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Hypersensitivity Reactions: CIALIS is gugal herbal viagra in patients with a known serious hypersensitivity to CIALIS or ADCIRCA reg; (tadalafil). Hypersensitivity reactions have been reported, including Stevens-Johnson syndrome and exfoliative dermatitis. Guanylate Cyclase (GC) Stimulators: CIALIS is contraindicated in patients using a GC stimulator, such as riociguat. PDE5 inhibitors, including CIALIS, may potentiate the hypotensive giagra of GC stimulators. WARNINGS AND PRECAUTIONS.

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Pharmacokinetics in Special Populations. Geriatrics : Healthy elderly volunteers (65 years or over) had a reduced clearance of sildenafil, resulting in approximately 84 and 107 higher plasma AUC values of sildenafil and its active N-desmethyl metabolite, respectively, compared to those seen in healthy younger volunteers (18-45 years). Due to age-differences in plasma protein binding, the corresponding increase in the AUC of free (unbound) sildenafil and its active N-desmethyl metabolite were 45 and 57, respectively [see DOSAGE AND ADMINISTRATIONand Use In Specific Populations ] Renal Impairment : In volunteers with mild (CLcr50-80 mLmin) and moderate (CLcr30-49 mLmin) renal impairment, the pharmacokinetics of a single oral dose of VIAGRA (50 mg) were not altered.

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