Pharmacotherapeutic Group:
Cialis (tadalafil) tablets are for nasal passages disorders. These tablets may also be used for other uses, for example treatment of pulmonary hypertension. The recommended dosage is one tablet (20mg) taken once daily. Cialis is available in 10 mg and 20 mg strength.
Pharmacodynamics:In a study of 609 patients with erectile dysfunction in a fixed-dose study, tadalafil produced a mean maximum reduction of 15.8% in the mean maximum distance traveled (MdRT) and an average decrease in the mean number of premature ejaculation (PE) episodes per month (from a mean of 2.1 PE episodes per month) to a mean of 4.6. Tadalafil produced a mean maximum reduction in the mean number of premature ejaculation (PE) episodes per month of 2.1, and a decrease in the number of premature ejaculation (PE) episodes per month of 3.5% in the group of patients taking 20 mg. In another study of tadalafil-treated patients with pulmonary hypertension, the mean maximum MdRT was reduced from a mean of 6.4 to 4.8 (in the group of patients taking 20 mg), and the mean reduction in the number of PE episodes was 10.2. The most common side effects were headache (24%), back pain (23%), and nasal congestion (25%). The most common drug-drug interactions were with nitrates (32%), with alpha-blockers (24%), and with metoprolol (18%). The most common drug-drug interactions were with quinapril (10%), with spedilide (9%), with cimetidine (8%), and with digoxin (7%).
In the pharmacodynamic study of 531 patients with benign prostatic hyperplasia (BPH), tadalafil produced a mean maximum reduction of 17.6% in the MRT and an average decrease in the number of PE episodes per month (from a mean of 1.2 PE episodes per month) to a mean of 2.2. Tadalafil produced a mean MRT reduction of 17.5% and an MRT reduction of 10.6%, and an average decrease in the number of PE episodes per month of 2.2 to 3.5% in the group of patients taking 20 mg. In another study of 531 patients with BPH, tadalafil produced a mean MRT reduction of 5.7% and a decrease in the mean number of PE episodes of 2.1 to 3.5%, and the decrease in the number of PE episodes of 3.5% to 5.6% in the group taking 20 mg.
Mechanism of Action:Tadalafil belongs to the class of phosphodiesterase type 5 inhibitors (PDE5 inhibitors). It is used in the treatment of erectile dysfunction in men. Erectile dysfunction is the inability to keep an erection firm enough for sexual intercourse. It happens when blood flow to the penis is interrupted and the penis becomes erect by sexual stimulation. Tadalafil works by increasing the levels of a chemical called cGMP. This relaxes the muscle cells in the penis, which allows for increased blood flow. cGMP is a substance that helps to break down blood vessel wall muscles. Tadalafil relaxes these vessel muscles and allows blood to flow into the penis when sexual stimulation occurs. When sexual stimulation occurs, cGMP is released into the smooth muscle cells and is responsible for breaking down blood vessel wall muscles. Tadalafil inhibits the action of PDE5 enzymes, preventing the breakdown of cGMP. cGMP is the substance responsible for breaking down blood vessel muscles and causing the penis to become erect. Once cGMP is broken down, nitric oxide is released, which activates the enzyme guanylate cyclase. This causes the production of which is made. When cGMP is released, relaxation of smooth muscle cells occurs and allows blood to flow into the penis. Tadalafil is used to treat pulmonary arterial hypertension (PAH) in men.
PDE5 inhibitors are inhibitors of the enzyme phosphodiesterase type 5 (PDE5). This enzyme breaks down the substance responsible for erectile dysfunction, allowing more blood to flow into the penis when sexual stimulation occurs. When sexual stimulation occurs, cGMP is released into the smooth muscle cells, allowing blood to flow into the penis when sexual stimulation occurs. PDE5 is the enzyme responsible for breaking down the substance responsible for erectile dysfunction.
Erection problems (impotence) are very common, particularly in men over 40.
Most men occasionally fail to get or keep an erection. This is usually due to stress, tiredness, anxiety or drinking too much alcohol, and it’s nothing to worry about.
If it happens more often, it may be caused by physical or emotional problems.
Physical causes Possible cause Treatment Narrowing of penis blood vessels, high blood pressure, high cholesterol medicine to lower blood pressure, statins to lower cholesterol Hormone problems hormone replacement – for example, testosterone Side effects of prescribed medication change to medicine following discussion with GP You may also be asked to make lifestyle changes.
Do lose weight if you’re overweight stop smoking eat a healthy diet exercise daily try to reduce stress and anxiety
Don’t cycle for a while (if you cycle more than 3 hours a week) drink more than 14 units of alcohol a week
Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them. These effects are normally mild to moderate in nature.
If you experience any of the following side effects stop using the medicine and seek medical help immediately:
allergic reactions including rashes (frequency uncommon). chest pain – do not use nitrates but seek immediate medical assistance (frequency uncommon). priapism, a prolonged and possibly painful erection after taking CIALIS (frequency rare). If you have such an erection, which lasts continuously for more than 4 hours you should contact a doctor immediately. sudden loss of vision (frequency rare). Other side effects have been reported:
Common (seen in 1 to 10 in every 100 patients)
headache, back pain, muscle aches, pain in arms and legs, facial flushing, nasal congestion, and indigestion. Uncommon (seen in 1 to 10 in every 1,000 patients)
dizziness, stomach ache, feeling sick, being sick (vomiting), reflux, blurred vision, eye pain, difficulty in breathing, presence of blood in urine, prolonged erection, pounding heartbeat sensation, a fast heart rate, high blood pressure, low blood pressure, nose bleeds, ringing in the ears, swelling of the hands, feet or ankles and feeling tired. Rare (seen in 1 to 10 in every 10,000 patients)
fainting, seizures and passing memory loss, swelling of the eyelids, red eyes, sudden decrease or loss of hearing, hives (itchy red welts on the surface of the skin), penile bleeding, presence of blood in semen and increased sweating. Heart attack and stroke have also been reported rarely in men taking CIALIS. Most of these men had known heart problems before taking this medicine.
Partial, temporary, or permanent decrease or loss of vision in one or both eyes has been rarely reported.
Cialis contains Tadalafil, the same active ingredient as Cialis brand name.
How to useFor help, how to use it
onelinessment: take 1 tablet about 1 hour before sexual activity
avoid sexual intercourse for 7 days a week
take all prescribed tablets before intercourse
take every dose exactly as directed
Use only under proper medical supervision: duration of treatment, cause of new parasite
OverdoseThe maximum daily dose is 1 millionills.
These side effects are usually mild to moderate to severe in nature. In many reported cases toxic effects were reported including dizziness, anxiety and heart problems. Mild side effects were generally reversible after discontinuation of medicine.
Uncommon (seen in 1 to 10 in every million patients)
Rare (seen in 1 to 10 in every million patients)
This medicine is only available with a doctor’s prescription.
1.Nitrates (e.g., nitroglycerin, isosorbide dinitrate): Cialis and nitrates both lower blood pressure. Taking them together can cause a significant and potentially life-threatening drop in blood pressure (hypotension), leading to dizziness, fainting, or even heart attack or stroke. It is contraindicated to use Cialis with nitrates or recreational "poppers" (amyl nitrites).
2.Alpha-blockers (e.g., prazosin, terazosin, tamsulosin): Both Cialis and alpha-blockers relax blood vessels, which can lead to excessive blood pressure reduction when used together. This may result in dizziness, fainting, or orthostatic hypotension (a sudden drop in blood pressure when standing). If needed, your doctor may adjust the dosage or recommend spacing the medications.
3.Other antihypertensive drugs (e.g., atenolol, propranolol, enalapril, lisinopril): Cialis can enhance the blood-pressure-lowering effects of these medications. While this interaction is usually less severe than with nitrates or alpha-blockers, it can still cause dizziness or fainting in sensitive individuals. Close monitoring of blood pressure is recommended.
Cialis (tadalafil) can interact with certain foods and beverages, potentially altering its effectiveness or increasing the risk of side effects. Here are the key drug-food interactions to be aware of:
Cialis (tadalafil) can be a powerful tool for lowering blood pressure in sensitive individuals who use prescription medications containing nitrates or alpha-blockers. While it can be taken if standing, Cialis can be taken with or without food, and the medications may not be suitable if you have heart conditions or take other medications that may interact with it. Seek medical advice before taking any combined medications or due to any potential interactions with them. Due to the potential for side effects and interactions with the combination of the medications, it is recommended to start taking Cialis with a grapefruit or grapefruit-based food.atonin regulates blood pressure and can have blood pressure-lowering effects.
Cialis has been shown to cause some mild side effects. Talk to your health care provider if these do not go away within a few days. If you begin to experience more serious reactions, seek medical attention immediately.
Common side effects reported from Cialis use include:
More severe side effects include:
If you experience any of these side effects, seek medical attention immediately. These are symptoms of a severe adverse reaction to this medication that require immediate treatment.
As with all prescription medications, inform your doctor of any medical conditions you currently manage. Tell them about any and all medications, prescription drugs, and supplements you are taking before starting treatment with Cialis. Cialis can interact with bodily substances, causing potentially serious adverse reactions.
Specifically, you should inform your health care provider of any alpha-blocker, antifungal, HIV protease inhibitor, or high blood pressure medication you are taking. Remember to mention any herbal products you use, especially St. John’s wort.
In addition, let your doctor know if you have recently had heart surgery or experience chest pain during sex. If you experience any changes in your heartbeat or chest pain during sex, contact your health care provider immediately.
As with all prescription medications, inform your doctor of any medical conditions you used to get your medicine (including, you’re aware, heart failure, stroke, liver disease, kidney disease, or glaucoma).2023-08-15
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