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Cialis - instructions for use, reviews, generics and dosage forms (tablets of 2.5 mg, 5 mg and 20 mg) of the drug for the treatment of erectile dysfunction and restoration of potency in men. The composition and effect of alcohol on the pharmacokinetics

Cialis - instructions for use, reviews, generics and dosage forms (tablets of 2.5 mg, 5 mg and 20 mg) of the drug for the treatment of erectile dysfunction and restoration of potency in men. The composition and effect of alcohol on the pharmacokinetics

In this article, you can read the instructions for using the drug Cialis. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Cialis in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Cialis in the presence of existing structural analogues. Use to treat erectile dysfunction and restore potency in men.The composition and effect of alcohol on the pharmacokinetics of the drug.

 

Cialis - The drug for the treatment of erectile dysfunction. It is a reversible selective inhibitor of specific phosphodiesterase type 5 (PDE5) cGMP. When sexual stimulation causes local release of nitric oxide, inhibition of PDE5 with Tadalafil leads to an increase in the level of cGMP in the cavernous body of the penis. The consequence of this is the relaxation of the smooth muscles of the arteries and the flow of blood to the tissues of the penis, which causes an erection. Tadalafil (the active ingredient of Cialis) has no effect in the absence of sexual stimulation.

 

In vitro studies have shown that tadalafil is a selective inhibitor of PDE5. PDE5 is an enzyme found in the smooth muscles of the cavernous body, in the smooth muscles of the vessels of internal organs, in skeletal muscles, platelets, kidneys, lungs, and the cerebellum.

 

Cialis improves the erection and the possibility of a successful sexual intercourse.

 

The drug acts for 36 hours. The effect manifests itself already 16 minutes after taking the drug in the presence of sexual arousal.

 

Tadalafil in healthy individuals does not cause a significant change in systolic and diastolic blood pressure, compared with placebo, in the prone position (the average maximum BP reduction is 1.6 / 0.8 mm Hg.respectively) and standing (the average maximum BP reduction is 0.2 / 4.6 mmHg, respectively). Tadalafil does not cause a significant change in heart rate.

 

Tadalafil does not cause changes in color recognition (blue / green), which is explained by its low affinity for PDE6. In addition, there is no evidence of tadalafil's influence on visual acuity, electroretinogram, intraocular pressure and pupil size.

 

To assess the effect of tadalphil with a daily intake of spermatogenesis, several studies have been carried out. None of the studies showed an undesirable effect on the morphology of spermatozoa and their mobility. In one study, a decrease in the average concentration of spermatozoa was found compared with placebo. Reducing the concentration of spermatozoa was associated with a higher incidence of ejaculation. In addition, tadalafil did not cause undesirable changes in the content of testosterone, LH and FSH in blood plasma, compared with placebo.

 

Composition

 

Tadalafil + auxiliary substances.

 

Pharmacokinetics

 

After ingestion, Cialis is rapidly absorbed. The speed and degree of absorption do not depend on the intake of food.The time of taking the drug (morning or evening) has no clinically significant effect on speed and degree of absorption.

 

In therapeutic concentrations, 94% of tadalafil binds to plasma proteins. In healthy individuals, less than 0.0005% of the administered dose is found in the sperm.

 

Tadalafil is excreted mainly in the form of inactive metabolites, mainly with feces (about 61%) and to a lesser extent with urine (about 36%).

 

Indications

  • erectile dysfunction.

 

Forms of release

 

Tablets, film-coated 2.5 mg, 5 mg and 20 mg.

 

Instructions for use and reception scheme

 

The drug is taken orally, regardless of food intake.

 

The recommended maximum dose of Cialis is 20 mg. The maximum recommended frequency of admission is 1 time per day.

 

Cialis is taken at least 16 minutes before the alleged sexual activity.

 

Patients can attempt to have intercourse at any time within 36 hours after taking the drug in order to establish the optimal response time for taking the drug.

 

Side effect

  • headache;
  • backache;
  • myalgia;
  • dizziness;
  • nasal congestion;
  • flushes of blood to the face;
  • dyspepsia;
  • swelling of the eyelids;
  • Pain in the eyes;
  • hyperemia of the conjunctiva;
  • hypersensitivity reactions (including rashes, hives and swelling of the face, Stevens-Johnson syndrome and exfoliative dermatitis);
  • arterial hypotension (in patients who have already taken antihypertensive drugs);
  • hypertension;
  • hyperhidrosis (increased sweating);
  • priapism and delayed erection;
  • blurry vision;
  • non-arterial anterior ischemic optic nerve neuropathy;
  • retinal vein occlusion;
  • violation of visual fields;
  • nose bleed;
  • myocardial infarction;
  • sudden cardiogenic death;
  • stroke;
  • chest pain;
  • tachycardia.

 

Contraindications

  • simultaneous administration of drugs containing any organic nitrates;
  • use in persons under the age of 18;
  • hypersensitivity to the components of the drug.

 

Application in pregnancy and lactation

 

The drug is not intended for use in women.

 

special instructions

 

Caution should be given to patients with severe hepatic insufficiency (class C on the Child-Pugh scale), as there are no data from controlled clinical trials on the safety and efficacy of Cialis in this category of patients.

 

Caution should be exercised when administering Cialis to patients taking alpha1-adrenergic blockers, such as doxazosin, since simultaneous use in some cases can lead to symptomatic arterial hypotension. In the study of clinical pharmacology in 18 healthy volunteers who took tadalafil in a single dose, no symptomatic arterial hypotension was observed with the simultaneous administration of alpha1-adrenoblocker tamsulosin.

 

Sexual activity has a potential risk for patients with cardiovascular disease. Therefore, the treatment of erectile dysfunction, incl. with the use of Cialis, should not be performed in men with heart diseases in which sexual activity is not recommended.

 

The potential risk of developing complications associated with sexual activity in patients with cardiovascular disease should be considered: myocardial infarction within the last 90 days; unstable angina or angina arising during intercourse; chronic heart failure (2 functional class and higher according to the NYHA classification),developed over the past 6 months; uncontrolled disturbances of the heart rhythm; arterial hypotension (BP less than 90/50 mm Hg) or uncontrolled hypertension; stroke, lasting for the last 6 months.

 

Precautions should be used Cialis in patients with severe renal impairment (creatinine clearance less than 30 mL / min), renal insufficiency moderate severity (QC from 31 to 50 ml / min), patients with predisposition to priapism (e.g., sickle cell anemia, multiple myeloma or leukemia) or in patients with anatomical deformation of the penis (e.g., angulation, cavernous fibrosis or Peyronie's disease).

 

There have been reports of the occurrence of priapism with the use of PDE5 inhibitors, including Cialis. The patient should be informed of the need to seek immediate medical attention in the event of an erection lasting 4 hours or more. Untimely treatment of priapism leads to damage to the tissues of the penis, as a result of which a long-term loss of potency may occur.

 

The safety and effectiveness of the combination of Cialis with other treatments for erectile dysfunction have not been studied. Therefore, the use of such combinations is not recommended.

 

Like other PDE5 inhibitors, tadalafil has systemic vasodilator properties, which can lead to a transient decrease in blood pressure. Before the appointment of Cialis, doctors should carefully consider whether patients with cardiovascular disease will not be exposed to such vasodilating effects.

 

Non-arterial anterior ischemic optic neuropathy (NAPION) is the cause of visual impairment, including complete loss of vision. There are rare post-marketing reports on cases of development of NAPION, in time associated with the intake of PDE5 inhibitors. It is not at present possible to determine whether there is a direct link between the development of NAPION and the intake of PDE5 inhibitors or other factors. Doctors should recommend to patients in case of sudden loss of vision stop taking tadalphil and seek medical help. Patients should be warned that people who have undergone NAPION have an increased risk of developing this condition again.

 

Impact on the ability to drive vehicles and manage mechanisms

 

Despite the fact that the incidence of dizziness against the background of placebo and Cialis is the same, during the treatment patients should be careful when driving vehicles and engage in other potentially dangerous activities that require increased concentration and speed of psychomotor reactions.

 

Drug Interactions

 

The effect of other drugs on tadalafil

 

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

 

An increase in the pH of the gastric juice as a result of taking the histamine H2 receptor blocker Nizatidine does not affect the pharmacokinetics of tadalafil.

 

Effect of tadalafil on other drugs

 

Cialis increases 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 appointment of Cialis against the background of the use of nitrates is contraindicated.

 

Tadalafil has no clinically significant effect on the clearance of drugs whose metabolism occurs with the participation of cytochrome P450 isoenzymes.Studies have confirmed that tadalafil does not inhibit and induce isoenzymes CYP3A4, CYP1A2, CYP2D6, CYP2E1, CYP2C9, CYP2C19.

 

Tadalafil does not have a clinically significant effect on the pharmacokinetics of S-and R-warfarin. Tadalafil does not affect the effect of Warfarin on prothrombin time.

 

Cialis does not increase the duration of bleeding against the background of the action of acetylsalicylic acid.

 

Tadalafil has systemic vasodilating properties and can enhance the effect of antihypertensive drugs aimed at reducing blood pressure. Additionally, in patients taking several antihypertensive agents, in whom hypertension was poorly controlled, there was a somewhat greater reduction in blood pressure. In the vast majority of patients, these decreases were not associated with hypotensive symptoms. Patients receiving treatment with antihypertensive drugs and taking tadalafil should be given appropriate clinical recommendations.

 

There was no significant reduction in blood pressure when tadalafil was used concomitantly with selective alpha1A-adrenoblocker tamsulosin.

 

When tadalafil was used by healthy volunteers who took alpha-1-adrenoblocker Doxazosin (8 mg per day),an increase in the hypotensive effect of doxazosin was observed. Some patients experienced dizziness. No cases of syncope were observed. Lower doses of doxazosin have not been studied.

 

Cialis did not affect the concentration of ethanol (alcohol), nor did ethanol (alcohol) affect the concentration of tadalafil. At high doses of ethanol (0.7 g / kg), the administration of tadalafil did not cause a statistically significant decrease in the average blood pressure. In some patients, postural dizziness and orthostatic hypotension were observed. When tadalafil was administered in combination with lower doses of ethanol (0.6 g / kg), arterial hypotension was not observed, and dizziness occurred with the same frequency as the intake of alcohol alone.

 

Tadalafil does not have a clinically significant effect on the pharmacokinetics and pharmacodynamics of theophylline.

 

Analogues of the drug Cialis

 

Structural analogs for the active substance:

  • Tadag (in gelatin capsules);
  • Tadajoi;
  • Tadarayz;
  • Tadasoft.

 

Analogues on the therapeutic effect (potency regulators):

  • Afrodor 2000;
  • Veromax;
  • Verona;
  • Viagra;
  • Viasan-LF;
  • Vigrande;
  • Vizarsin;
  • Dynamics;
  • Zidena;
  • The Impaza;
  • Iohimbin "Der Spiegel";
  • Yohimbine hydrochloride;
  • Levitra;
  • Maxigra;
  • Muse;
  • Reilis;
  • Sildenafil citrate;
  • Spem;
  • Spemann forte;
  • Super Yohimbe-Plus;
  • Tentex forte;
  • Testalamine;
  • Himkoline;
  • Edex.

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Reviews (6):
Guests
Alexander
I'm not that young, but the problem that caught me took me by surprise, I always had everything excellent in sexual terms, but here's the problem, I did not know what to do, an erection is missing if there is a desire. I, of course, went to the doctor and passed all the tests, it was the cause, the nerves. How to be? To me the doctor has advised a raylis, a natural agent, long action. after the course of admission everything was normalized and all my male functions came back to normal, now I'm a man) and I'm calm
Guests
George
Normal riser on the cialis. As in the young. The truth is that I do not act right away, I once pierced it when I invited a friend, and I took it right before sex, eventually a bummer.
Guests
Michael
I was 63. There was almost complete loss of erection. With Cialis almost recovered. Side effect - long does not come orgasm. And the sensations are less acute. Operates no more than 5 hours, and not 36 as in the instruction.
Guests
ayrate
good thing))
Visitors
sonilloazy
Cialis no longer accept. It was enough once. After taking the drug, his nose was flushed and his face flushed. And it lasted two days.
Guests
Dmytro
Hello, I'm 54 years old. Before sialis took Viagra. Honestly, the effect is much better and health, too. Now I accept generics, the price is lower - the effect is the same wink

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