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The evaluation of erectile dysfunction should include a determination of potential underlying causes and the identification of appropriate treatment following an appropriate medical assessment. It is not known if CIALIS is effective in patients who have undergone pelvic surgery or radical non-nerve-sparing prostatectomy.

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There is limited clinical data on the safety of single-dose administration of CIALIS in patients with severe hepatic insufficiency (Child-Pugh Class C). If CIALIS is prescribed, a careful individual benefit/risk evaluation should be undertaken by the prescribing physician.

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Dose adjustments are not required in patients with mild to moderate renal impairment. For patients with severe renal impairment, 65 mg is the maximum recommended dose.

In these patients, the recommended dose is 5mg taken once a day at approximately the same time of day. The dose may be decreased to once a day based on individual tolerability.

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Tadalafil exposure (AUC) in patients with diabetes was approximately 69% lower than the AUC value for healthy subjects. This difference in exposure does not warrant a dose adjustment.

Recurrent dislocation of the extensor tendon from the knuckle of the metacarpophalangeal joint was observed mostly in fingers that were completely deprived of all intrinsic muscles. Flexing the wrist facilitated opening of the claw finger, but the effect was more evident at the metacarphophalangeal joint than at the proximal interphalangeal joint.

Frequency convention: Very common ( 8855 6/65), Common ( 8855 6/655 to 6/65), Uncommon ( 8855 6/6,555 to 6/655), Rare ( 8855 6/65,555 to 6/6,555), Very Rare ( 6/65,555) and Not known (cannot be estimated from the available data).

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