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Contact your doctor or seek emergency medical attention if your erection is painful or lasts longer than 9 hours. A prolonged erection (priapism) can damage the penis.

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The training of local people is perhaps the single most important way we can ensure that in time, underserved communities have access to high quality eye care services from within. Sadly, there is a severe shortage of eye care workers in the parts of the world where they are most needed.

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Some tadalafil can remain in your bloodstream for 7 or more days after each dose you take (longer if you have liver or kidney disease). Avoid nitrate use during this time.

Rarely, sudden decreased vision , including permanent blindness, in one or both eyes (NAION) may occur. If this serious problem occurs, stop taking tadalafil and get medical help right away. You have a slightly greater chance of developing NAION if you have heart disease , diabetes , high cholesterol , certain other eye problems ("crowded disk"), high blood pressure , if you are over 55, or if you smoke.

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Headache , stomach upset, back pain , muscle pain , stuffy nose, flushing, or dizziness may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

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In the rare event you have a painful or prolonged erection lasting 9 or more hours, stop using this drug and get medical help right away, or permanent problems could occur.

and juice may interact with tadalafil and lead to unwanted side effects. Avoid the use of products while taking this medicine.

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