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Generic Cialis

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Cialis is an effective innovative drug for the treatment of erectile dysfunction.

Mechanism of action

The effect of Cialis is based on the therapeutic effects of tadalafil. It belongs to a specific reversible type 5 phosphodiesterase inhibitor (PDE-5). Phosphodiesterase is an enzyme that inactivates cAMP and cGFM. These two substances are secondary transmitters in reactions with prostacyclin or nitric oxide. The rationale for its clinical use is the property of PDE-5 inhibitors to express the oxide pathway through inhibition of cGMP hydrolysis. An increase in the concentration of the latter has vasodilating, antiproliferative and proapoptotic effects. The drug’s ability to directly improve the contractile function of the right ventricle has also been proven.

The mechanism of its main effect can be described as follows. Due to sexual stimulation, a large amount of nitric oxide (latent phase) is locally released in the tissues of the penis. Due to the inhibition of PDE-5 by tadalafil, the level of cyclic guanosine monophosphate increases in the cavernous penile body. This contributes to the relaxation of smooth muscles and the flow of blood to the tissues, due to which an erection occurs that is sufficient for sexual intercourse.

Dosage and administration

For oral administration. For patients with frequent sexual activity (more than twice a week): the daily recommended dosage is 5 mg once a day, 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 (less than twice a week): the appointment of Cialis in a dose of 20 mg is recommended. The pill is taken immediately before sexual intercourse according to the instructions. The maximum daily dose of generic Cialis is 20 mg.

Contraindications

Two main contraindications are:

  • hypersensitivity to tadalafil or other drug components;
  • simultaneous use of organic nitrates in any dosage form.
  • The drug is not used in men with heart disease, for whom sexual activity is contraindicated. Doctors should consider the potential cardiac risk of sexual activity for patients with cardiovascular disease.
  • the following groups of patients with cardiovascular diseases were not included in clinical trials, therefore, the use of tadalafil in them is contraindicated:
  • patients with myocardial infarction over the past 90 days;
  • patients with unstable angina that occurs during sexual intercourse;
  • patients with heart failure that corresponds to NYHA class II or higher over the past 6 months;
  • patients with uncontrolled arrhythmias, arterial hypotension (<90/50 mm Hg), or uncontrolled hypertension;
  • patients after a stroke that has occurred over the past 6 months.
  • The drug is contraindicated in patients with loss of vision as a result of non-arterial anterior ischemic optic neuropathy, regardless of whether this was due to a previous effect of PDE-5 inhibitors.
  • 20 mg tablets: Cialis should not be used in patients under the age of 18.

Side effects

Cardiovascular system:

  • infrequently (> 0.1%): palpitations, tachycardia, decreased blood pressure, (in patients who have already taken antihypertensive drugs), increased blood pressure;
  • rarely (> 0.01%): myocardial infarction;
  • unknown (it is impossible to estimate the frequency of reactions according to the available data): unstable angina pectoris.

Nervous system:

  • very often (> 10%): headache;
  • often (> 1%): dizziness;
  • rarely (> 0.01%): fainting, migraine, transient ischemic attack, stroke.

Organs of vision:

  • infrequently (> 0.1%): blurred vision;
  • rarely (> 0.01%): visual field impairment;
  • unknown (it is impossible to assess the frequency of reactions according to the available data): non-arterial anterior ischemic optic neuropathy, retinal vein occlusion.

Respiratory system: infrequently (> 0.1%): nosebleeding.

Digestive disorders:

  • often (≥ 1%): abdominal pain;
  • infrequently (> 0.1%): gastroesophageal reflux.

Skin and subcutaneous tissue:

  • infrequently (> 0.1%): rash, urticaria, hyperhidrosis (excessive sweating);
  • unknown (it is impossible to assess the frequency of reactions according to available data): Stevens-Johnson syndrome and exfoliative dermatitis.

Common violations:

  • uncommon (> 0.1%): chest pain;
  • Rarely (> 0.01%): facial swelling;
  • unknown (it is impossible to estimate the frequency of reactions according to the available data): sudden cardiac death.

Immune system disorders: infrequently (> 0.1%): hypersensitivity reactions.

Reproductive system disorders:

  • rarely (> 0.01%): prolonged erection;
  • unknown (it is impossible to estimate the frequency of reactions according to available data): priapism.

Overdose

Symptoms: with single-use in healthy individuals, tadalafil in a dose of up to 500 mg and patients with erectile dysfunction – repeatedly up to 100 mg/day. Side effects were the same as when used in lower doses. Treatment: in case of an overdose, standard symptomatic treatment is necessary. With hemodialysis, tadalafil is slightly excreted.

Cialis and alcohol

Tadalafil did not affect the concentration of ethanol, and ethanol did not affect the concentration of tadalafil. While taking ethanol in high doses (0.7 g/kg body weight), concomitant use of tadalafil did not lead to a statistically significant decrease in blood pressure. Some patients reported postural dizziness and orthostatic hypotension. The use of tadalafil on the background of ethanol at lower doses (0.6 g/kg) did not cause the development of arterial hypotension. Dizziness was detected with the same frequency as with alcohol alone.