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For our very special and very busy clients, here’s the NEW menu for our Weekly Meals drop off service. We will transform the space into a winter wonderland. Erectile dysfunction (for as-needed use) Adults: Initially, 10 mg (Cialis) P. before anticipated sexual activity; may increase to 20 mg or decrease to 5 mg based on patient response and tolerance. For most patients, maximum recommended dosing frequency is once daily. Erectile dysfunction (for daily use) Adults: 2.5 mg (Cialis) P. once daily, given at approximately the same time without regard to sexual activity; may increase to 5 mg P. once daily based on efficacy and tolerability Use cautiously in: • mild to moderate hepatic or renal impairment • severe renal impairment (avoid Adcirca use; once-daily Cialis use not recommended) • severe hepatic impairment (Cialis use not recommended; avoid Adcirca use) • cardiac risk that makes sexual activity inadvisable, left ventricular outflow obstruction, myocardial infarction within last 90 days, unstable angina or angina occurring during sexual intercourse, New York Heart Association Class II or greater heart failure in last 6 months, uncontrolled arrhythmias, blood pressure below 90/50 mm Hg, uncontrolled hypertension (blood pressure above 170/100 mm Hg), stroke within last 6 months, pulmonary veno-occlusive disease), erectile dysfunction whose cause hasn't been evaluated, conditions that increase risk of priapism (use not recommended) • concurrent use of potent CYP450-3A4 inhibitors or inducers, or other PDE5 inhibitors (avoid use) • concurrent use of alpha blockers (except tamsulosin 0.4 mg/day), antihypertensives, or alcohol • pregnant or breastfeeding patients • children (safety and efficacy not established). CNS: headache, fatigue, dizziness, insomnia, hyperesthesia, paresthesia, drowsiness, vertigo, asthenia, transient global amnesia CV: angina pectoris, chest pain, hypertension, hypotension, orthostatic hypotension, palpitations, syncope, tachycardia, myocardial infarction EENT: blurred vision, color vision changes, conjunctivitis, eye pain, increased lacrimation, eyelid swelling, epistaxis, nasal congestion, pharyngitis GI: nausea, vomiting, diarrhea, dyspepsia, esophagitis, gastroesophageal reflux, gastritis, upper abdominal pain, dysphagia, dry mouth GU: increased or spontaneous erection Musculoskeletal: myalgia; back, neck, limb, and joint pain Respiratory: dyspnea Skin: pruritus, rash, sweating Other: facial edema, pain Drug-drug. 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