Man's health

Cialis: instructions for use, price, reviews and analogues

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Men's consistency among any representative of a strong half of humanity is almost in the first place. The problems that have arisen in the intimate sphere can deprive a man of peace and sleep, significantly lower self-esteem and lead to depression. And do not think that such problems occur only in men over 50 and older. Erectile dysfunction is much younger, and quite often you can hear about 30-year-old young men suffering from sexual disorders.

The modern market of medical products is ready to offer its patients a large list of tools that will help to cause a quality erection for quite a long time. One of these tools is Cialis. In pharmacies, it can be purchased one by one (1 tablet each), and in packages with the most varied quantities (5, 10, 20, 30, 40, 50, 100 pieces).

What is "Cialis": composition and pharmacodynamics

Cialis refers to a group of drugs designed to improve erectile function. The main active ingredient of the drug is tadalafil. Auxiliary are lactose monohydrate, hyprolase, sodium lauryl sulfate, croscarmelose sodium and vegetable magnesium stearate. The tablets are oval-shaped in a light yellow film coating. On one side of the tablet you can see the engraving C5.

In Cialis, the action is based on the fact that tadalafil, the main active ingredient, suppresses specific PDE-5 (phosphodiesterase). During the onset of sexual arousal, nitrous oxide is released in a sufficiently large amount, which leads to an increase in cGMP concentration in the cavernous body of the penis (the action is similar to cAMP, it acts as a secondary mediator in the human body, the purpose of which is intracellular signaling to break the cell membrane).

The result of this process is the relaxation of the smooth muscles of the arteries and the rush of blood to the tissues of the male organ, that is, an erection occurs. However, consumers need to know that tadalafil will cause the desired effect only if there is sexual arousal.

The effect of tadalafil on the human body

As mentioned earlier, the main active ingredient of the drug "Cialis" - tadalafil. After conducting clinical trials, it was found that this substance does not cause any significant, significant changes in blood pressure (the comparison was made with placebo). Also tadalafil does not contribute to any changes in heart rate.

Since "Cialis" (or "Viagra", "Levitra", etc.) is a drug for solving problems with erectile dysfunction, clinical studies were conducted on the effect of medications with daily use on the process of spermatogenesis. The results showed that there are no undesirable effects on the morphology of spermatozoa, their mobility has not decreased to any critical value. In one study, a decrease in sperm concentration was found compared to placebo. The reason turned out to be high sexual activity and a higher frequency of ejaculation.

Also, the daily intake of the main active component of Cialis (compared to placebo) did not affect the average concentration of sex hormones, testosterone, FSH and LH. No abnormalities in color recognition (blue / green) were observed in patients. Tadalafil had no effect on the sharpness of visual perception, intraocular pressure, on pupil size and on the electroretinogram.

The drug "Cialis" (5 mg) reviews doctors describe as a very effective tool to improve erection in patients with very different degrees of severity of the disease.

Generic "Cialis"

A generic in the field of pharmaceuticals is called a medical product offered to customers under the international name, not protected by a patent, or under a patented, but not identical, brand name, which the developer has given to the drug. Today, generic drugs are also called medicines for which the active substance has either expired patent, or have patents and are manufactured under a compulsory license. Usually, the effectiveness of generic medicines is no lower than that of the original ones, but their cost is much less, they are accessible to a wide range of consumers.

Generic "Cialis" (reviews of patients and physicians confirm) corresponds to the brand-name medication for all characteristics. Compared with all other analogues and generics, Cialis is characterized by a rapid onset of effect, the duration of which reaches up to one and a half days. Alcohol has no effect on the effect of the medical device, so you can absolutely not worry about your male consistency, even if you spend time at a party or in a restaurant accompanied by the use of strong drinks.

Generic "Cialis" (5 mg) physicians reviews and instructions for use recommend to take at least 20 minutes before the alleged sexual contact. Power mode does not matter. A persistent erection will occur within the next 36 hours, i.e. a man will be able to have sex as many times as he wants and at the time it is needed.

For whom is the drug intended?

The drug "Cialis" is not intended to be taken by women. Its main consumers are men suffering from erectile dysfunction. In addition, this medication is prescribed to men suffering from benign prostatic hyperplasia (BPH), who have symptoms of diseases of the lower urinary tract. Erectile dysfunction with such symptoms on the background of BPH is also a good reason for appointing the drug Cialis.

Contraindications for the use of "Cialis"

Generic "Cialis" reviews of medical specialists are described as a drug with a sufficiently large list of contraindications.

Absolutely for all medications, patients who are hypersensitive to the main active ingredient, Tadalafil, and to any component of Cialis, should refrain from taking it. Do not prescribe medication to young people under 18 years old (because there is no need and no clinical studies have been conducted on this matter). It is unacceptable to use "Cialis" in parallel with the drugs, which have in their composition any organic nitrates.

Can not be assigned to the reception of "Cialis" those patients who are contraindicated sexual activity. Contraindications in this area may be associated with diseases of the cardiovascular system. These include myocardial infarction, which occurred less than 3 months ago, unstable angina (there is always a chance of developing an attack of angina in the process of sexual contact). Also, this group of diseases includes heart failure (chronic form), uncontrolled arrhythmia, hypertension and hypotension (blood pressure lower than 90/50), ischemic stroke, which occurred less than six months ago.

Further, the drug "Cialis" is unacceptable to use in case of loss of vision, provoked by non-arterial ischemic neuropathy of the optic nerve. It is impossible to take “Doksazozin” and drugs in parallel with “Cialis”. People suffering from chronic kidney failure, the drug should not be taken more than twice a week.

The lactose deficiency in the patient’s body, its intolerance, glucose-galactose malabsorption (loss of nutrients entering the gastrointestinal tract, due to the lack of absorption in the small intestine) are also good reasons for not taking Cialis.

Possible side effects

Like any medical drug, Cialis, the price of which can vary from 70 to 200 rubles per pill, can cause some side effects from different systems of the body.

Most often, patients diagnosed with erectile dysfunction (ED) complained of headaches, disorders of the gastrointestinal tract, myalgia, back pain. Possible blood flow to the face, nasal congestion.

Men whose ED was accompanied by benign prostatic hyperplasia (BPH), often talked about the appearance of headaches and dyspepsia, pain in the limbs and myalgia. In some cases, gastroesophageal reflux developed.

The nervous system can respond to Cialis by impaired cerebral circulation, fainting, migraine, epileptic seizures, transient amnesia or ischemic attacks.

Changes in visual perception (fuzziness), negative changes in the visual field, pain in the eyeball, optic neuropathy of the ischemic type, occlusion (impaired patency) of the retinal vessels are possible. Sudden hearing loss is possible.

The cardiovascular system in response to taking the drug "Cialis" (analogs often cause the same deviations) can declare itself tachycardia, fluctuations in blood pressure, manifestations of unstable angina.

Sometimes you can hear from patients about the appearance of skin rash, the development of hyperhidrosis (sweating), urticaria, exfoliative dermatitis, Stevens-Johnson syndrome.

Strangely enough, sometimes the question arises as to whether Viagra or Cialis is better, because the latter can provoke negative manifestations on the part of the genitals, manifested in prolonged erections and priapism (painful erections not associated with arousal).

Dosing regimen

For patients with ED and high frequency of sexual contacts (more than 2 times during the week), 1 tablet of Cialis (5 mg) is recommended by doctors to be taken every day. It is advisable to do this at the same time, regardless of the diet. If individual sensitivity is observed in the medication, the daily dose may be reduced to 2.5 mg.

For men with low frequency of sexual contacts, the instruction recommends taking the medication immediately before contact in a dosage of 20 mg.

If Cialis, the price of which per tablet is lower, the larger the package, is prescribed to patients with BPH or ED / BPH, the drug is regulated to receive according to a slightly different scheme. The drug is very desirable to take at least about the same time, regardless of the time of sexual activity. For patients with such diagnoses, the maximum daily volume of the drug “Cialis” is 5 mg. Reviews of doctors, their recommendations on the duration of the course of treatment are purely individual.

Features of the drug

The drug "Cialis", its analogues should not be used for the treatment of ED in patients suffering from diseases of the cardiovascular nature, because sexual activity for these patients is not recommended. Men with a diagnosis of BPH before the course of treatment should be examined in order to exclude oncology of the prostate gland.

In addition to the above, patients should be aware that the occurrence of an erection lasting more than 4 hours is a reason for seeking emergency help from a doctor, as priapism without proper and timely treatment will lead to damage to the tissues of the penis and the possible onset of irreversible impotence.

With regard to driving and performing work that requires high psychomotor skills, patients should be careful, as though not often, but there is a possibility of adverse reactions in the form of dizziness, headaches and fainting.

Analogs "Cialis"

Currently, Viagra, Levitra or Cialis are most commonly used for the treatment of ED. The difference of all three from each other - in the duration of action. At Levitra, the time period is 10-12 hours, at Viagra - no more than 6 hours. Leads on this indicator "Cialis" - up to 36 hours. If you compare "Cialis" with "Viagra" in terms of food intake, then "Viagra" should be taken only on an empty stomach, "Levitra" can become less effective after ingestion of fatty foods, but "Cialis" doesn't care what a person eats, and , in general, did he eat food in principle: the drug is effective regardless of the food.

You can not unequivocally answer the question of what is better - Viagra or Cialis. Or maybe even prefer Levitra? "Viagra" is the most studied, its effect on the patient's body is known. It is a powerful drug, but its duration is relatively small. "Cialis" is effective for 36 hours, which allows a man to engage in sexual relations when he sees fit. About Levitra, we can say that it is the safest drug for the man's body for the treatment of ED. However, the effectiveness of the drug may decrease after a meal. It all depends on the individual characteristics of the organism.

Reviews of patients and health workers

Reviews of patients on the drug "Cialis" are mostly positive color. A large group of patients said that they didn’t see anything better than Cialis, because the duration of the drug’s action is very high (he took the pill - and you can’t worry about your male consistency for at least a day or a day and a half) food and alcohol will not affect efficacy. After all, rarely does a romantic date cost at least without a glass of champagne (and sometimes more).

Although there is, of course, in a barrel of honey and a fly in the ointment. Sometimes you can hear about headaches, pain in the back and limbs. Some patients talk about indigestion. You can often hear about pain in the area of ​​the heart, less often - a violation of visual perception. All that can be done in this case is to consult a doctor who will take into account all the features of the body, the state of health and select the most effective drug (Viagra, Levitra or Cialis), with which the patient will feel real, healthy and wealthy man.

Cialis release form

Depending on the individual characteristics, a dosage of 5 or 20 mg is prescribed. The higher the dosage - the smaller the interval between taking the pill and the stronger the erection. Reduced and the period of the drug. Prescribing a dose of Cialis is carried out by a doctor without fail.

Cialis (20mg) recommended for single use, in this case, the effect of the drug can last up to 36 hours, because the daily dose of this dose is contraindicated. According to the instructions, a repeated dose of 20 mg is possible every other day, in the morning, in the afternoon or in the evening. This is convenient for those who are sexually active no more than 2-3 times a week.

Cialis (5 mg) intended for a course of treatment. After 5-6 days, with daily intake, the concentration of the active substance in the blood becomes constant, and the man can continue to have sex at any time of the day, regardless of the time of taking the medicine. This option is suitable for men who are sexually active.

Based on the age, diagnosis, associated diseases and other patient characteristics, a course of 2.5 to 10 mg may be prescribed by a doctor:

  • in case of a malfunction of the kidneys, it is usually prescribed 5 or 10 mg per dose per 2 days. Based on the complexity of the disease, the dosage can be reduced by a doctor to 2.5 mg,
  • in case of violations of the liver, including mild, the dosage should not exceed 10 mg,
  • if, along with Cialis, the patient is undergoing treatment with strong inhibitors, the maximum dose should not exceed 10 mg per dose every three days.

The drug is available in the form of tablets, each of which contains the active substance - tadalafil, as well as excipients (magnesium stearate, sodium lauryl sulfate, hyprolose, lactose monohydrate). Tablets are film coated. Release 14 tablets in a blister of aluminum foil coated with PVC film. In carton packaging - 1 or 2 blisters.

It is proved that Cialis 5 mg has a positive effect on the psychological state, which contributes to recovery. Cialis is prescribed in this dosage for diseases of the prostate gland and urination disorders.

Instructions for use

There is a standard instructions for use for men of different ages, however, before use it is still better to consult with your doctor for more effective action of the drug.

Cialis is usually applied without taking meals 15-25 minutes before sexual intercourse. After taking a persistent erection is observed at any time (in the presence of sexual stimulation), for 36 hours, at any time. The recommended dose is 1 tablet per day. No dosage change is required for patients with hepatic and renal insufficiency.

How does Cialis

Сиалис не оказывает негативное влияние на работу органов и систем организма, не повышает уровень тестостерона и прочих гормонов. Эффект от употребления возникает в течение 15-20 минут и длиться около 36 часов. Механизм работы для препарата в любой дозировке идентичный:

  • активное вещество препарата – тадалафил – ингибирует гуанозинмонофосфат (цГМФ),
  • гладкие мышцы полового члена расслабляются,
  • активное вещество не вызывает возбуждающего эффекта. Положительный эффект возможен только при сексуальной стимуляции,
  • фиксируются небольшие скачки давления,
  • in the process of sexual stimulation, an increase in blood flow to the penis occurs, erection improves.

Given all the processes, Cialis pill is recommended to take 25-30 minutes before sexual intercourse.

Contraindications to the reception and side effects

Cialis has a different effect on each organism, therefore it should be used with caution, and it is better to consult a doctor before use. Do not use the drug in the following cases:

  • minor age (up to 18 years),
  • ischemic neuropathy of the optic nerve, resulting in loss of vision,
  • diseases of the cardiovascular system (stroke,heart attack,angina pectoris,heart failure and others)
  • individual intolerance to the components of the drug,
  • lack of lactose or intolerance.

There are a number of other diseases when Cialis should be taken with caution. Possible and the occurrence of side effects:

  • pressure increase
  • dry nasal mucosa,
  • disruption of the digestive system,
  • severe dizziness, headaches,
  • blood flow to the face and neck.

Basically, such troubles occur when exceeding the daily dose of Cialis, most patients have no side effects.

Cost in pharmacies

Cialis prices depend on the content of the active substance in one tablet and their quantity in the package. Here is the approximate cost of the drug, depending on the pharmacy, the price may vary.

  • 1 tablet (average cost) - 900 rubles,
  • 4 tablets (20 mg) - 3000 rubles,
  • 14 tablets of 5 mg - 1800 rubles,
  • 28 tablets on 5 mg - from 3500 rubles.

Cialis generics are cheaper than the original drug, you can also find an analogue, which will cost less.

Analogs and generics

There are many analogs of the drug, they also act effectively, however, they have different side effects, active ingredients, cost and dosage.

  • Viagra is a world famous drug that contains sildenafil as an active ingredient. It has a relaxing effect on the smooth muscles of the penis, increases blood circulation, causing a persistent erection for 4 hours.
  • Tadalafil is a complete substitute for Cialis.
  • Dapoxetine - a drug that prevents rapid ejaculation, which increases the duration of sexual intercourse. Effective for 3-4 hours.
  • Levitra has a Cialis-like mechanism of action. The positive effect manifests itself after 20 minutes. It lasts 5-6 hours.
  • Shpansky front sight is a natural aphrodisiac made on the basis of cantharidin, a substance derived from an insect. Enhances blood circulation in the pelvic area. Valid for 4 hours.
  • Vimax is a herbal preparation that has ginkgo biloba, ginseng, cayenne pepper and many other ingredients. Strengthens the attraction for a period of up to 24 hours.

Cialis generic - the equivalent of the original drug with identical effects on the body. It is distinguished from the original by a lower cost, but it meets all quality standards and is officially allowed.

Which is better: Cialis, Viagra or Levitra?

Opinions about the effectiveness of Viagra, Levitra and Cialis diverge. However, all patients note that it is better to use Viagra or Levitra for one-time use. Cialis also has a longer effect, and therefore suitable for course taking. Also noticeable difference in action - Cialis makes sensations noticeably brighter, while, when taking Levitra and Viagra, only a persistent erection and the possibility of prolonging sexual intercourse are noted. Most of the men noted the absence of side effects after the use of Levitra and Cialis, these same drugs will be cheaper than Viagara. Among men of more mature and elderly age, Viagra is more popular, since it is more convenient for single use.

Cialis for women

Female Cialis is a unique drug that has a pronounced effect and is able to qualitatively improve sex life. Renders the following action:

  • increases blood flow to the pelvic organs,
  • more actively produced lubrication
  • there are new, brighter feelings when caressing partner,
  • provides multiple orgasms.
  • arousal persists for a long time, which makes it possible to repeat intercourse repeatedly.

Acts female Cialis the whole day, but it does not affect the libido, but on the quality of sexual intercourse and sensation. It is not recommended to exceed the permissible dose - 1 tablet per 24 hours, otherwise there will be serious side effects. The drug is used 30 minutes before sex, regardless of the meal.

In solving problems with sexuality or health, Cialis has proven itself well among both men and women. It is proved that the drug has a long and positive effect on the body and at the same time has a minimum of side effects.

Customer reviews read below in the comments.

Therapist, gastroenterologist, hepatologist, infectious diseases. I spend preventive measures of complications of the digestive system after a long treatment with NSAIDs and blood thinning drugs.

What is Cialis?

Cialis (tadalafil) Is a drug that reversibly and selectively suppresses specific PDE-5 of cGMP (cyclic guanosine monophosphate).

Wikipedia says that the drug is intended for the treatment of disorders in which a man is unable to achieve and maintain an erection necessary for sexual intercourse.

Pharmacodynamics

With sexual arousal, local release of nitric oxide occurs, and as a result of the suppression of PDE-5 with the drug, the concentration of cyclic guanosine monophosphate in the cavernous body of the penis increases.

As a result of this, the smooth muscles of the arteries relax, the influx increases. of blood to the tissues of the penis and an erection occurs. In the absence of sexual arousal, this effect is absent.

Elevated concentrations of cGMP are also observed in the smooth muscles of the bladder, prostate and blood vessels supplying them.

Relaxing the muscles of the blood vessels increases the perfusion (passage) of blood in these organs and reduces the severity of symptoms of BPH, and relaxation of the smooth muscles of the bladder and prostate further enhances the vascular effects.

Improving erection tadalafil thus increases the possibility of PA (sexual intercourse).

However, in healthy men, compared with placebo, it does not cause a significant change in the change in DBP, SBP, and HR, does not affect the electroretinogram, visual acuity, IOP, and pupil size, does not violate the ability of color recognition (green / blue).

Pharmacokinetics

After taking the pill, tadalafil is well absorbed in the body. Substance concentration in blood plasma Peaks 2 hours after administration. Food and time of administration do not have a clinically significant effect on the rate of absorption of tadalafil and its bioavailability.

About 94% of the substance is in a state bound to plasma proteins. It is metabolized in the liver with the participation of the CYP3A4 isoenzyme. Main circulating metabolite in comparison with tadalafil shows at least 13 thousand times less activity in relation to PDE-5.

The average half-elimination period in healthy men is 17.5 hours. The drug is excreted mainly in the form of pharmacologically inactive metabolites. About 61% of the dose taken is excreted in the feces, about 36% is excreted in the urine.

Relative contraindications

Due to the lack of data on individuals with liver failureCareful for the Child-Pugh C-class, care should be taken when applying tadalafil in this group of patients.

With caution, Cialis is prescribed to persons undergoing treatment with α1-adrenoreceptor blockers. This is due to the fact that while applying tadalafil with these drugs has a risk of developing symptomatic hypotension(SAG).

Clinical studies of pharmacological properties tadalafilin the group of healthy men, showed that a single dose of a standard dose of Cialis does not lead to SAH with simultaneous use of α1A-adrenergic blocker tamsulosin. The study involved 18 people.

Other restrictions for use:

  • predisposition to priapism,
  • anatomical deformation of the penis,
  • simultaneous reception antihypertensive drugs, as well as drugs that powerfully suppress the CYP3A4 isoenzyme (Erythromycin, Saquinavir, Itraconazole, Ritonavir, Ketoconazole).

Diagnosis of ED should include identifying the underlying cause. impotence, conducting an appropriate examination and determination of adequate therapy.

Side effects

With an erection dysfunction, Cialis is most often accompanied by pain in the muscles or back, headache, blood flushes to the face, dyspepsianasal congestion.

In patients with ED / BPH, pain in the limbs and / or muscles, headache, gastroesophageal reflux (GER), and dyspepsia were most often recorded.

Other possible adverse reactions:

  • often - dizziness,
  • infrequently - hypersensitivity reactions, blurred perception of visual images, pain in the eyeball, tachycardiapalpitations, raising or lowering HELL (the latter is possible with persons who have already taken antihypertensive drugs), dyspnea, nasal congestion, GER, abdominal pain, hyperhidrosis, rash,
  • seldom - stroke (including acute impaired blood circulation of the brain with rupture of the vessel and hemorrhage (stroke of the hemorrhagic type)), transient amnesia, epileptic seizure, eyelid swelling, visual field impairment, injection (expansion) of the sclera vessels of the eyeball, myocardial infarction, nose bleeding, hivesprolonged erection.

Patients with previously existing risk factors for CVD occur:

  • infrequently - chest pain,
  • in rare cases - fainting, migrainetransient ischemic attackssudden heart death.

However, to say exactly, these phenomena are associated with tadalafilrisk factors for CVD, sexual arousal, other factors, or a combination of factors or not, is not possible.

There are also reports of isolated cases of sudden hearing loss with the use of PDE-5 inhibitors (including tadalafil) during clinical and post-marketing research.

Side effects that occurred during post-marketing studies, but were not detected during clinical placebo-controlled studies:

  • edema faces that
  • migraine,
  • NAION,
  • retinal vascular occlusion,
  • unstable angina,
  • ventricular arrhythmias,
  • exfoliative dermatitis,
  • priapism,
  • Stevens-Johnson syndrome,
  • sudden cardiac death.

How to take Cialis with ED?

Patients with frequent sexual activity, when the PA occurs more than 2 p. / Week., 5 mg tablets are recommended to be taken daily, one at a time, at the same time. Depending on individual tolerance, the dosage can be reduced.tadalafil up to 2.5 mg.

If PAs occur less frequently than 2 p. / Week, it is recommended to take tablets immediately before coitus at a dose of 20 mg.

The permissible upper limit of the daily dose of Cialis is 20 mg.

Overdose

Single dose up to 0.5 g tadalafilhealthy person and repeated use up to 100 mg / day. Tadalafil in patients with erection dysfunction is accompanied by side effects similar to those that occur with the use of lower medications.

In case of overdose, standard symptomatic therapy is performed. Cialis practically does not appear when hemodialysis.

The effect of other drugs on tadalafil

Cialis biotransformation is carried out with the participation of CYP3A isoenzyme, in connection with which the drugs inhibiting this isoenzyme, increase the amount of Cmax and AUC tadalafil.

Despite the fact that specific studies were conducted only on the interaction tadalafil with Ketoconazole and RitonavirIt can be assumed that such drugs as Itraconazoleand Erythromycin, also able to increase activity tadalafil.

Rifampicin, which is an inducer of CYP3A, reduces the exposure of a single dose of the drug and the value of Cmax. Most likely, the simultaneous use of other drugs from the group of inducers of CYP3A, should contribute to a decrease in plasma concentration tadalafil.

The use of Cialis in combination with antacids(Al hydroxide / Mg hydroxide) helps to reduce the rate of absorption of the active substance of the drug without changing the AUC for tadalafil.

Drugs that increase the acidity of the stomach (pH), and, in particular, H2-blocker nizatidinedo not affect pharmacokinetic parameters tadalafil.

A study of the safety and efficacy of Cialis in combination with other methods of treating erectile dysfunction (including in combination with other PDE-5 inhibitors) has not been conducted, and therefore it is recommended to avoid such combinations.

Tadalafil does not contribute to an increase in bleeding time caused by taking ASA.

The effect of tadalafil on other drugs

Tadalafil able to amplify hypotensive effect of nitrates, because of what these drugs are not prescribed in combination.

The substance has no significant effect on the clearance of drugs that are metabolized with the participation of the cytochrome P450 system. During the research it was found that tadalafil:

  • does not inhibit and does not induce isoenzymes CYP3A4, CYP1A2, CYP2C19, CYP2C9, CYP2T1 and CYP2D6,
  • does not have a significant effect on the pharmacokinetics of S- or R-warfarin, as well as on the effect of warfarin on PTV (prothrombin time),
  • does not increase the duration of bleeding caused by taking ASA,
  • causing a systemic vasodilating effect, is able to enhance the hypotensive effect of agents intended to reduce blood pressure (in patients taking several antihypertensive drugs for poorly controlled hypertension, blood pressure decreased more pronounced, while in most patients this phenomenon was not associated with hypotensive symptoms),
  • no significant effect on pharmacodynamics and pharmacokinetic profile Theophylline.

The results of two studies show that the use of the drug in healthy men in combination with Tamsulosin (α1A-adrenergic blocker) does not cause a significant reduction in blood pressure.

Use by healthy volunteers of a drug with α1-blockerDoxazosin (provided that the latter is taken in a dose ranging from 4 to 8 mg / day.) was accompanied by an increase in doxazosin's hypotensive effect. In some patients, symptoms associated with pressure reduction occurred, including syncope.

special instructions

Sexual activity can be dangerous in a number of pathologies of the heart and blood vessels. In this regard, men with diseases that require limiting sexual activity, treatment of erectile dysfunction, including tadalafilis contraindicated.

There are reports of cases of priapism (long-term, not associated with sexual arousal, involuntary erection) against the background of treatment with PDE-5 inhibitors.

Patients should be informed about the need to urgently consult a doctor if an erection persists for four (or more) hours. In the absence of timely assistance, such conditions lead to irreversible impotence.

Like other PDE-5 inhibitors, the drug causes systemic vasodilation, which can provoke a transient decrease in blood pressure. Before appointment tadalafil the doctor must make sure that the patient with pathology of the heart / blood vessels will not be subject to undesirable effects due to this effect.

Non-arterial AION is one of the causes of visual impairment (in some cases until it is completely lost). In the course of post-marketing observations, there were reports of rare cases of the development of this pathology (cases were related in time with the use of PDE-5 inhibitors).

Establish exactly whether there is between treatments. tadalafil and NAION direct link, impossible today.

In case of sudden loss of vision tadalafil should stop and seek medical attention.

The patient should also be warned that people who have undergone NAION have a high risk of re-development. optic neuropathy.

If a patient is supposed to have a diagnosis of BPH, he should undergo an additional examination to rule out prostate cancer.

Although dizziness when taking tadalafil occurred with the same frequency as when taking a placebo, during the period of treatment should be careful when driving and mechanisms.

Cialis generics - what is it and how do they differ from the original drug?

The most popular generic Cialis - Cialis Soft, Cialis Forte, Cialis Capsules.

Generic feature Cialis Forte is that with the same duration as Cialis, it acts faster and provides a more stable erection.

Generic Cialis Soft also works faster than regular Cialis pills. The effect is achieved due to the fact that the drug is taken sublingually, and because of this, it contains tadalafil enters the systemic circulation more quickly.

In preparation Cialis Capsules the active substance is contained in the form of a concentrated gel, placed in an instant gelatin shell. This dosage form provides a higher rate of exposure. tadalafil. An important feature of the capsules is that tadalafil they contain 4 times more than pills.

The duration of the effect with the use of capsules is approximately the same as with the use of the tablet form of the drug.

For people who for some reason can not or do not want to take pills, is available Cialis Gel.

Another analogue of the drug is Female Cialis - Female Cialis. Generic contributes to an increase in blood flow to the female genitals and thus enhances their sensitivity to stimulation.

Along with pills Cialis Orange both high power and long duration tablets are produced Cialis Black 800 mg.

There are also generics with extra-dosage of the active substance:
Cialis Extra Dosage (40, 50, 60, 200, 100 mg, 30 tablet, 40 tablet, 60 tablet, 90 tablet, 120 tablet, 180 tablet, 10 or 20 tablet),
Cialis Professional (20 mg and 40 mg, 10, 20, 30, 40, 60, 90, 120, 180 tablets).

On many foreign websites and online pharmacies (pharmacy / apotheke / eczane) it is possible to purchase the drug online without a prescription (eng - without a prescription, es - sin receta, de - ohne rezept bestellen).

Before ordering a tool, it is very convenient to make a price comparison (price / preise / precio, price comparison / preiswert im internet bestellen) in different stores. Search can be done by the requests “discount cialis send thread”, “buy cialis 5mg”, “kaufen ohne rezept 20mg”, “cialis rezeptfrei kaufen deutschland”, “daily cialis forum”.

You can also compare the prices of generic drugs (generics in uk / generika in deutschland / generico en espana) and explore their effects, contraindications (contraindications / gegenanzeigen / sontraindicaciones / kontrendikasyonlar) and side effects (side effects / nebenwirkungen / efectos secundarios / yan etkileri ).

Information on Cialis can also be obtained at www.cialis.com.

Cialis or Sealeks?

Due to the consonance of the names Cialis is often confused with the drug Sealex. However, these tools have a lot of differences.

Cialis promotes the emergence of a natural erection, without creating artificially sexual arousal. If necessary, it can be taken one-time, immediately before sexual activity.

Effects Sealex due to the properties contained in it of components of plant origin, which are obtained by the method of special extraction.

The burner root Monnier, whose active substance is Ostol, has a prophylactic effect on erectile dysfunction, yohimbine stimulates the synthesis of endogenous testosterone, ginseng helps to relax the smooth muscles of the blood vessels of the penis.

Indole-3-carbinol is a powerful natural antioxidant that prevents the proliferation of prostate tissue, makes it easier to urinate with problems with the prostate gland and ejaculation.

Quercetinregulates the permeability of the walls of blood vessels, has a vasodilator and blood-thinning effect.

Vitamins B6 and AT 12 actively participate in metabolismamino acids, show antioxidant properties and protect the walls of blood vessels.

Essential Amino Acid L-arginine necessary for the synthesis of nitrous oxide (NO) with the participation of NO-synthase. The synthesis of nitrous oxide, in turn, is one of the key points without which it is impossible to perform an erectile function.

Folic acid provides protection of the cavernous bodies of the penis when associated with diabetes mellitus erection dysfunction, reduces the concentration of homocysteine ​​and the risk of damage atherosclerosis significant for erection of blood vessels.

Zinc is involved in the formation of dihydrocorticosterone and inhibition of the enzyme PDE-5, which affects the blood filling of the cavernous bodies of the penis.

The advantages of Sealex are ease of use (capsules are taken one per day, one-time or - if necessary, the overall recovery of the body - the course), a comprehensive healing effect, safety, availability, a pronounced effect after the first use.

Sealex It has a natural composition, due to which side reactions against the background of treatment with this drug are extremely rare.

What is better - Cialis, Levitra or Viagra?

Levitra and Viagra today are the main analogues of Cialis tablets.

Active substance Levitra is an vardenafil. The effect after the use of this drug develops on average after 15 minutes and lasts up to 12 hours.

Active substance Viagrasildenafil. The substance begins to act within half an hour after taking the pill, the effect lasts for 4 hours.

A distinctive feature and advantage of Cialis over analogues is its duration of action: the effect of conventional tablets lasts up to 36 hours, the effect of tablets with extra dosage of tadalafil lasts up to 72 hours.

Cialis can be taken immediately before sexual activity, Levitra - in 20 minutes Viagra - in 30-60 minutes.

Another important point is that on the pharmacokinetics of Cialis and Levitra food intake (as well as the amount of food eaten) and alcohol consumption does not affect, ViagraIt is recommended to take on an empty stomach.

Thus, trying to find an answer to the questions “Viagra or cialis, cialis or Levitra - which is better? ”, You should focus on how quickly you need to get the effect, how long the obtained effect should be maintained, whether you plan to use alcohol before sexual activity.

Cialis or Ziden - which is better?

Ziden - these are coated p / o tablets, which include as an active substanceudenafil (100 mg / tab.).

Liketadalafil, udenafilselectively and reversibly suppresses PDE-5 - enzymepromoting the metabolism of cGMP.

The substance starts to act after half an hour after taking the pill, the effect lasts up to 24 hours, but the severity of the action udenafil somewhat less than that of tadalafil.

Wherein Ziden It acts very gently, stabilizing the most important processes in the body of a man, increasing the duration of erection and contributing to the extension of the time of sexual intercourse.

The positive aspects of the drug are also no effect on blood pressure and vision, the concentration and amount of sperm, the morphology and motility of sperm.

Cialis and alcohol

The drug does not affect the concentration of alcohol, and alcohol does not affect the concentration tadalafil.

Alcohol use in a dose exceeding 0.7 g / kg, against the background of application tadalafil does not lead to a statistically significant reduction in average blood pressure. Individual men have been noted orthostatic hypotension and postural vertigo.

Taking the drug with alcohol at a dose of less than 0.6 g / kg was not accompanied by a decrease in blood pressure, and dizziness occurred with a frequency similar to the occurrence of dizziness only when drinking alcohol.

Cialis Reviews

Reviews of Cialis tablets on the forums are mostly good. And they are confirmed by the results of a number of clinical studies, according to which, while taking 20 mg of the drug, potency improvement was noted in 81% of men who participated in the experiment with varying degrees of erectile dysfunction (from minor to severe).

Reviews about Cialis Softand Cialis Forte (generic cialis) are also good. The main advantages of drugs men call a faster onset of effect in comparison with conventional tablets 5 mg and a significantly lower price.

Reviews of Cialis and reviews of generic Cialis suggest that, despite the good portabilitytadalafilsome patients may have side effects in the form of heartburnmuscle pain, lower back pain, headache, dizziness.

Some patients say that in the morning after taking the pill there was a sensation similar to that of a hangover.

In this regard, before using the drug, it is very important to read the reviews of doctors about contraindications for Cialis.

It should also be remembered that tadalafil only provides blood flow to the male genital organ, but in the absence of sexual stimulation "does not work." That is, if a man is not physically ready for sexual intimacy and is not excited, there will be no effect.

Cialis is not intended for women. You can use the generic instead. Female cialis, the action of which is aimed at increasing blood flow to the genitals and enhancing arousal.

Cialis price

Cialis price in pharmacies in Moscow and St. Petersburg - from 980 rubles. per package No. 1, 20 mg. Cialis price 5 mg number 14 - from 3000 rubles. Most online pharmacies sell the drug throughout Russia: in Yekaterinburg, in Krasnodar, in Novosibirsk, Ufa, etc.

Buy Cialis in Ukraine can be from 390 UAH. In Kiev, in Odessa, in Dnepropetrovsk, in Kharkov and in other large cities, the average price of Cialis tablets 20 mg №1 is 470 UAH, tablets 20 mg №2 - 740 UAH.

In Minsk, the cost of tablets 20 mg number 1 - from 151.5 thousand rubles, in Kazakhstan - from 2950 tg.

The price of generics is somewhat lower. So, for example, the price of Cialis Soft tablets (pack No. 5) in Ukraine is from 200 UAH. You can buy Cialis generic in Russia (pack number 5) for 450 rubles.

pharmachologic effect

Cialis is a drug used to treat erectile dysfunction. The drug is able to improve orgasm and allows you to have a successful sexual relationship. The effect of the drug is observed for 36 hours. The effect comes only a quarter of an hour after ingestion of the drug pill in the presence of sexual arousal.

When using the drug 10 mg per day, no effect on the volume and concentration of spermatozoa was detected. The tool does not affect the motor function of sperm.

Side effect

Among the frequently encountered adverse reactions of the drug should be noted headache, as well as dyspepsia. What other side effects do Cialis have? They are insignificant or moderate, and are able to decrease when the medicine is further used.

Possible negative manifestations in the form of:

  • Spinal pain
  • Some nasal congestion
  • Minor myalgia,
  • Blood rushes to your face
  • Less commonly marked swelling of the eyelids.

Instructions for use

Instructions for use Cialis states that the drug is available in the form of tablets with a dosage of 5 mg and 20 mg. How to take Cialis and whether it is harmful to the health of men? Since there is no information about studies in renal and hepatic insufficiency, such people should be used with caution only if absolutely necessary.

A man's activity in sex can bring a risk for cardiovascular activity. Therapy of erectile dysfunction is undesirable in cardiac abnormalities.

It is also necessary to take into account the risk of the formation of complications with activity in terms of sex in patients with diseases such as:

  • Myocardial infarction, which occurred over the past 3 months,
  • Angina, appearing at the time of sexual intercourse,
  • Chronic heart failure, which has developed in the last six months,
  • Uncontrollable heartbeat failures,
  • Hypotension with an index of less than 90/50 mm. Hg Art. either uncontrolled arterial hypertension,
  • A stroke that occurred in the last 6 months.

Use Cialis with caution with the probability of priapism:

  1. When diagnosed with sickle cell anemia,
  2. Leukemia is present,
  3. There are multiple myelomas,
  4. The penis is anatomically deformed.

The patient should immediately visit the doctor in the case of an erection that does not fall more than 4 hours. Delays in eliminating priapism can cause damage to the tissues of the penis. This phenomenon will lead to long-term loss of potency. On the background of the use of Cialis, cases of priapism have not yet been reported.

Drug interaction

Although the specific interactions have not been studied by anyone, there is an assumption that inhibitors increase the activity of the drug. The simultaneous intake of Cialis and antacid or Tadalafil somewhat reduces the rate of absorption of the first. An increase in the pH of the stomach contents due to the use of the histamine H2 receptor blocker does not affect Cialis pharmacokinetics.

The drug enhances the hypotensive effect of nitrates, so its purpose in this situation is strictly contraindicated.

Cialis is not able to prolong bleeding when taking acetylsalicylic acid. The remedy is neutral with respect to antihypertensive drugs used in different doses for treatment.

Is it allowed to drink dapoxetine and cialis together? Naturally, this makes sense. Cialis will quickly restore potency, maintaining an erection for a long time, and Dapoxetine is also fast. With the simultaneous use of drugs provided:

  • The duration of intercourse,
  • Persistent erection.

Pregnancy

The drug is not used for the treatment of sexual dysfunction in pregnant women.

What are Cialis analogues? These should include drugs:

  • Sildenafil
  • Papazol
  • Yohimbine Hydrochloride,
  • Tornetis,
  • Taxier
  • Olmax Strong,
  • Revacio,
  • Dynamic
  • Kaverdzhekt,
  • Reilis,
  • Tentex Forte.

Some analogues are cheaper than Cialis, others are more expensive.

Pharmacies sell a drug called Cialis Forte. This is a generic Cialis, a feature of which is the same duration of action at a higher rate of onset of action and enhanced erection. Generic acts faster because it is taken sublingually, so tadalafil penetrates the circulatory system much faster.

Another generic is Cialis Capsules. In it, the active substance has the form of a concentrated gel, which is placed inside a gelatinous shell, which dissolves instantly. This dosage form ensures a high rate of onset of exposure to tadalafil. Also feature of the capsules is that the active substance in them is four times more than in tablets.

The duration of the effect of the use of capsules is similar to the use of tablets. For people who are not able to drink pills for some reason, Cialis Gel was developed.

Also, the pharmaceutical industry produces a female version of Cialis, called Female Cialis. This generic provokes a surge of blood to the female genitalia, increasing, thanks to this, the sensitivity to active stimulation.

Cialis or Sealeks?

Due to the consonance of the names of drugs confused - but in vain. Medications have a lot of difference. Cialis is used one-time, before sexual contact, contributes to the development of natural erection and does not artificially cause sexual arousal. The effect of Sealex is in the properties of the ingredients of the drug.

They are of vegetable origin and are harvested by special extraction:

  1. Monnier biteroot has the active ingredient Ostol. It acts as a prophylactic for erectile dysfunction,
  2. The second active ingredient is yohimbine, which accelerates the production of endogenous testosterone,
  3. Ginseng root helps relax muscles belonging to the smooth muscles surrounding the blood vessels of the male member,
  4. Quercetin provides permeability of the vascular walls. It dilutes the blood and dilates the blood vessels
  5. Indole-3-carbinol is a natural antioxidant that prevents the growth of prostate tissue. It facilitates ejaculation and urination, if there are problems with the prostate,
  6. Vitamins B6 and B12 contribute to the metabolism of amino acids. They act as antioxidants, protecting the vascular walls,
  7. An essential L-arginine amino acid is necessary for the synthesis of NO synthase and nitrous oxide to occur. This chemical process is a key element in the implementation of the function of erection of the penis,
  8. Folic acid protects male cavernous bodies in the penis with diabetes and the dysfunction caused by it, reduces the concentration of homocysteine, prevents the risk of atherosclerosis,
  9. Zinc forms dihydrocorticosterone, it is involved in the inhibition of the enzyme PDE-5. Such functions contribute to the filling of cavernous bodies with blood inside the male member.

The undoubted advantages of Sealex are:

  • Ease of use (it is enough to drink the capsules once a day or by taking a course if necessary),
  • Guaranteed security
  • Action in the complex of recreational activities
  • The pronounced effect observed after the first application,
  • Availability.

What is better to drink - Cialis, Viagra or Levitra?

Levitra with Viagra is now recognized as the main analogues of the drug Cialis. Consider which is better? In Levitra, the active ingredient is vardenafil. The effectiveness of the drug is achieved after a quarter of an hour and readiness for sexual contact is maintained for 12 hours. In terms of duration of exposure, the choice between Cialis or Levitra is obvious - everything speaks in favor of the first remedy.

The active substance of the advertised Viagra is sildenafil. It is valid only after half an hour, while maintaining the effectiveness of only 4 hours. It is clear that the cardinal difference and the advantage of Cialis medicine over these analogues is the duration of action: if the effect of simple tablets is maintained for one and a half days, then the effect of the drug in extra dosage is 72 hours.

In this case, Cialis is permissible to use immediately before sexual intercourse, but for Levitra this period is increased by 20 minutes. The famous Viagra in general should be drunk an hour before the alleged sexual intimacy.

It is also important that the pharmacokinetics of both Cialis and Levitra does not depend on food intake or the amount of food eaten, they "calmly" perceive the use of alcohol. But Viagra is advised to drink on an empty stomach.

Trying to answer that it is better to use to enhance an erection, you should take as a guideline the speed of the effect and the necessary duration. Also consider whether you have to drink alcohol before the alleged sexual exploits.

Cialis and Ziden

Analogue Cialis only half an hour later begins to act after administration, while maintaining the effectiveness of the day. However, the severity of the active component of Zidena is somewhat less than that of Cialis. It should be borne in mind that Ziden extremely gently affects, normalizing the most important processes occurring in the male body. The drug prolongs an erection, contributing to prolonged sexual contact. The positive characteristics of the drug include the fact that it does not change the amount of sperm, as well as its concentration, leaves unchanged sperm motility.

Сиалис или Импаза

Considering what is better, Cialis or Impaza, it should be noted that the last medication should be drunk an hour before sexual intimacy, it is valid for a day. In this case, Impaza eliminates various erectile pathologies, which include psychogenic dysfunctions. Also, the tool is prescribed for the treatment of autonomic disorders of the menopausal period, when physical activity falls, weakness and rapid fatigue are manifested.

Cialis or Vizarsin

What is better to drink, Vizarsin or Cialis? The first drug acts similarly to the second, but it should be taken on an empty stomach, because the food eliminates the effect of the agent. Also, Vizarsina has enough contraindications for use.

Doctors reviews about Cialis

Skatov B. V.: If a man wants to spend a pleasant evening trying any dishes and washing them down with a good dose of alcohol, and then not be disgraced in bed at night with his beloved - he should drink Cialis pill. The drug acts for a long time, it is not affected by alcohol and fatty foods. This makes the medicine an important tool for increasing the erection of a modern man!

Hestanov S. N .: In therapeutic practice I use Cialis for the treatment of male impotence. The market offers the drug in a dosage of 20 mg. I prescribe medicine, recommending taking it on demand, immediately before sexual intercourse. Since the tablet is 36 hours long, it is enough to take it once a day.

Harm and benefits of tablets

Cialis tablets help to achieve persistent erection and long-term sexual intercourse, as a result of which a man gains confidence in his strength, receives satisfaction and positive emotions.

If you follow the recommendations of Cialis specialists not harmful

Men reviews

Nikolay: Power! Men, do not be discouraged if the pills do not help you! Try these,). I am sure - the best option!

Alexey: I decided to buy Cialis - a great drug, better than Viagra. It starts to work faster and the effect is longer. The manual says 12 hours, but it seemed to me, at least 15-16, at least side effects. There is no tachycardia, increased heart rate and similar symptoms. If we talk about sex, then with Cialis, it really becomes brighter, richer, and therefore more interesting. I have no problems with potency, but in the evening it's really hard to make myself, and as a prevention, I use it once a month - the effect lasts a long time.

Boris: Hello. Recently, I began to fall into embarrassment, after which the lady was very unhappy, and it was very unpleasant to herself. I read the reviews on Cialis, I decided to buy a dozen tablets per sample. I took one, half an hour later my face caught fire a little, but quickly passed. A bit of foreplay and stanchion was such as it was not in his youth. Yes, and sex was just awesome. In general, I was in a sweet shock and a lady.

Egor: Cool - these pills are acceptable to take in a state of slight intoxication. Unlike other drugs, their effectiveness does not decrease and the result is always there! Particularly pleased with the price. Having tried different means, I can say - generic Cialis Soft is the best among them in terms of cost and quality!

Andrew: 10 mg has effectively strengthened my weak erection for several days, which is much longer than 36 hours as advertised. Side effects: redness, nasal congestion - quickly passed. With cialis, the action is longer.

Igor: I never complained about the "male power", everything was fine until 43 years old. Recently, I developed prostatitis, I effectively and comprehensively treated it. Then began to show problems with erection. The doctor prescribed me Cialis in a dosage of 5 mg. Took a few hours before sexual intercourse. The effect of the drug continues for several days. The effect is super, I am very pleased. After the first 4 tablets I immediately purchased a pack of 28 pcs.

Below is a video about the drug.

The use of the drug is recommended for men suffering from low libido and erectile dysfunction. Under erectile dysfunction implies a short and sluggish erection, accompanied by premature ejaculation in the first minute of sexual intercourse or before its occurrence.

This pathology occurs in men of middle and old age, but as a result of an unhealthy lifestyle, all the many young people are increasingly faced with these problems. The drug allows you to normalize the reproductive system, impaired as a result of the impact of psychological or physiological factors.

Cialis is used for prevention such diseases:

Composition and release form

The drug Cialis is made in the dosage form of oral tablets, film-coated. They have a yellow color, a round shape and a biconvex surface. The main active ingredient of the drug is tadalafil, its content in one tablet is 5 and 20 mg. It also includes auxiliary substances, which include:

  • Magnesium stearate.
  • Lactose monohydrate.
  • Sodium lauryl sulfate.
  • Giproloza.
  • Titanium dioxide.
  • Croscarmellose sodium.
  • Triacetin.
  • Iron oxide yellow.
  • Hypromellose.

Cialis tablets are packaged in a blister of aluminum foil in 1, 2, 4, 8 or 14 pieces. The carton pack contains 1 or 2 blisters with pills, as well as instructions for use of the drug.

Dosing and Administration

Cialis tablets are intended for oral administration (oral administration). They are taken whole, not chewed and washed down with a sufficient amount of water at least 16 minutes before the intended sexual contact, regardless of the pre-meal. The average recommended therapeutic dosage of the drug is 20 mg. Taking tablets is not allowed more than once a day. Improved erections and the ability of men to have full sexual intercourse on average persist for 36 hours after taking Cialis tablets.

Cialis price

The average cost of a package of Cialis in pharmacies in Moscow depends on the dosage and the number of tablets in it:

  • 1 tablet, 20 mg - 1082-1099 rubles.
  • 2 tablets, 20 mg - 1780-1892 rubles.
  • 4 tablets, 20 mg - 3262-3425 rubles.
  • 8 tablets, 20 mg - 5440-6197 rubles.
  • 14 tablets, 5 mg - 3027-3309 rubles.
  • 28 tablets, 5 mg - 5422-6075 rubles.

FAQ: Answers to Frequently Asked Questions

How often to take Cialis?

The drug is taken once a day or two, regardless of the dosage of tadalafil in the tablet. It is not recommended to divide the intake of Cialis per day into several times - this will not affect the effectiveness of the drug, but will increase the likelihood of side effects.

Can I combine Cialis and alcohol?

Alcohol does not affect the action of Cialis, and Cialis does not aggravate the negative effects of alcohol.

Is Cialis compatible with antibiotics?

The instructions for use of a pharmacological agent show that the manufacturer does not indicate antibiotics as substances that cannot be mixed with tadalafil. According to the instructions of doctors, drug potency instructions for antibiotics should be used with caution for potency.

How fast does cialis start and how long does it take?

In some patients, Cialis begins to act after 16 minutes. More often in men, this time is 30 minutes. But remember, without sexual arousal, the effect does not come. Cialis lasts approximately 36 hours after ingestion.

What is the price in pharmacies?

  • 20 tablets - 2400 r.
  • 30 tablets - 3300 r.
  • 50 tablets - 4500 r.
  • 100 tablets - 8500 p.

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