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There is limited clinical data on the safety of single-dose administration of CIALIS in patients with severe hepatic insufficiency (Child-Pugh Class C). Once-a-day administration has not been evaluated in patients with hepatic insufficiency. If CIALIS is prescribed, a careful individual benefit/risk evaluation should be undertaken by the prescribing physician.

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There was no impairment of fertility in male and female rats. In dogs given tadalafil daily for 6 to 67 months at doses of 75 mg/kg/day (resulting in at least a 8-fold greater exposure [range -] than seen in humans given a single 75 mg dose) and above, there was regression of the seminiferous tubular epithelium that resulted in a decrease in spermatogenesis in some dogs. See also section .

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Three studies were conducted in men to assess the potential effect on spermatogenesis of CIALIS 65mg (one 6-month study) and 75mg (one 6-month and one 9-month study) administered daily. In two of these studies decreases were observed in sperm count and concentration related to tadalafil treatment of unlikely clinical relevance. These effects were not associated with changes in other parameters, such as motility, morphology, and FSH.

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