Tadalista CT 20 contains tadalafil 20 mg, follow-up with a doctor is appropriate when: It isn't working adequately despite correct use, or its effect seems to be changing. Side effects are persistent or troublesome, such as headaches, indigestion, flushing, back pain, or muscle aches. You develop dizziness, fainting, or unusually low blood pressure, particularly if taking blood-pressure medicines or alpha-blockers. Tadalista CT 20 start taking new medicines, especially nitrates, alpha-blockers, antihypertensives, or strong CYP3A4 inhibitors, because interactions may require treatment changes. You have kidney, liver, or cardiovascular problems, which can affect appropriate tadalafil dosing. You are considering continued or frequent use and need your treatment reviewed. Seek emergency care for chest pain after taking tadalafil, sudden vision or hearing loss, or an erection lasting more than 4 hours. A clinician should also confirm that a 20 mg dose is appropriate for you rather than assuming a higher dose is better.