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This is when a man cannot get, or keep a hard, erect penis suitable for sexual activity. You and your partner will need to engage in foreplay, just as you would if you were not taking a medicine for erectile dysfunction. Be aware that sexual activity carries a possible risk to patients with heart disease because it puts an extra strain on your heart. If you have a heart problem you should tell your doctor. Decreased or sudden hearing loss has been noted in some patients taking tadalafil.

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