Especially for those who want to improve their health with the high-quality drug for ED, there is Cialis that is produced by Eli Lilly. This product is manufactured in the USA and is popular all over the world due to its unique property to provide erection up to 36 hours. A table of the weekend works rather effectively. Find out more about its action and use the drug following instructions to get the best effect.
Cialis is drug for the treatment of erectile dysfunction. It is a reversible selective inhibitor of specific phosphodiesterase type 5 (PDE5) cGMP. When sexual arousal causes a local release of nitric oxide, the inhibition of PDE5 by 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 has no effect in the absence of sexual stimulation. The effect of tadalafil on PDE5 is more active than on other phosphodiesterases. Tadalafil is 10,000 times more active against PDE5 than with PDE1, PDE2, PDE4, PDE7, which are localized in the heart, brain, blood vessels, liver, leukocytes, skeletal muscles and other organs. Tadalafil 10,000 times more actively blocks PDE5 than PDE3 – an enzyme that is found in the heart and blood vessels. This selectivity for PDE5 in comparison with PDE3 is important, since PDE3 is an enzyme involved in the contraction of the heart muscle. In addition, tadalafil is approximately 700 times more active with respect to PDE5 than with PDE6, found in the retina and is responsible for photo transmission.
Tadalafil also exhibits an effect of 9000 times more potent on PDE5, compared to its effect on PDE8, at 9 and 10 and 14 times more potent for PDE5, compared with PDE11. The distribution in tissues and the physiological effects of the inhibition of PDE8-PDE11 have not yet been elucidated. Tadalafil improves the erection and the possibility of a successful sexual intercourse.
The drug acts for 36 hours. The effect manifests itself 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 pressure compared with placebo in the supine position (mean maximum decrease is 1.6 / 0.8 mmHg, respectively) and standing (the mean maximum decrease 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. Tadalafil does not cause changes in the level of testosterone, LH and FSH in the blood plasma. There was no clinically significant effect on sperm characteristics in men taking tadalafil in daily doses for 6 months in placebo-controlled studies.
After oral administration, Cialis is rapidly absorbed. Cmax is achieved on average after 2 hours. The speed and degree of absorption are independent of food intake. The time of taking the drug has no clinically significant effect on speed and degree of absorption. The pharmacokinetics of tadalafil in healthy individuals is linear with respect to time and dose. In the dose range of 2.5 to 20 mg, the AUC increases in proportion to the dose. Css in the plasma are reached within 5 days with the drug taken 1 time / day. The pharmacokinetics of Tadalafil in patients with impaired function of erection is similar to the pharmacokinetics of the drug in persons without a violation of the function of erection.
Pharmacokinetics in special clinical cases
Healthy elderly people (65 years and over) have a lower clearance of tadalafil, which is expressed in an AUC increase of 25% compared with healthy individuals aged 19 to 45 years.
The drug is taken orally. The recommended maximum dose of Cialis is 20 mg. The maximum recommended frequency of reception is 1 time / day. Cialis is taken at least 16 minutes before you plant to have sexual intercourse.
Patients can attempt to have intercourse at any time within 36 hours after taking the drug in order to establish an optimal response time for taking the drug.
Contraindications Cialis have
Use of Cialis in men with the violations of liver function
Patients with impaired renal liver function are not required to select a specific dose. Since there are no data from controlled clinical trials on the safety and efficacy of Cialis in patients with severe hepatic insufficiency, use the drug in this category of patients with extreme caution and only in case of emergency.
Use of Cialis in men with the violations of kidney function
Patients with impaired renal function (CK> 30 ml / min) do not need a special dose selection. Against the backdrop of treatment with Cialis, patients with moderate renal insufficiency (CK 31 to 50 ml / min) were more likely to have backache than patients with mild renal insufficiency (KC 51 to 80 ml / min) or healthy volunteers . Patients with KK-50 ml / min should be given caution. Since there are no data from controlled clinical trials on the safety and efficacy of Cialis in patients with severe renal insufficiency (CK ≥ 30 mL / min), the drug should be used with caution in this category of patients only if absolutely necessary.
With a single appointment to healthy volunteers at a dose of 500 mg / day and patients with erectile dysfunction – repeatedly to 100 mg / day, the undesirable effects were the same as with the use of the drug in lower doses.Treatment: Conventional symptomatic therapy. With hemodialysis, Tadalafil is practically not excreted.