Dosage and administration
Inside. Use of Cialis Tadalafil 20 Mg Tablets Tadalafil Dosage For Erectile Dysfunction 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 Cialis Tadalafil 20 Mg Tablets at a dose of 20 mg, immediately before sexual activity, according to the instructions for medical use of Tadalafil Tablets Usp 20 Mg. The maximum daily dose of Tadalafil 5mg India is 20 mg. the Use of Tadalafil 5mg India according to the indication of BPH or ED/BPH. The recommended dose of Tadalafil Tablets Usp 20 Mg when used once a day is 5 mg; Cialis Tadalafil 20 Mg 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 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 Eli Lilly 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 Eli Lilly 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 Buy Tadalafil Canada 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 Citrate Dosage 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 Tadalafil Citrate Dosage. The simultaneous administration of antacid (magnesium hydroxide/aluminium hydroxide) and Buy Cialis Tadalafil reduced the rate of absorption of the latter without changing the AUC. Tadalafil Citrate Dosage enhances the hypotensive effect of nitrates. This is due to the additive effect of nitrates and Cialis Tadalafil Tablets on the metabolism of nitric oxide and cGMP. Therefore, the use of Buy Tadalafil Canada in patients receiving nitrates is contraindicated
Pharmacological action
Cialis Tadalafil 20 Mg Tablets for the treatment of erectile dysfunction. Cheap Generic Tadalafil is a reversible selective inhibitor of cyclic guanosine monophosphate (cGMP) PDE5. When sexual arousal causes local release of nitric oxide, inhibition of PDE5 by Cheap Generic Tadalafil 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. Cialis Tadalafil Buy Online has no effect in the absence of sexual arousal.
In vitro studies have shown that Buy Cialis Tadalafil is a selective PDE5 inhibitor. PDE5 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 Generic Cialis 20mg on PDE5 is more active than on other PDES. Tadalafil Dosage For Erectile Dysfunction is 10,000 times more potent against PDE5 than against PDE1, PDE2, PDE4 and PDE7, which are localized in the heart, brain, blood vessels, liver, leukocytes, skeletal muscles and other organs. Buy Cialis Tadalafil is 10,000 times more active in blocking PDE5 than PDE3, an enzyme that is found in the heart and blood vessels. This selectivity concerning PDE5 compared to ФДЭ3 is important because ФДЭ3 is an enzyme participating in the reduction of cardiac muscle. In addition, Tadalafil Citrate Dosage is approximately 700 times more active against PDE5 than against PDE6 found in the retina and responsible for photo transmission. Buy Cialis Tadalafil is also showing the action in 9000 times more potent against PDE5 compared to its effect on PDE8, PDE9 and PDE10, and 14 times more potent against PDE5 compared to PDE11. Tissue distribution and physiological effects of inhibition of PDE8 - PDE11 have not yet been clarified.
Tadalafil Generic Cialis 20mg improves erection and increases the possibility of a full sexual intercourse.
Buy Tadalafil Canada in healthy individuals does not cause a significant change in systolic and diastolic pressure in comparison with placebo in the supine position (the average maximum decrease is 1.6/0.8 mm Hg. respectively) and in the standing position (the average maximum decrease is 0.2/4.6 mm Hg. art., respectively). Tadalafil Tablets India does not cause a significant change in heart rate. Tadalafil Tablets India does not cause changes in color recognition (blue/green), due to its low affinity for PDE6. In addition, there is no effect of Tadalafil Cialis From India on visual acuity, electroretinogram, intraocular pressure and pupil size.
Several studies have been conducted to assess the effect of daily Tadalafil Generic 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 Tadalafil Cialis 20mg compared to placebo.
The efficacy and safety of Cialis Tadalafil 10mg 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 Tadalafil Citrate Dosage 1 time/day. In studies of the primary efficacy of Tadalafil For Erectile Dysfunction at a dose of 5 mg, 62% and 69% of sexual intercourse attempts were successful compared to 34% and 39% of placebo patients. Tadalafil For Erectile Dysfunction at a dose of 5 mg significantly improved erectile function for 24 hours between doses.
It is known that Tadalafil Tablets Usp 20 Mg increases 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 (NO) and cGMP. Therefore, the use of Tadalafil Cialis 20mg in patients receiving nitrates is contraindicated.
Tadalafil Dosage For Erectile Dysfunction does not have a clinically significant effect on the clearance of drugs whose metabolism occurs with the participation of cytochrome P450. Studies have confirmed that Tadalafil 40 Mg Dosage does not inhibit or induce isoenzymes CYP1A2, CYP3A4, CYP2C9, CYP2C19, CYP2D6, CYP2E1.
Cialis Tadalafil Tablets does not have a clinically significant effect on the pharmacokinetics of S-warfarin or R-warfarin. Tadalafil Citrate Dosage does not affect the action of warfarin against PV.
Tadalafil 40 Mg Dosage does not increase the duration of bleeding caused by acetylsalicylic acid.
Tadalafil Usa has systemic vasodilating properties and can enhance the effect of antihypertensive drugs aimed at reducing blood PRESSURE.
In addition, patients who took several antihypertensive drugs, in which hypertension was poorly controlled, there was a slightly greater decrease in blood PRESSURE. In the vast majority of patients, this decrease was not associated with hypotensive symptoms. Patients receiving treatment with antihypertensive drugs and taking Cialis Tadalafil Buy Online should be given appropriate clinical recommendations.
Did not observed a significant reduction in blood pressure in the application of Tadalafil Dosage For Erectile Dysfunction in healthy individuals taking selective альфа1А-blocker tamsulosin on the results of two clinical studies.
Coadministration of Buy Cialis Tadalafil with doxazosin is contraindicated. When using Tadalafil Tablets Usp 20 Mg healthy volunteers, taking doxazosin (4-8 mg/day), alfa1-adrenoblokator, there was an increase in the hypotensive effect of doxazosin. Some patients experienced symptoms associated with a decrease in blood PRESSURE, including fainting.
Tadalafil Tablets India did not affect the concentration of alcohol, nor did alcohol affect the concentration of Buy Tadalafil Canada. At high doses of alcohol (0.7 g/kg), Tadalafil Eli Lilly did not cause a statistically significant decrease in the average blood PRESSURE. Some patients had postural dizziness and orthostatic hypotension. When taking Tadalafil Usa in combination with lower doses of alcohol (0.6 g/kg), a decrease in blood PRESSURE was not observed, and dizziness arose with the same frequency as when taking one alcohol.
Tadalafil Cialis From India has no clinically significant effect on the pharmacokinetics or pharmacodynamics of theophylline.
Pharmacokinetics
The pharmacokinetics of Cialis Tadalafil Tablets in patients with erectile dysfunction is similar to the pharmacokinetics of Tadalafil Dosage For Erectile Dysfunction in persons without erectile dysfunction.
Suction
After taking Cialis Tadalafil 10mg Tablets inside Tadalafil Usa is rapidly absorbed. The average plasma Cmax is achieved in an average of 2 hours after ingestion. The rate and degree of absorption of Cialis Tadalafil Tablets 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 Buy Cialis Tadalafil 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.
Distribution
Css in plasma are attained within 5 days while taking Cialis Tadalafil 10mg Tablets 1 time/day.
The average Vd is about 63 liters, which indicates that Buy Cialis Tadalafil is distributed in the tissues of the body.
The plasma protein binding of Buy Cialis Tadalafil 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 the CYP3A4 isoenzyme. The major circulating metabolite is methylethanolamine. This metabolite is at least 13,000 times less active against PDE5 than Cialis Tadalafil Buy Online. Therefore, the concentration of this metabolite is not clinically significant.
Breeding
In healthy individuals, the average clearance of Buy Tadalafil Canada when administered is 2.5 l/h, and the average T1/2 - 17.5 h. Tadalafil 5mg 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
Binding to proteins does not change with impaired renal function.
Healthy elderly patients (65 years and more) had a lower clearance of Tadalafil Dosage For Erectile Dysfunction 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 Dosage For Erectile Dysfunction (AUC), patients with severe renal insufficiency are not recommended to use Tadalafil Cialis 20mg®.
The pharmacokinetics of Tadalafil Cialis From India 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 Cialis Tadalafil 10mg Tablets® patients with severe liver failure must first assess the risk and benefit of Tadalafil 5mg India.
In patients with diabetes mellitus during the use of Tadalafil Eli Lilly AUC was less by about 19% than in healthy individuals. This difference does not require dose selection.
Tadalafil Cialis From India
