Clinical pharmacology

Cialis Tadalafil Tablets is a reversible selective inhibitor of specific PDE-5 cGMP. When sexual arousal causes local release of nitric oxide, inhibition of PDE-5 by Cialis Tadalafil 20 Mg Tablets 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. Tadalafil 10mg Dosage has no effect in the absence of sexual arousal.

In vitro studies have shown that Tadalafil Dosage For Erectile Dysfunction 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 Tadalafil Tablets Usp 20 Mg 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. Tadalafil Citrate Dosage 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 5mg India 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. Tadalafil Cialis From India 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.

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

Tadalafil For Erectile Dysfunction 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 Cialis 20mg does not cause a significant change in heart rate.

Tadalafil 40 Mg Dosage does not cause changes in color recognition (blue/green), due to the low affinity for PDE-6. In addition, there is no effect of Buy Cialis Tadalafil on visual acuity, electroretinogram, intraocular pressure and pupil size.

Dosage and administration

Inside. Use of Cialis Tadalafil Tablets Cialis Tadalafil 10mg Tablets 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 Tablets Usp 20 Mg at a dose of 20 mg, immediately before sexual activity, according to the instructions for medical use of Buy Cialis Tadalafil. The maximum daily dose of Tadalafil 10mg Dosage is 20 mg. the Use of Tadalafil 40 Mg Dosage according to the indication of BPH or ED/BPH. The recommended dose of Tadalafil Generic Cialis 20mg when used once a day is 5 mg; Tadalafil Dosage For Erectile Dysfunction 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 Cialis From India 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 Cialis Tadalafil Buy Online 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 Tablets India in lower doses. Treatment: in case of overdose, standard symptomatic treatment is necessary. In hemodialysis Tadalafil Cialis 20mg practically displayed.

Interaction with other drugs

Tadalafil Dosage For Erectile Dysfunction 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 Tablets. The simultaneous administration of antacid (magnesium hydroxide/aluminium hydroxide) and Cialis Tadalafil 20 Mg Tablets reduced the rate of absorption of the latter without changing the AUC. Tadalafil 10mg Dosage enhances the hypotensive effect of nitrates. This is due to the additive effect of nitrates and Cialis Tadalafil 10mg Tablets on the metabolism of nitric oxide and cGMP. Therefore, the use of Tadalafil 5mg India in patients receiving nitrates is contraindicated

Clinical pharmacology

Several studies have been conducted to assess the effect of daily Tadalafil Cialis 20mg on spermatogenesis. None of the studies showed an undesirable effect on the morphology of sperm and their mobility. One study found a decrease in the average sperm concentration compared to placebo. A decrease in sperm concentration was associated with a higher ejaculation rate. In addition, there was no undesirable effect on the average concentration of sex hormones, testosterone, LH and FSH when taking Buy Tadalafil Canada compared to placebo.

The efficacy and safety of Cialis Tadalafil Tablets (at doses of 2.5 mg and 5 mg) was studied in clinical trials. There was an improvement in erection in patients with erectile dysfunction of all degrees of severity when taking Cialis Tadalafil Buy Online 1 time per day. In studies of the primary efficacy of Tadalafil Generic Cialis 20mg at a dose of 5 mg, 62% and 69% of sexual intercourse attempts were successful compared to 34% and 39% of placebo patients. Taking Tadalafil Cialis 20mg at a dose of 5 mg significantly improved erectile function for 24 hours between doses.

The mechanism of action of Tadalafil Eli Lilly in patients with BPH — inhibition of PDE-5 Tadalafil 5mg India, leading to an increase in the concentration of cGMP in the cavernous body of the penis, is also observed in the smooth muscles of the prostate, bladder and blood vessels that supply them. Relaxation of the smooth muscles of the vessels leads to an increase in blood perfusion in these organs and as a consequence — to reduce the severity of symptoms of BPH. Relaxation of the smooth muscles of the prostate and bladder can further enhance vascular effects.

The use of Tadalafil For Erectile Dysfunction Tadalafil Cialis From India according to 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 may 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 Buy Cialis Tadalafil at a dose of 20 mg, immediately before sexual activity, according to the instructions for medical use of Tadalafil Cialis From India. The maximum daily dose of Tadalafil Usa is 20 mg.

The use of Tadalafil 40 Mg Dosage Buy Cialis Tadalafil for indication of BPH or ED/BPH.The recommended dose of Cialis Tadalafil 10mg Tablets when used once a day is 5 mg; Cialis Tadalafil Tablets 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 renal insufficiency of mild severity (creatinine Cl from 51 to 80 ml/min) and moderate severity (creatinine Cl from 31 to 50 ml/min) dose adjustment is not required.

In patients with severe renal insufficiency (Creatinine CL <30 ml/min and hemodialysis):the use of Tadalafil Tablets India once a day is not recommended.

Pharmacokinetics

The pharmacokinetics of Tadalafil Generic Cialis 20mg in patients with erectile dysfunction is similar to the pharmacokinetics of Buy Cialis Tadalafil in persons without erectile dysfunction. Absorption After taking Buy Cialis Tadalafil inside Tadalafil Generic Cialis 20mg 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 Citrate Dosage does not depend on the meal, so Tadalafil Dosage For Erectile Dysfunction 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 Cialis Tadalafil Tablets 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 Buy Cialis Tadalafil 1 time/day. The average Vd is about 63 liters, which indicates that Cheap Generic Tadalafil is distributed in the tissues of the body. The plasma protein binding of Tadalafil For Erectile Dysfunction at therapeutic concentrations 94%. In healthy individuals, less than 0.0005% of the administered dose was found in sperm. Metabolism Cialis Tadalafil 20 Mg Tablets 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 Cheap Generic Tadalafil. Therefore, the concentration of this metabolite is not clinically significant. Excretion In healthy individuals, the average clearance of Tadalafil Generic Cialis 20mg when administered is 2.5 l/h, and the average T1/2 - 17.5 h. Tadalafil Cialis From India 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 Citrate Dosage 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 Cialis From India (AUC), patients with severe renal insufficiency are not recommended to use Tadalafil Usa. The pharmacokinetics of Buy Cialis Tadalafil 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 Usa to patients with severe liver failure, it is necessary to pre-assess the risk and benefit of using Cialis Tadalafil Tablets. In patients with diabetes mellitus during the use of Tadalafil Tablets Usp 20 Mg AUC was less by about 19% than in healthy individuals. This difference does not require dose selection.

Tadalafil Tablets Usp 20 Mg