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Even if you decide against that, they can talk to you privately if you re confused, unsure, or just curious about sexual activity. Therefore, it eliminates the need to have an uncomfortable conversation with your primary physician or get a referral to a specialist to address the issue. Most antibiotics shouldn t cause your pill to be less effective, but the antibiotics rifampicin and rifabutin can reduce the effectiveness of the combined pill. It is possible to take Sialis in the morning and to be ready even next day.