Mechanism of action

The active substance of Tadalafil Generic Cialis 20mg is Buy Tadalafil Canada, which contributes to the inhibition of the production of the enzyme phosphodiesterase type 5 (PDE5). The enzyme (PDE5) regulates the concentration of cGMP (cyclic guanosine monophosphate) in the smooth muscles of the penis's tricky body.

After taking the pill, the concentration of cGMP increases to normal, which creates conditions for a full, healthy erection with sexual arousal. After the act of love, the penis, as expected, relaxes.

The highest concentration of the substance in the blood occurs approximately 2 hours after taking Cialis Tadalafil Tablets.

Rules of admission

The duration of the generic Cialis Tadalafil 20 Mg Tablets reaches 36 hours, but it is recommended to take a 20mg tablet 30 minutes before the intended sexual intercourse. Drink Tadalafil Eli Lilly should be water.

Per day is allowed to take no more than 40mg, the optimal dose — 1 tablet 20mg. And, as before taking any other medication, you should carefully study the instructions, namely the indications and contraindications.

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• virtually no side effects
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Clinical pharmacology

Tadalafil 40 Mg Dosage is a reversible selective inhibitor of specific PDE-5 cGMP. When sexual arousal causes local release of nitric oxide, inhibition of PDE-5 by Tadalafil Tablets India leads to an increase in the concentration of cGMP in the cavernous body of the penis. The consequence of this is the relaxation of the smooth muscles of the arteries and blood flow to the tissues of the penis, which causes an erection. Buy Cialis Tadalafil has no effect in the absence of sexual arousal.

In vitro studies have shown that Tadalafil Citrate Dosage is a selective PDE-5 inhibitor. PDE-5 is an enzyme found in the smooth muscles of the cavernous body, in the smooth muscles of the vessels of the internal organs, in skeletal muscles, platelets, kidneys, lungs and cerebellum. The effect of Cialis Tadalafil 20 Mg Tablets on PDE-5 is more active than on other PDES. Cialis Tadalafil 20 Mg Tablets is 10,000 times more powerful against PDE-5 than against PDE-1, PDE-2, PDE-4 and PDE-7, which are localized in the heart, brain, blood vessels, liver, leukocytes, skeletal muscles and other organs. Cialis Tadalafil Tablets is 10,000 times more active in blocking PDE-5 than PDE-3, an enzyme that is found in the heart and blood vessels. This selectivity for PDE-5 versus PDE-3 is important because PDE-3 is an enzyme involved in cardiac muscle contraction. In addition, Tadalafil Usa is approximately 700 times more active against PDE-5 than against PDE-6, which is found in the retina and is responsible for photo transmission. Cialis Tadalafil Tablets is also showing the action in 9000 times more potent against PDE-5 compared with its effect on PDE-8, PDE-9, PDE-10 and 14 times more potent against PDE-5 compared to PDE-11. Tissue distribution and physiological effects of PDE-8 — PDE-11 inhibition have not yet been clarified.

Cialis Tadalafil Tablets improves erection and increases the possibility of a full sexual intercourse.

Tadalafil 40 Mg Dosage in healthy individuals does not cause a significant change in sad and dad in comparison with placebo in the supine position (the average maximum decrease is 1.6/0.8 mm Hg. art respectively) and standing (mean maximum decrease of 0.2/4.6 mm Hg. art., respectively). Tadalafil Citrate Dosage does not cause a significant change in heart rate.

Tadalafil Tablets Usp 20 Mg does not cause changes in color recognition (blue/green), due to the low affinity for PDE-6. In addition, there is no effect of Tadalafil Tablets India on visual acuity, electroretinogram, intraocular pressure and pupil size.

Pharmacokinetics

The pharmacokinetics of Tadalafil Eli Lilly in patients with erectile dysfunction is similar to the pharmacokinetics of Tadalafil 5mg India in persons without erectile dysfunction. Absorption After taking Tadalafil Tablets Usp 20 Mg inside Tadalafil 10mg Dosage is rapidly absorbed. The average plasma Cmax is achieved in an average of 2 hours after ingestion. The rate and degree of absorption of Tadalafil Dosage For Erectile Dysfunction does not depend on the meal, so Tadalafil Generic Cialis 20mg can be used regardless of the meal. The time of administration (morning or evening) had no clinically significant effect on the rate and degree of absorption. The pharmacokinetics of Tadalafil Generic Cialis 20mg in healthy individuals is linear in terms of time and dose. In the dose range from 2.5 to 20 mg AUC increases in proportion to the dose. The distribution of Css in plasma is achieved within 5 days when taking Tadalafil 5mg India 1 time/day. The average Vd is about 63 liters, which indicates that Tadalafil Dosage For Erectile Dysfunction is distributed in the tissues of the body. The plasma protein binding of Cialis Tadalafil Tablets at therapeutic concentrations 94%. In healthy individuals, less than 0.0005% of the administered dose was found in sperm. Metabolism Tadalafil Citrate Dosage is mainly metabolized with the participation of CYP3A4 isoenzyme. The major circulating metabolite is methylethanolamine. This metabolite is at least 13,000 times less active against PDE5 than Tadalafil 5mg India. Therefore, the concentration of this metabolite is not clinically significant. Excretion In healthy individuals, the average clearance of Cialis Tadalafil Buy Online when administered is 2.5 l/h, and the average T1/2 - 17.5 h. Cialis Tadalafil Tablets is excreted mainly in the form of inactive metabolites, mainly with feces (about 61% of the dose) and, to a lesser extent, with urine (about 36% of the dose). Pharmacokinetics in special clinical cases, protein Binding does not change with impaired renal function. Healthy elderly patients (65 years and more) had a lower clearance of Tadalafil Eli Lilly when administered, which was expressed in an increase in AUC by 25% compared with healthy individuals aged 19 to 45 years. This difference is not clinically significant and does not require dose adjustment. In patients with renal insufficiency of mild to moderate severity dose adjustment is not required. Due to the increased exposure of Tadalafil 40 Mg Dosage (AUC), patients with severe renal insufficiency are not recommended to use Tadalafil Dosage For Erectile Dysfunction. The pharmacokinetics of Tadalafil For Erectile Dysfunction in patients with weak and moderate hepatic insufficiency is comparable to that in healthy individuals In patients with severe hepatic insufficiency (class C according to the child-Pugh classification) data are not available. When prescribing Tadalafil Dosage For Erectile Dysfunction to patients with severe liver failure, it is necessary to pre-assess the risk and benefit of using Tadalafil 10mg Dosage. In patients with diabetes mellitus during the use of Tadalafil Cialis From India AUC was less by about 19% than in healthy individuals. This difference does not require dose selection.

Dosage and administration

Inside. Use of Tadalafil 5mg India Tadalafil 10mg Dosage according to the indication of erectile dysfunction (ED). For patients with frequent sexual activity (more than 2 times a week): the recommended frequency of intake is daily, 1 time per day 5 mg, at the same time, regardless of food intake. The daily dose can be reduced to 2.5 mg, depending on individual sensitivity. For patients with infrequent sexual activity (at least 2 times a week): it is recommended to prescribe Tadalafil Usa at a dose of 20 mg, immediately before sexual activity, according to the instructions for medical use of Tadalafil For Erectile Dysfunction. The maximum daily dose of Cialis Tadalafil Buy Online is 20 mg. the Use of Cialis Tadalafil Buy Online according to the indication of BPH or ED/BPH. The recommended dose of Cialis Tadalafil 10mg Tablets when used once a day is 5 mg; Tadalafil Generic Cialis 20mg should be taken at approximately the same time of day, regardless of the time of sexual activity. The duration of treatment is set by the doctor individually. In patients with mild renal insufficiency (creatinine Cl from 51 to 80 ml/min) and moderate (creatinine Cl from 31 to 50 ml/min) dose adjustment is not required. In patients with severe renal failure (Creatinine CL <30 ml/min and hemodialysis): use of Tadalafil For Erectile Dysfunction is contraindicated.

Side effect

Most often: headache, dyspepsia. Possible: back pain, myalgia, nasal congestion, blood flow to the face. Rarely: swelling of the eyelids, pain in the eyes, conjunctival hyperemia, dizziness.

Overdose

Symptoms: with a single appointment to healthy individuals Tadalafil Cialis 20mg at a dose of up to 500 mg and patients with erectile dysfunction - repeatedly up to 100 mg/day, the undesirable effects were the same as when using Tadalafil Cialis 20mg in lower doses. Treatment: in case of overdose, standard symptomatic treatment is necessary. In hemodialysis Tadalafil Generic Cialis 20mg practically displayed.

Interaction with other drugs

Tadalafil Generic Cialis 20mg is mainly metabolized by the enzyme CYP3A4. Selective inhibitor CYP3A4 ketoconazole increases AUC by 107%, and rifampicin reduces it by 88%. Although specific interactions have not been studied, it can be assumed that protease inhibitors such as ritonavir and saquinavir, as well as CYP3A4 inhibitors such as erythromycin and Itraconazole, increase the activity of Cialis Tadalafil 20 Mg Tablets. The simultaneous administration of antacid (magnesium hydroxide/aluminium hydroxide) and Buy Tadalafil Canada reduced the rate of absorption of the latter without changing the AUC. Buy Cialis Tadalafil enhances the hypotensive effect of nitrates. This is due to the additive effect of nitrates and Tadalafil 40 Mg Dosage on the metabolism of nitric oxide and cGMP. Therefore, the use of Tadalafil Dosage For Erectile Dysfunction in patients receiving nitrates is contraindicated

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