Tadalista 60 mg contains tadalafil, and tadalafil can affect the cardiovascular system mainly by causing blood-vessel relaxation and a temporary reduction in blood pressure. In healthy people, standard tadalafil doses have generally produced only small blood-pressure changes. However, 60 mg is above the usual tadalafil dose used for erectile dysfunction. Standard labeling recommends 10 mg as an as-needed starting dose, with adjustment to 5–20 mg, and no more than once daily. Important points: Do not combine tadalafil with nitrate medicines such as nitroglycerin; the combination can cause a dangerous fall in blood pressure. Extra medical assessment is important for people with significant cardiovascular disease or conditions where ***** activity itself may be unsafe. Serious cardiovascular events have been reported after tadalafil use, although many reports involved people with existing cardiovascular risk factors, and the available reports cannot establish that tadalafil itself caused those events. Chest pain during or after ***** activity requires immediate medical attention.