Vidalista CT 20 with a healthcare professional include: Anyone with heart or cardiovascular problems, particularly if ***** activity may be unsafe. People taking nitrates, as tadalafil must not be combined with nitrate medicines. Those taking alpha-blockers or blood-pressure medicines, because tadalafil can further lower blood pressure. People with significant kidney or liver problems, who may require different dosing or additional precautions. Anyone taking other PDE5 inhibitors or interacting medicines. People who have experienced unusual reactions to tadalafil or have conditions that could increase the risk of prolonged erections. A healthcare professional can review the person's medical history and medicines before deciding whether tadalafil 20 mg is appropriate.