Cialis 20mg
Drug is used to treat erection.
It is a reversible selective inhibitor of specific phosphodiesterase type 5 (PDE-5) cGMP. When sexual stimulation causes local release of nitric oxide, inhibition of PDE-5 tadalafilom leads to increased levels of cGMP in the cavernous body of penis. The result is relaxation of smooth muscles of arteries and blood flow to the tissues of the penis that causes an erection. Tadalafil has no effect in absence of sexual stimulation.
Studies in vitro have shown that tadalafil is a selective inhibitor of PDE-5. PDE-5 - an enzyme found in smooth muscles of cavernous bodies in the vascular smooth muscles of internal organs, skeletal muscle, platelets, kidney, lung cerebellum.
Effects of tadalafil for PDE-5 is more active than other phosphodiesterase. This selectivity against PDE-5 compared with FDE3 is important, because FDE3 is an enzyme involved in the reduction of cardiac muscle. In addition, tadalafil is approximately 700 times more active against PDE-5 than in respect FDE6 found in the retina. Tadalafil also 10 000 times more active than PDE-5, compared with its effect on FDE7-FDE10.
Tadalafil improves erection and the possibility of successful sexual intercourse.
The drug acts within 36 h. The effect is manifested as little as 16 minutes after taking the drug in the presence of sexual stimulation.
Tadalafil in healthy individuals causes no significant change in systolic and diastolic blood pressure compared with placebo in the supine position (mean maximum decrease of Cialis Table. 20 mg. ¹ 1lyaet 1.6/0.8 mm Hg, respectively) and standing (mean maximum decrease of Cialis Table. 20 mg. ¹ 1lyaet 0.2/4.6 mm Hg, respectively). Tadalafil is no significant change in heart rate.
Tadalafil does not cause changes color recognition (blue / green), which explains its low affinity for FDE6. In addition, no marked effect of tadalafil on visual acuity, electroretinogram, intraocular pressure and pupil size.
When using tadalafil in a daily dose of 10 mg found no clinically significant effect of the drug on the number and concentration of sperm motility and sperm morphology.
- Simultaneous reception of preparations containing any organic nitrates;
- Childhood and adolescence to 18 years;
- Established by Hypersensitivity to tadalafilu and other components of the drug.
Cialis pills designed to provide relief for men who are suffering from erectile dysfunction or impotency as it is more commonly known. However, in order to enjoy the benefits of Cialis 20mg, you will need to ensure that you use the tablets correctly. Many people, all too often fail to get the desired results with tadalafil because of the way they use their tablets. For the best results in Cialis medication, it is important that you take steps which will result in enhancing the effects of Cialis whilst avoiding those that will limit the results that you hope to experience.
In order to improve the effect of Cialis, you will need to pay attention to when you take your tablets. The average male begins to notice the effect of Cialis 30 minutes after he has taken the pill. You should therefore aim at taking Cialis at least an hour before the commencement of sexual activity. The effects following the taking of tadalafil tablets are found to last for at least three hours after the pill has been taken. Cialis pills should only be taken within the prescribed limits. Exceeding the dosage advised by your physician will not improve the experience of your sex or a man’s sexual stamina as is commonly wrongly claimed. Instead, by taking more than your intended dosage, you leave your system open to possible unpleasant side effects.
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The influence of other drugs on tadalafil
Tadalafil is mainly metabolized with the participation of the enzyme CYP3A4. Selective CYP3A4 inhibitor ketoconazole increase the AUC by 107%, and rifampicin reduces it by 88%.
Despite the fact that the specific interactions have not been studied, one can assume that protease inhibitors such as ritonavir and saquinavir, as well as inhibitors of CYP3A4, such as erythromycin and itraconazole, increase the activity of tadalafil.
At the same time taking an antacid (magnesium hydroxide / aluminum hydroxide) and tadalafil reduced the rate of absorption of the latter without changing its AUC.
Increasing the pH of gastric juice as a result of receiving blocker histamine H2-receptor nizatidina, no effect on the pharmacokinetics of tadalafil.
Effect of tadalafil on other drugs
Tadalafil enhances the hypotensive effect of nitrates. This is due to the additive action of nitrates and tadalafil on the metabolism of nitric oxide and cGMP. Therefore, the appointment of Cialis on a background of nitrate contraindicated.
Cialis does not have a clinically significant effect on clearance of drugs, the metabolism of which occurs with the participation of cytochrome P450 isozymes. Studies have confirmed that tadalafil does not inhibit or induce isozymes CYP3A4, CYP1A2, CYP2D6, CYP2E1, CYP2C9.
Tadalafil has no clinically significant effect on the pharmacokinetics of S-and R-warfarin. Tadalafil does not affect the action of warfarin on prothrombin time.
Tadalafil does not increase the duration of bleeding on the background of acetylsalicylic acid.
Tadalafil showed no clinically significant interaction with the major classes of antihypertensive drugs, including calcium channel blockers (amlodipine), ACE inhibitors (enalapril), beta-blockers (metoprolol), alpha-blockers, thiazide diuretics (bendoflyuazid), angiotensin receptor II, which were applied in different doses as monotherapy or in combination. There were no differences in adverse manifestations in patients treated with tadalafil in combination with other antihypertensive drugs with or without them.
There were no effect of single dose of tadalafil on the concentration of ethanol in the blood, the influence of ethanol on cognitive function and blood pressure. In addition, there was no changes in the level of concentrations tadalafil in the blood 3 h after his admission, in combination with ethanol.
Tadalafil has no clinically significant effect on the pharmacokinetics and pharmacodynamics of theophylline.
