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Do not take Cialis if you are also using a nitrate drug for chest pain or heart problems, including nitroglycerin, isosorbide dinitrate, isosorbide mononitrate, and some recreational drugs such as “poppers”. Taking tadalafil with a nitrate medicine can cause a sudden and serious decrease in blood pressure..Some medicines can cause unwanted or dangerous effects when used with Cialis. Tell your doctor about all your current medicines, especially (Adempas). Taking Cialis with other medicines can cause a serious decrease in blood pressure and some other side effects arise. Heart disease or heart rhythm problems, a heart attack or stroke, angina(chest pain), high or low blood pressure, pulmonary hypertension, a condition called pulmonary veno-occlusive disease, liver or kidney disease, vision loss, or retinitis pigmentosa, a bleeding disorder, a blood cells disorder such as sickle cell anemia, multiple myeloma, or leukemia, a stomach ulcer and heart problems that make sexual activity unsafe, etc. without doctors permission you cannot take this because it may be harmful to us.