Cialis

Generic name: Tadalafil
Brand Name: Cialis

Indications

Cialis is indicated for the treatment of erectile dysfunction.

Dosage and Administration

Cialis is available for oral administration as 2.5mg, 5mg, 10mg and 20mg tablets.

Normal Dosage:

Cialis for Use as Needed

• The recommended starting dose of Cialis for use as needed in most patients is 10 mg, taken prior to anticipated sexual activity.
• The dose may be increased to 20 mg or decreased to 5 mg, based on individual efficacy and tolerability. The maximum recommended dosing frequency is once per day in most patients.
• Cialis for use as needed was shown to improve erectile function compared to placebo up to 36 hours following dosing. Therefore, when advising patients on optimal use of Cialis, this should be taken into consideration.

Cialis for Once Daily Use

• The recommended starting dose of Cialis for once daily use is 2.5 mg, taken at approximately the same time every day, without regard to timing of sexual activity.
• The Cialis dose for once daily use may be increased to 5 mg, based on individual efficacy and tolerability.

Use with Food
Cialis may be taken without regard to food.

Overdose?

Symptoms of a Cialis Soft overdose may include chest pain, nausea, irregular heartbeat, and feeling light-headed or fainting.

Drug Description
Cialis (tadalafil), an oral treatment for erectile dysfunction, is a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5). Tadalafil has the empirical formula C22H19N3O4 representing a molecular weight of 389.41. The structural formula is:

The chemical designation is pyrazino[1′,2′:1,6]pyrido[3,4-b]indole-1,4-dione, 6-(1,3-benzodioxol-5-yl)-2,3,6,7,12,12a- hexahydro-2-methyl-, (6R,12aR)-. It is a crystalline solid that is practically insoluble in water and very slightly soluble in ethanol.

Side effects
The following Cialis side effects have been reported:

• Headache
• Back pain: In clinical trials, Back pain or myalgia was reported to occur 12 to 24 hours after dosing and typically resolved within 48 hours. This side effect was characterized by discomfort in the diffuse bilateral lumbar, gluteal, thigh, or thoracolumbar muscular discomfort. In general, the pain was reported as mild or moderate in severity and resolved without medical treatment, but severe back pain was reported infrequently (<5% of all reports).
• Colour Vision: Changes in colour vision is rare. Across all studies, (<0.1%) of patients experienced it.
• Effects on the Digestive System: Effects include diarrhea, dry mouth, dysphagia, esophagitis , abnormal liver, loose stools, nausea, upper abdominal pain, vomiting and gastroesophageal reflux.
• Nervous: Dizziness, hypesthesia, insomnia, paresthesia, somnolence and vertigo.
• Cardiovascular: Angina pectoris, chest pain, hypotension, hypertension, myocardial infarction, and palpitations.
• Musculoskeletal: Arthralgia, neck pain.
• Respiratory: Dyspnea, epistaxis and pharyngitis.
• Nasal congestion
• Flushing

There may be additional unreported Cialis side effects.

Precautions

• Avoid drinking alcohol, which can increase some of the side effects of Cialis.
• Grapefruit and grapefruit juice may interact with Cialis. Discuss the use of grapefruit products with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.
• Avoid using other medicines to treat impotence, such as alprostadil (Caverject, Muse, Edex) or yohimbine (Yocon, Yodoxin, others), without first talking to your doctor.
• CIALIS can cause your blood pressure to drop suddenly to an unsafe level if it is taken with certain other medicines. You could get dizzy, faint, or have a heart attack or stroke.
• Do not take CIALIS if you take any medicines called nitrates. Nitrates are commonly used to treat angina. Angina is a symptom of heart disease and can cause pain in your chest, jaw, or down your arm.
• You should tell all your healthcare professionals that you take Cialis. If you need emergency medical care for a heart problem, it will be important for your healthcare professionals to know when you last took Cialis.
• Before using Cialis, tell your healthcare professional if you:
• have or had heart problems
• have low blood pressure or have high blood pressure that is not controlled
• have had a stroke
• have liver problems
• have kidney problems or require dialysis
• have ever had severe vision loss
• have retinitis pigmentosa, a rare genetic (runs in families) eye disease
• have stomach ulcers
• have a bleeding problem
• have a deformed penis shape or Peyronie's disease
• have had an erection that lasted more than 4 hours
• have blood cell problems such as sickle cell anemia, multiple myeloma, or leukemia
• take medicines called "alpha blockers" (alpha blockers are sometimes prescribed for prostate problems or high blood pressure)

Drug Interactions

Do not take Cialis if you are also using a nitrate drug for chest pain or heart problems, including nitroglycerin (Nitrostat, Nitrolingual, Nitro-Dur, Nitro-Bid, Minitran, Deponit, Transderm-Nitro), isosorbide dinitrate (Dilatrate-SR, Isordil, Sorbitrate), and isosorbide mononitrate (Imdur, ISMO, Monoket), or recreational drugs such as amyl nitrate or nitrite ("poppers").
Before taking Cialis, consult your doctor about all other medications you use for erectile dysfunction, or if you are using any of the following medications:

• heart or blood pressure medications;
• cimetidine (Tagamet, Tagamet HB);
• erythromycin (E-Mycin, Eryc, Ery-Tab) or clarithromycin (Biaxin);
• doxazosin (Cardura), prazosin (Minipress), terazosin (Hytrin);
• HIV medicines such as amprenavir (Agenerase), tipranavir (Aptivus), darunavir (Prezista), efavirenz (Sustiva), nevirapine (Viramune), indinavir (Crixivan), saquinavir (Invirase, Fortovase), lopinavir/ritonavir (Kaletra), fosamprenavir (Lexiva), ritonavir (Norvir), atazanavir (Reyataz), or nelfinavir (Viracept);
• itraconazole (Sporanox) or ketoconazole (Nizoral);
• carbamazepine (Tegretol), phenobarbital (Luminal), or phenytoin (Dilantin); or
• rifampin (Rifadin, Rimactane).

This list is not complete and there may be other drugs that can interact with Cialis. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

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