Having looked at the shelves of pharmacies, where goods related to men’s intimate health are located, with a high probability, in addition to condoms and lubricants, you will see a medicine called Cialis there. What is it and what is it used for?
Cialis, produced in form of pills, is a medication that belong to PDE-5 inhibitors, like the slightly better known Viagra. It is used to increase potency, i.e. for the treatment of erectile dysfunction (ED) of various etiology. According to the official classification, the main indication for the use of Cialis is designated as insufficiency of the genital reaction. In addition, this drug is used to reduce the symptoms of benign prostatic hyperplasia (BPH), in particular, urination difficulty.
Branded Cialis is manufactured in the USA by the pharmaceutical company Eli Lilly. This drug was approved by the FDA for the treatment of erectile dysfunction in 2003, and in 2011 the same organization recognized its effectiveness in treating BPH.
How And Why Does Cialis (Tadalafil) Work?
The effect of Cialis on an erection is based on the properties of its main active ingredient – Tadalafil. This substance is a reversible selective inhibitor of cGMP-specific enzyme PDE-5, responsible for termination of an erection in men. With the onset of sexual arousal, accompanied by the release of nitric oxide in the cavernous bodies of the penis, Tadalafil begins to inhibit the enzyme PDE-5. This leads to an increase in the concentration of cGMP in the cavernous bodies, relaxation of the smooth muscles of the arteries and increased blood flow to the penis, due to which an erection occurs. In the absence of sexual arousal, Cialis doesn’t cause an erection.
Cialis begins to act approximately 20-30 minutes after the intake. This medicine is a record holder for the duration of action, it can reach 36 hours. After taking the pill of Cialis, men experience a stronger and longer erection than usual, while the period of refraction between intercourse is also reduced. This allows you to normalize your sex life and please your partner and yourself.
What Is The Status of Dispensing Cialis (Tadalafil) from Pharmacies?
In most countries, including the United States, Cialis is a prescription drug. Therefore, before purchasing this medicine, it is recommended to visit an urologist and get a prescription. Consultation with a doctor is also important because a number of patients are contraindicated in taking this medication, and a specialist will be able to detect if you have diseases in which taking Cialis is undesirable. In addition, this medicine is not a universal solution to all problems with potency. It happens that a medical examination reveals such causes of erectile dysfunction that require a completely different treatment – for example, a malfunction of the thyroid gland or a lack of testosterone. Despite the fact that Cialis is effective in most cases of psychogenic erectile dysfunction, there are also situations in which the optimal treatment is psychotherapy, rather than taking pills to improve potency.
What Are The Dosages of Tadalafil?
Like most other PDE-5 inhibitors, Cialis is available in three dosage options: 5, 10 and 20 mg. The minimum dosage is used to eliminate weak manifestations of erectile dysfunction, the average is suitable for the successful treatment of most cases of weakened potency, and the maximum is used to achieve the strongest result in the shortest possible time. 5 mg pills seldom last longer than 24 hours, while 10 and 20 mg pills last for up to one and a half days.
Most often, doctors prescribe taking Cialis in a dosage of 10 mg, since this dosage is optimal in terms of the ratio of its effectiveness and the severity of side effects. If it turns out to be more than enough, it can be reduced to 5 mg, and in case of insufficient efficiency it is increased to 20 mg. Please note that 20 mg is the maximum permitted daily dosage of Tadalafil.
Given that older men (over 65) usually have more concomitant diseases and tend to experience more severe side effects from taking Tadalafil, the optimal dosage for Cialis is from 5 to 10 mg. However, everything is individual, and in order to determine which dosage and regimen of taking are suitable for a particular patient, it is recommended to consult a doctor.
What Are Dosage Regimens of Cialis?
Unlike other PDE-5 inhibitors which are used only directly before sex, Cialis can be taken both on demand and on a regular basis.
Intake of this drug on demand means that the patient takes a pill shortly before sex, this method is suitable for men who have difficulties with achieving an erection not on an ongoing basis, and also if the sex life is not very regular. In this case, you can take any dosage in accordance with the severity of erectile dysfunction.
Taking Cialis on a regular basis is justified either with more or less regular sex life (more than four times a week), or in case a man suffers from BPH, which is in vast majority of cases accompanied by ED. As a rule, for daily intake, the doctor prescribes 5 mg of Cialis. Daily intake of the medication provides approximately the same level of Tadalafil in the blood around the clock if the medicine is taken at about the same time. Thanks to this, a man can have sex at any time of the day.
How To Take Cialis?
Cialis is made in form of film-coated pills which should be taken whole and washed down with water or other liquid. Despite the fact that Cialis can be combined with alcohol, it is not recommended to take a tablet directly with it. It is also better to limit the dose of alcohol to a couple of glasses of wine or shots of whiskey, since an excess of ethyl alcohol plus Tadalafil is not a pleasant combination for the cardiovascular system. Avoid taking this medicine with grapefruit juice or grapefruit directly – this citrus fruit contains substances that interfere with the production of enzymes in the liver that destroy Tadalafil and remove it from the organism. As a result, if you eat this seemingly harmless fruit with a Cialis pill, you can get an overdose, because the mechanism of absorption of the medicine will be disrupted.
The presence or absence of food intake, as well as its fat content and quantity, doesn’t affect absorption of Tadalafil into blood and thus the action of Cialis. This is a significant advantage of this drug in comparison with other PDE-5 inhibitors used for the treatment of ED. You can take the pill with food or on an empty stomach – it all depends on how you prefer. However, if you experience pain in the stomach or heartburn after taking Cialis, it is better to take the medicine with at least a small amount of food or after eating.
What Side Effects of Tadalafil Can A Man Experience?
Placebo-controlled clinical trials, as well as numerous patient reviews subjected to statistical analysis, show that the first place in prevalence among the side effects of Cialis is occupied by a headache experienced some time after taking the drug. In most patients, it disappears within one to two hours, but in some it lasts as much as the action of Tadalafil, which spoils the impression from an improvement in potency.
The next side effects, which occur almost equally often, are nasal congestion, flushing of the face, back pain, myalgia, and dyspepsia. The list looks pretty impressive, but one patient rarely has more than two side effects at the same time. Most often, headache and nasal congestion or nasal congestion and a rush of blood to the skin of the face are combined. Dyspepsia or diarrhea are noted mainly in men suffering from gastritis or gastric ulcer. Some patients report a combination of headache and dizziness.
Rarely encountered side effects include change in color perception, redness of the eyes, allergic rash, insomnia, angina pectoris, hypertension, and hypotension.
As a rule, side effects disappear without any treatment. If they bother you very much, especially if you experience chest pain, tachycardia, difficulty breathing, or fainting, it is recommended that you stop using Cialis and consult a doctor. You may be intolerant of Tadalafil, or this medicine may be contraindicated because of your concomitant diseases.
Numerous studies and patient reviews show that the most severe side effects occur after the first one or two doses of the drug, and subsequent ones tend to weaken or even disappear completely. Men who take Cialis pills on a daily basis, rarely report any unpleasant sensations that accompany the intake of this medicine.
Whom Is Cialis Contraindicated?
Cialis is contraindicated for men taking drugs that contain organic nitrates, as well as alpha-blockers. Tadalafil is not recommended to be taken together with any other drugs for the treatment of erectile dysfunction. As for other contraindications, Cialis is not advised in case of hypersensitivity to Tadalafil, hereditary degenerative diseases of the retina, for men under the age of 18, as well as those who suffer from decompensated diseases of the cardiovascular system. The latter include unstable angina pectoris, heart failure of class II and above, uncontrolled arrhythmia, severe hypotension or hypertension. If a man has suffered a myocardial infarction or stroke, at least six months after this, Cialis and any other medicines against erectile dysfunction shouldn’t be taken, and after this time one needs to consult a cardiologist and a neurologist. Uncontrolled intake of Tadalafil can be extremely dangerous for the health of such patients.
A partial limitation to use is predisposition to priapism, Peyronie’s disease, cavernous fibrosis, as well as physiological angular curvature of the penis.
If you have compensated diseases of the cardiovascular system, for example, controlled arrhythmia or non-severe heart failure, this is unlikely to be an obstacle to getting rid of potency problems with the help of Cialis, but care should be taken to avoid the maximum dosage of this drug. The doctor will help to determine the optimal dosage regimen.
