Brand Cialis

Brand Cialis is an agent for the treatment of erectile dysfunction. The active ingredient – tadalafi – is a reversible selective inhibitor of specific PDE5. The sexual excitement causes local release of nitric oxide. The inhibition of PDE5 by tadalafil leads to an increase in cGMP levels in the penis. As a result, a man gets relaxation of the smooth muscles. The blood fills the penile tissues contributing to a firm erection. Cialis is effective in the presence of sexual stimulation only.

Indications

This drug is intended for the treatment of erectile dysfunction in men.

Dosage

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

Side effects

Most often: headache (11%), dyspepsia (7%).

Side effects are usually minor or moderate in severity, transient and decrease with continued drug administration.

Possible side effects: back pain, myalgia, dizziness, nasal congestion, flushing.

Rare adverse reactions: eyelid edema, eye pain, conjunctival hyperemia.

Very rare negative events: hypersensitivity reactions (including rashes, hives and facial edema, Stevens-Johnson syndrome and exfoliative dermatitis); arterial hypotension (in patients who have already taken antihypertensive drugs), hypertension and syncope; abdominal pain and gastroesophageal reflux; hyperhidrosis (excessive sweating); priapism and delayed erection; blurry vision, non-arterial anterior ischemic neuropathy of the optic nerve, retinal vein occlusion, visual field disturbance, migraine, epistaxis.

Contraindications

Concomitant use of drugs containing any organic nitrates;
Children and adolescents up to 18 years old;
Hypersensitivity to tadalafil.

Drug interactions

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

Protease inhibitors such as ritonavir and saquinavir, as well as CYP3A4 inhibitors such as erythromycin and itraconazole, increase the activity of tadalafil.

The combined use of an antacid (magnesium hydroxide / aluminum hydroxide) and tadalafil decreases the rate of absorption of the latter without changing its AUC.

Tadalafil enhances the hypotensive effect of nitrates. This is due to the additive effect of nitrates and tadalafil on the metabolism of nitric oxide and cGMP. Therefore, the use of tadalafil in patients taking nitrates is contraindicated.

Overdose

A single dose of 500 mg / day to healthy volunteers and repeatedly up to 100 mg / day to patients with erectile dysfunction, the undesirable effects were the same as when using the drug at lower doses.

Treatment: holding standard symptomatic therapy. Tadalafil is practically not excreted through hemodialysis.