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caution advisedSevere (Child-Pugh class C) Not recommended Mild-to-moderate (Child-Pugh class A or B) Consider starting dosage of 20 mg PO once dailySevere (Child-Pugh class C) Avoid use Orphan designation for Duchenne muscular dystrophy (DMD) Eli Lilly and Company; Lilly Corporate Center; Indianapolis, IN 46285 Orphan designation of a fixed dose combination of macitentan cialis 5mg bestellen tadalafil for treatment of pulmonary arterial hypertension Actelion Clinical Research, Inc; 1820 Chapel Avenue West, Suite 300; Cherry Hill, New Jersey 08002 Indicated for treatment of erectile dysfunction (ED) Cialis or generic equivalent only: No dosage adjustment is warranted solely on basis of age; however, greater sensitivity to medications in some older cialis 5mg bestellen should be considered Indicated for pulmonary arterial hypertension (PAH) (WHO Group 1) to improve exercise ability; studies establishing effectiveness included predominately patients with NYHA Functional Class II III symptoms and etiologies of idiopathic or heritable PAH (61% or PAH associated with connective tissue diseases (23% Adcirca, Alyq, or generic equivalent only: Lower dose or reduced dosing frequency may be required in elderly because of decreased renal or hepatic clearanceHeadache (11-42% Myalgia (1-14% Respiratory tract infection (3-13% Nasopharyngitis (2-13% Dyspepsia (1-13% Flushing (1-13% Back pain (2-12% Nausea (10-11% Nasal congestion (9% Gastroesophageal reflux disease (1-3% Hypertension cialis 5mg bestellen Bronchitis (2% Genitourinary tract infection (2% Amnesia Angina pectoris Arthralgia Change in color vision Conjunctival hyperemia Dyspnea Epistaxis Hypotension Visual field defect, retinal vein occlusion, retinal artery occlusion, and non arteritic anterior ischemic optic neuropathy (NAION) Hearing loss Priapism Hypersensitivity, including Stevens-Johnson syndrome and exfoliative dermatitis Soluble guanylate cyclase (sGC) stimulators (eg, riociguat) concomitant use can cause hypotension Coadministration with nitrates (either regularly and/or intermittently) and nitric oxide donorsConsistent with the effects of PDE5 inhibition on the nitric oxide/cyclic guanosine monophosphate pathway, PDE5 inhibitors may potentiate the hypotensive effects of nitratesA suitable time interval following PDE5 dosing for the safe administration of nitrates or nitric oxide donors has not been determined Use caution in patients with anatomic deformation of penis, cardiovascular disease, left ventricular outflow obstruction, myocardial infarction in preceding 90 days, unstable angina, cialis 5mg bestellen occurring during sexual intercourse, NYHA class 2 or greater heart failure in preceding 6 months, uncontrolled arrhythmias, hypotension, uncontrolled hypertension, cerebrovascular accident in preceding 6 months, bleeding disorders, active peptic ulcer disease, liver disease, renal impairment, conditions predisposing to priapism, concomitant use of CYP3A4 inhibitors May cause dose-related impairment of color discrimination; 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