Cialis

Cialis is an agent for the erectile dysfunction treatment. Tadalafil belongs to a reversible selective inhibitor of specific PDE5 cGMP. Sexual excitement in combination with this ED drug causes local release of nitric oxide and inhibition of PDE5. Such a combination contributes to an increase in cGMP levels in the corpus cavernosum. This operation leans to the relaxation of the smooth muscles of the arteries and increases the blood flow to the penile tissues. In such a way, it causes an erection. Cialis (Tadalafil) is ineffective in the absence of sexual stimulation.

Indications

Erectile dysfunction

Mode of application and dosage

Oral application. For patients with infrequent sexual activity (less than twice a week), it is recommended to prescribe Cialis at a dose of 20 mg, immediately before sexual activity, according to the instructions for use. The maximum daily dose is 20 mg. It may be reduced to 10 mg.

Contraindications

Hypersensitivity to tadalafil or to any drug components;
The combination with medications containing any organic nitrates;
Men under 18 years of age;
The contraindications to sexual activity in patients with diseases of the cardiovascular system: myocardial infarction within the last 90 days, unstable angina pectoris, the occurrence of an angina pectoris attack
during intercourse, chronic heart failure of classes II-IV according to NYHA classification, uncontrolled arrhythmias, arterial hypotension ( BP less than 90/50 mm Hg), uncontrolled arterial hypertension, ischemic stroke within the last 6 months;
Loss of vision due to non-arterial anterior ischemic neuropathy of the optic nerve;
Concomitant use of doxazosin, as well as drugs for the treatment of erectile dysfunction;
More than 2 times a week use in patients with chronic renal failure (creatinine clearance less than 30 ml/min);
Lactose deficiency, lactose intolerance, glucose-galactose malabsorption.

Side effects

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

Most often adverse reactions:

headache (11%);
dyspepsia (7%).

Possible side effects:

backache;
myalgia;
nasal congestion;
face flushing.

Rare side effects:

swelling of the eyelids;
pain in the eyes;
hyperemia of the conjunctiva;
dizziness.

Very rare side reactions:

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;
violation of visual fields.

The cardiovascular system side effects are:

cardiovascular risk factors – myocardial infarction;
sudden cardiogenic death;
stroke, chest pain;
palpitations;
tachycardia.

However, it is impossible to determine with certainty whether these events are directly related to these risk factors of tadalafil, sexual arousal, or a combination of these or other factors.

Overdose

A single appointment of tadalafil to healthy individuals at a dose of up to 500 mg and to patients with erectile dysfunction – repeatedly up to 100 mg / day provokes the same undesirable effects as when using lower doses.

In case of overdose, it is necessary to carry out standard symptomatic treatment. With hemodialysis, tadalafil is practically not excreted.

The effect on the ability to drive vehicles and operate mechanisms

Despite the fact that the incidence of dizziness on the background of placebo and tadalafil is the same, during the treatment period, be cautious when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.