Tadalafil + Sildenafil ISI

Safety Information: Compounded Tadalafil & Sildenafil

What are compounded tadalafil and sildenafil?

Compounded tadalafil and sildenafil contain the same active ingredients found in FDA-approved medications commonly used to treat erectile dysfunction (ED). Compounded formulations are prepared by licensed pharmacies to meet specific patient needs, such as customized dosages or alternative forms.

Compounded medications are not FDA-approved but are made using FDA-approved active ingredients and prepared according to pharmacy standards.

Who should NOT take these medications?

You should not use tadalafil or sildenafil if you:

Take nitrates (commonly prescribed for chest pain or heart conditions)
Use riociguat (for pulmonary hypertension)
Have been advised to avoid sexual activity due to heart conditions
Are allergic to tadalafil, sildenafil, or any component of the formulation

Always inform your provider of your full medical history before starting treatment.

Important precautions

Tell your provider if you have a history of:

Heart disease, heart attack, or stroke
High or low blood pressure
Liver or kidney disease
Vision problems, including non-arteritic anterior ischemic optic neuropathy (NAION)
Bleeding disorders or stomach ulcers
Peyronie’s disease or other penile conditions

Your provider will determine whether treatment is safe for you.

Possible side effects

Common side effects may include:

Headache
Flushing
Nasal congestion
Indigestion
Back or muscle pain
Dizziness

These effects are usually mild and temporary.

Serious side effects (rare)
Seek immediate medical attention if you experience:

Chest pain
Sudden vision or hearing loss
An erection lasting longer than 4 hours (priapism)
Severe dizziness or fainting

Drug interactions

Tadalafil and sildenafil may interact with:

Nitrates and nitric oxide donors
Alpha-blockers (used for blood pressure or prostate conditions)
Certain antifungal or antibiotic medications
HIV protease inhibitors
Excessive alcohol

Always disclose all medications and supplements you are taking.

How should I take this medication?

Take only as prescribed by your provider
Do not exceed the recommended dose
Do not combine tadalafil and sildenafil unless specifically instructed
Avoid excessive alcohol use, which may increase side effects

Effectiveness

Results vary by individual. Some patients notice improvements shortly after starting treatment, while others may require dosage adjustments or additional time.