CIALIS

CIALIS

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If you've been diagnosed with ED (erectile dysfunction), talk with your doctor to see if CIALIS is right for you. We're so confident you'll like CIALIS for daily use, we promise to let you try it for the first time free. Or if you'd rather, you can try 36-hour CIALIS for use as needed for the first time free. After you try CIALIS, if you decide that the other dosing option might be a better choice for you, you can try it at no cost.

Not all men with ED have the same needs or lifestyle. That's why CIALIS offers 2 dosing options. Talk with your doctor to decide whether CIALIS for daily use or 36-hour CIALIS fits your lifestyle better.

To help you and your doctor decide if a CIALIS option is right for you, view the CIALIS Benefits Chart. >>

Print and fill out the CIALIS Free Trial Voucher. Your doctor discussion packet (which includes the voucher, a CIALIS dosing benefits chart, and your Promise Card) will print out at the same time.

Visit your doctor to see if CIALIS is right for you. Take your printed doctor discussion packet with you.

If you receive a prescription for CIALIS, take the prescription and the CIALIS Free Trial Voucher with you to your pharmacy to get your free trial—either 30 tablets of CIALIS for daily use or 3 tablets of
36-hour CIALIS.

Please answer the following questions in order to receive your CIALIS Free Trial Voucher and the CIALIS Promise Card.

Male Female*

*Remember, CIALIS is only approved for the treatment of ED (erectile dysfuntion) in men.

Age

Which of the following best describes you or your partner?

Taking 36-hour CIALIS now

Not taking ED medicine now

Taking CIALIS for daily use now

Never used ED medicine

Taking Viagra^® or Levitra^® now

Prefer not to answer

Eli Lilly and Company will not sell or rent your personally identifiable information from the CIALIS Promise Program to third parties for their marketing use.

I understand that by submitting this form I am consenting to participate in the CIALIS Promise Program and to the collection by Eli Lilly and Company of the personal information I provide. I acknowledge that to administer the Program Eli Lilly and Company will need to track my prescription activity associated with the redemption of vouchers and to use my personal information to send correspondence in connection with the Program. If I do not consent I will be unable to participate in the CIALIS Promise Program and receive free trial vouchers for CIALIS.

I have read and accept the terms listed above.

Important: The information you provide in this form will be used in accordance with the Eli Lilly and Company Privacy Statement. The information you provide to Eli Lilly and Company may also be used for marketing purposes. Also, any information or suggestions you provide regarding the content of any Web site, published document, or product will be handled in accordance with our Copyright Statement.

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Photos are for illustrative purposes only.

CIALIS is indicated for the treatment of erectile dysfunction.

Important Safety Information for CIALIS^® (tadalafil)

CIALIS IS NOT FOR EVERYONE. Only your doctor can decide if CIALIS is right for you. Before taking CIALIS, ask if you're healthy enough for sexual activity and be sure to tell your doctor about all your medical conditions and all medications. Don't take CIALIS if you take nitrates as the combination can cause a sudden, unsafe drop in blood pressure.

CIALIS for daily use remains in your body for as long as you take it. Tell your doctor about all medications, especially if you take nitrates (often used for chest pain) or medicines for blood pressure, alpha blockers, antifungals, or HIV, so your doctor can be aware of potential drug interactions.

Don't drink alcohol in excess (to a level of intoxication) with CIALIS, as this may increase your chances of getting dizzy or lowering your blood pressure. CIALIS does not protect against sexually transmitted diseases, including HIV. The most common side effects with CIALIS were headache and upset stomach. Backache and muscle ache were also reported, sometimes with delayed onset.

As with any ED tablet, in the rare event of an erection lasting more than 4 hours, seek immediate medical help to avoid long-term injury.

In rare instances, men taking prescription ED tablets (including CIALIS) reported a sudden decrease or loss of vision or hearing (sometimes with ringing in the ears and dizziness). It's not possible to determine if these events are related directly to the ED tablets or to other factors. If you have a sudden decrease or loss of vision or hearing, stop taking any ED tablet, including CIALIS and call your doctor right away.

CIALIS is available by prescription only. For additional safety information, talk to your doctor about this medicine and see the full Patient Information.