blood pressure that occurs in the main artery that carries blood from the right side of the heart (the ventricle) to the lungs. When the smaller blood vessels in the lungs become more resistant to blood flow, the right ventricle must work harder to pump enough blood through the lungs. Tadalafil works on the PDE5 enzyme in the lungs to relax the blood vessels. This will increase the supply of blood to the lungs and reduce the workload of the heart.

The recommended starting dose for tadalafil is 10mg taken once per day, as needed. A clinician will review your online consultation and determine if this is appropriate for you. If you feel the effect of tadalafil is too strong or too weak, feel free to contact us and we can advise you on adjusting your dosage. If your prescription is approved by a Numan clinician&nbsp