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Therefore, administration of CIALIS to patients who are using any form of organic nitrate is contraindicated (see section 4.3). In such circumstances, nitrates should only be administered under close medical supervision with appropriate haemodynamic monitoring. If you are taking sildenafil to treat erectile dysfunction, follow your doctor's directions and the guidelines in this paragraph. The best time to take sildenafil is about 1 hour before sexual activity, but you can take the medication any time from 4 hours to 30 minutes before sexual activity. Sildenafil usually should not be taken more than once every 24 hours. If you have certain health conditions or are taking certain medications, your doctor may tell you to take sildenafil less often.

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