Cialis

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Cialis is considered one of the most highly effective drugs for men. This drug is prescribed to improve potency. With its use, blood flow to the penis increases. The action of Cialis lasts much longer than that of Viagra or Levitra. The effect remains for up to 36 hours.

How does it work?

The main active ingredient in Cialis is tadalafil. It provides a stable erection at the time of natural excitement or during sexual stimulation. The drug begins to act 30 minutes after administration. The effect lasts at least 36 hours.

Unlike other potency stimulants, you do not need to plan sexual intercourse. The drug provides a stable effect. Those who keep a regular sex life, it is recommended to buy and take Cialis at a rate of 5 mg per day.

For those planning a one-time appointment, 1 tablet before intercourse is enough. The maximum daily dose: 20 mg.

The main advantage of Cialis is that the effect of the drug does not appear in the absence of natural excitement, without sexual stimulation. Cialis differs from other drugs in that the effect appears much faster than from other drugs in this group.

Dosage regimen

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 may conduct 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.

Overdose

Symptoms: with a single-use in healthy individuals of tadalafil in a dose of up to 500 mg and patients with erectile dysfunction – repeatedly up to 100 mg/day – side effects were the same as when prescribed in lower doses.

Treatment: in case of an overdose, standard symptomatic treatment is required. Tadalafil is excreted slightly with hemodialysis.

Contraindications

  • Hypersensitivity to tadalafil or other components of the drug;
  • Simultaneous use of organic nitrates in any dosage form.

Side effects

  • General reactions: hypersensitivity reactions – skin rash, urticaria and swelling of the face, Stevens-Johnson syndrome, exfoliative dermatitis;
  • Cardiovascular system: myocardial infarction, sudden cardiac death, stroke, angina pectoris, tachycardia are described, however, most patients had a history of risk factors from the cardiovascular system.
  • However, it is impossible to establish a reliable connection between the development of the above reactions with cardiac risk factors, tadalafil, sexual activity, or a combination of all of the above factors.
  • Gastrointestinal tract: abdominal pain, gastroesophageal reflux;
  • Skin system: hyperhidrosis;
  • The organ of vision: blurred vision, non-arterial anterior optical ischemic neuropathy, retinal vein occlusion, visual field disturbance;
  • Genitourinary system: prolonged erection, priapism.from the central nervous system: migraine;
  • Respiratory system: epistaxis.

Side effects have not been reported during clinical trials, therefore their frequency is unknown: seizures, temporary memory loss, some disorders affecting ocular blood circulation, arrhythmia, skin rash, as well as a sudden decrease or loss of hearing.

Drug interactions

Tadalafil is mainly metabolized by the CYP3A4 enzyme. The selective inhibitor of CYP3A4 ketoconazole increases AUC by 107%, and rifampicin reduces it by 88%.

Although specific interactions have not been studied, it can be assumed that protease inhibitors such as ritonavir and saquinavir, as well as CYP3A4 inhibitors such as erythromycin and itraconazole, increase tadalafil activity.

With the simultaneous administration of an antacid (magnesium hydroxide/aluminum hydroxide) and tadalafil, the absorption rate of the latter decreases without changing its AUC.

Tadalafil enhances the hypotensive effect of nitrates. This occurs as a result of the additive effect of nitrates and tadalafil on the metabolism of nitric oxide and cGMP. Therefore, the use of tadalafil in patients receiving nitrates is contraindicated.

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