Cialis

Cialis is an agent for treating erectile dysfunction. It is a reversible selective inhibitor of specific PDE5 cGMP. When sexually excited, it causes local release of nitric oxide. The inhibition of PDE5 by tadalafil contributes to an increase in the level of cGMP in the penile cavernous body. The main consequence is the relaxation of the arteries’ smooth muscles. It increases blood flow to the penile tissues, which provokes an erection. Tadalafil is ineffective in the absence of sexual stimulation.

Indications

The main indication is erectile dysfunction.

Middle-aged men are recommended to take a dose of 20 mg at least 16 minutes before the planned sexual activity, regardless of food intake. Patients can attempt intercourse at any time within 36 hours after administration in order to establish the optimal response time to tadalafil. The maximum frequency of admission is 1 time/day.

• Hypersensitivity to tadalafil or to any excipients;
• Combination with any organic nitrates;
• Use in persons under 18 years of age;
• The presence of contraindications to sexual activity in patients with diseases of the cardiovascular system: myocardial infarction in the last 90 days, unstable angina, the occurrence of an angina attack during intercourse, chronic heart failure II-IV classes according to the NYHA classification, uncontrolled arrhythmias, hypotension ( BP less than 90/50 mm Hg), uncontrolled arterial hypertension, ischemic stroke over the past 6 months;
• Loss of vision due to non-arterial anterior ischemic neuropathy of the optic nerve;
• Simultaneous administration of doxazosin, as well as drugs for the treatment of erectile dysfunction;
• Patients with chronic renal failure (creatinine clearance less than 30 ml/min);
• Lactose deficiency, lactose intolerance, glucose-galactose malabsorption.

Disorders from the cardiovascular system:

• infrequently: palpitations, tachycardia¹, decreased blood pressure, (in patients who have already taken antihypertensive drugs), increased blood pressure.
• rarely: myocardial infarction.
• unknown: unstable angina pectoris.

Violations of the nervous system:

• very common: headache.
• often: dizziness.
• rarely: fainting, migraine, transient ischemic attack, stroke.

Violations of the organs of vision:

• infrequently: blurred vision.
• rarely: visual field impairment.
• unknown: non-arterial anterior ischemic optic neuropathy, retinal vein occlusion.

Disorders of the respiratory system:

infrequently: nosebleeds.

Digestive disorders:

• often: abdominal pain.
• infrequently: gastroesophageal reflux.

Violations of the skin and subcutaneous tissue:

• infrequently: rash, urticaria, hyperhidrosis (excessive sweating).
• unknown: Stevens-Johnson syndrome and exfoliative dermatitis.

General violations:

• uncommon: chest pain.
• rarely: facial swelling.
• unknown: sudden cardiac death.

Immune system disorders:

infrequently: hypersensitivity reactions.

Reproductive system disorders:

• rarely: prolonged erection.
• unknown: priapism.

Before you start using Cialis, you should consult a physician on how it interacts with other preparations.

• The simultaneous administration of cytochrome inhibitor – Ketoconazole isoenzyme promotes a several-fold increase in the total Tadalafil concentration in blood plasma.
• Ritonavir inhibitor also increases this indicator. That is, the simultaneous administration of Cialis in the composition and potent inhibitors requires dosage control – the dose should not exceed 10 mg for 72 hours.
• Concomitant use with erythromycin and itraconazole also enhances the Cialis effect.
• Some drugs such as phenytoin, rifampicin, carbamazepine lower the Tadalafil effect.
• Gastrointestinal and antihistamines do not have mutual effects.
• The combination of Cialis with significant doses of alcohol results in rapid heart rate, low blood pressure, and headache.
• The combination of Cialis with organic nitrates and alpha-blockers is strictly prohibited. Also, co-administration with other drugs aimed at treating erectile dysfunction is not recommended.