Before we start - have you read the Patient Information Leaflet (PIL) for Cialis?

The leaflet lists who must not take it, the warnings about other medicines, and the side effects. Ask us if you do not have a copy.

Is this medicine for you, to take yourself?

A prescription-only medicine can only be supplied to the person who will take it, from their own account, and the consultation must be answered by them.

What is your biological sex?

Cialis for erectile dysfunction is prescribed for people whose biological sex is male.

How old are you?
Have you had erectile dysfunction symptoms for more than 3 months, and has it been a persistent (not occasional) problem?

This helps the prescriber understand the picture.

How would you rate the firmness of your erections, typically? (IIEF-style scale.)
Have you used ED medication (Viagra, Cialis, Levitra, Spedra, etc.) before?
Are you currently taking, or have you taken in the last week, any nitrate medicine - for example glyceryl trinitrate (GTN spray or tablets), isosorbide mononitrate, isosorbide dinitrate, or nicorandil?

Nitrates are usually prescribed for chest pain (angina) or heart failure.

Are you taking riociguat (Adempas) or another soluble guanylate cyclase stimulator (for pulmonary hypertension)?
Have you had any of these in the LAST 6 MONTHS: a heart attack, a stroke, unstable angina (chest pain at rest or with little activity), or a serious irregular heartbeat?
Are you fit enough for sexual activity? (For most people this is comparable to climbing 2 flights of stairs without being very out of breath.)

ED medicines do not in themselves cause heart problems, but the increased exertion of sex can - so prescribers ask this.

Do you have heart failure, severe heart valve disease, or has a doctor told you that you should avoid sexual activity for heart reasons?
Have you had low blood pressure, fainting attacks, or have you been told you have low blood pressure (below 90/50)?
Have you had uncontrolled high blood pressure (above 170/100), or are you on more than one blood pressure medicine?
Do you have any of these eye conditions: NAION (non-arteritic ischaemic optic neuropathy), or a history of sudden vision loss in one or both eyes?

Rare but serious eye reactions have occurred with PDE5 inhibitors.

Do you have hereditary degenerative retinal disorders, such as retinitis pigmentosa?
Do you have severe liver problems, severe kidney problems, or are you on dialysis?
Have you ever had priapism (a painful erection lasting more than 4 hours), or do you have a condition that predisposes you to it (sickle cell disease, multiple myeloma, leukaemia)?
Do you have, or have you had, a deformity of the penis (such as Peyronie's disease, angulation, or cavernosal fibrosis)?
Are you taking any medicine that strongly affects the liver enzyme CYP3A4 - for example ritonavir, ketoconazole, itraconazole, erythromycin, clarithromycin, or any HIV protease inhibitor?

These can sharply raise tadalafil levels.

Are you taking an alpha-blocker (e.g. doxazosin, tamsulosin) for blood pressure or prostate symptoms?
Do you have any other long-term medical condition we should know about (diabetes, depression, prostate problems, anything else)?
Are you taking any other prescription, over-the-counter, or herbal medicines we have not already asked about?
Have you ever had an allergic reaction to tadalafil, sildenafil, vardenafil, or avanafil?
Do you drink alcohol heavily, or do you use recreational drugs (including poppers / amyl nitrite)?

Poppers contain nitrates and must not be combined with tadalafil.

Can we share information about this prescription with your GP?

This helps your medical records stay complete.

Do you understand that this medicine helps with the response to sexual stimulation but does not cause an erection on its own, that it does not protect against STIs, and that you should seek urgent help if you have an erection lasting more than 4 hours?