Cialis

Generic Cialis (tadalafil) is a popular medication used for the treatment of men who experience difficulty having and maintaining an erection (impotence).

How does it work?

This is a very effective drug, which is a selective inhibitor of the special type 5 phosphodiesterase (PDE5) cyclic guanosine monophosphate (cGMP). At the time of sexual stimulation, it causes local release of nitric oxide. Inhibition of PDE5 by tadalafil leads to an increase in the level of cGMP in the cavernous bodies of the penis. As a result of this, the smooth muscles of arteries relax, blood flow to the tissues of the penis increases, and an erection occur. The drug will not work if you have no sexual stimulation.

Indications

Cialis is used to treat erectile dysfunction. The most commonly used dose is 20 mg. The pill is taken before a planned sexual intercourse, regardless of meals. The pill should be taken at least twenty minutes before sexual intercourse. Men can have sex for 36 hours after taking the drug, which makes intimacy spontaneous and natural. The drug can only be taken once a day.

Contraindications

1. You should not take the drug if you have hypersensitivity to tadalafil or other components of the drug;
2. Cialis should not be used together with other drugs containing nitrates;
3. Do not use these pills if you have not reached the age of majority.

Side effects

The most common unpleasant consequences of taking this drug can be headache and dyspepsia. Side effects associated with the use of tadalafil are often minor and short-lasting, and they usually disappear with regular use of the drug. In rare cases, men experience back pain, face flushing, nasal congestion and myalgia. In very rare cases, men reported eye pain, eyelid swelling, dizziness and conjunctival hyperemia.

Overdose

When healthy men took a single dose of tadalafil up to 500 mg, side effects were the same as when they took lower doses. The situation was the same when patients with erectile dysfunctions took up to 100 mg of tadalafil per day. If you exceed the dose of the drug, standard symptomatic treatment is required.

Special instructions

Sexual activity poses some risk for men with heart and vascular disease. For this reason, it is not recommended to treat impotence with Cialis if you are suffering from such diseases. The potential risks of worsening conditions in patients with cardiovascular disease during sexual activity in general should also be taken into account. Such diseases include:

• myocardial infarction over the past three months;
• a stroke that occurred during the last six months;
• unstable angina pectoris or angina pectoris which occurs during intercourse;
• uncontrolled arrhythmia, hypotension with blood pressure 90 to 50 mm RT. Art. or uncontrolled hypertension;
• heart failure of the second class and higher on the NYHA scale, which developed during the last six months.

Interaction with other medicines

The effect of other drugs on Cialis

Tadalafil is mostly metabolized due to the enzyme CYP3A4. The selective CYP3A4 inhibitor, ketoconazole, expands the area under the concentration-time function by 107%, and rifampicin narrows it by 88%. Special studies on the interaction of the drug have not been carried out, however, protease inhibitors such as saquinavir and ritonavir, as well as CYP3A4 inhibitors such as intraconazole and erythromycin can enhance the effect of tadalafil. The simultaneous administration of antacid (magnesium hydroxide / aluminum hydroxide) and tadalafil reduces the metabolic rate of tadalafil without correcting the lower area of ​​the pharmacokinetic curve for Cialis. An increase in the acidity of the stomach due to the administration of the H2 antagonist of nizatidine does not affect the pharmacokinetics of tadalafil.

The effect of Cialis on other drugs

It’s no secret that tadalafil intensifies hypotensive effect of nitrates. This is due to the additional effect of nitrates and tadalafil on the metabolism of nitric oxide and cGMP. That is why the use of Cialis together with nitrates is contraidicated. There are currently no studies confirming the relationship of a single dose of tadalafil and changes in the amount of alcohol in the blood, the effects of alcohol on cognitive ability and pressure. At the same time, there was no quantitative decrease in the concentration of tadalafil in the blood several hours after it was taken in combination with alcohol. Tadalafil also has no significant effect on the pharmacodynamics and pharmacokinetics of theophylline.

Storage conditions

Store the drug at room temperature. Keep out of the reach of children ad pets. Do not use the drug after the expiration date indicated on the blister.