Cialis is a drug containing an active substance called Tadalafil. Like Viagra, Cialis is a selective, reversible inhibitor of cGMP specific phosphodiesterase type 5 (PDE5). When sexual stimulation leads to the release of nitrogen-II-oxide (NO), inhibition of PDE5 leads to an increase in cGMP levels in the cavernous body of the penis resulting in relaxation of smooth muscles, increased blood flow to the penis, thus leading to erection.
The effects of Cialis Tadalafil last much longer than effects of Viagra. Cialis achieve its effects from 15 to 45 minutes after oral administration. In addition to being used to treat erectile dysfunction (ED), studies have shown that this drug is also effective in the treatment of benign prostatic hyperplasia.
Cialis is also known as the “weekend pill”, and it earned this reputation due to its long-lasting effect, which can last up to 36 hours. For comparison, effects of Viagra and Levitra last up to 8 hours. These two drugs are also the main competitors of Cialis.
In October 2011, the US Food and Drug Administration has approved use of Cialis Tadalafil for the treatment of signs and symptoms of benign prostatic hyperplasia, as well as for erectile dysfunction.
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Contraindications and Precautions
Cialis Tadalafil exhibits a significantly higher potential for interactions than Viagra and Levitra, because it retains much longer in the blood. The concomitant use with the following drugs is contraindicated:
- Riociguat
- Nitroglycerin
- Isosorbide mononitrate
- Isosorbide dinitrate
- Amyl nitrite
- ACE inhibitors like Enalapril (medicine used to treat hypertension and heart failure)
Cialis does not interact with Amlodipine and Ritonavir, as is the case with Viagra.
An active substance of the drug –Tadalafil can cause optic neuropathy, so its use is contraindicated in patients who already have eye diseases.
Cialis Tadalafil should not be used in the following situations:
- If you are using nitrate drugs, such as Isosorbide dinitrate, Nitroglycerine, and Isosorbide mononitrate. These drugs are used in the treatment of angina pectoris. The concomitant use with these drugs may lead to a sudden increase in blood pressure
- If you use a recreational drug known as “poppers” (amyl nitrite or butyl nitrite). The concomitant use with these drugs may also lead to hypotension.
- If you are allergic to Tadalafil or other chemically similar substances (Sildenafil and Vardenafil). If you notice sings of an allergic reaction, such as itchy skin, swelling of the lips, tongue or throat, difficulty breathing, or swallowing, you must seek immediate medical attention.
After taking one tablet of Cialis, some of its ingredients can remain in your body for more than 2 days. These ingredients will stay longer in your body if you have kidney or liver problems or if you are taking other medicines concomitantly. Therefore, use of this medicine is not recommended in patients with impaired renal or hepatic function.
If you experience side effects, such as chest pain, dizziness, or feeling sick during or after sex, it you must stop using Cialis Tadalafil and seek medical help. Sexual activity can cause cardiac overload, especially if you already have a history of heart disease such as heart attack.
You must consult with your doctor before you start using Cialis Tadalafil in the following situations:
- If you have heart problems, such as angina pectoris, rapid heartbeat, or history of heart attack.
- If you have low blood pressure (hypotension) or high blood pressure (hypertension).
- If you have positive history of stroke.
- If suffer from experience liver problems.
- If you have kidney problems.
- If you have rare genetic disease that affects the eyes and is called retinitis pigmentosa.
- If you have had sudden loss of vision, including a condition called non-arteritic anterior ischemic optic neuropathy (NAION).
- If you have duodenal ulcer or active stomach.
- If you have anatomic abnormality of the penis, such as Peyronie’s disease.
- If you have had a painful erection that lasts longer than 4 hours (medically called priapism).
- If you have sickle-cell anemia, multiple myeloma, or leukemia.
Dosage
The recommended dose of Cialis Tadalafil is 10mg, at least 30 minutes before the planned sexual activity. If necessary, the dose may be increased up to 20mg. Cialis can be taken regardless of food, because the food does not change the absorption of this drug. The maximum daily dosage is 20mg. The concomitant use with alcoholic drinks reduces the efficacy of Cialis.
Unlike Viagra, Cialis can be taken on a daily basis, but in a lower dose (2.5-5mg once a day).
In patients with impaired renal or hepatic function, a reduction in dose is recommended (the maximum dose for these patients is 10mg).
The Cialis tablets are administered orally. You should swallow the tablet whole with sufficient amount of water. Decrease in efficacy of Cialis Tadalafil may occur if you crush or chew the tablet.
Overdose
A single 500mg dose and multiple daily doses of up to 100mg were administered to healthy subjects. Adverse reactions were similar to those observed at lower doses.
In the case of an overdose, standard appropriate measures should be initiated as necessary. Hemodialysis negatively contributes to the elimination of Tadalafil, therefore hemodialysis is not recommended in the case of the Cialis overdose.
Side Effects
As with Viagra, the most common side effect of Cialis Tadalafil is a headache. Cialis can cause all side effects like Viagra, but does not cause change of color perception. Tadalafil can cause stroke and migraine, unlike Viagra which does not cause these adverse effects.
In addition, Cialis Tadalafil may also cause following side effects:
- Dyspepsia
- Back pain
- Muscle pain
- Angioedema
- Blurred vision
- Visual disturbances
- Sudden loss of hearing
- Tinnitus
- Tachycardia (rapid heartbeat)
- Dyspnea (shortness of breath)
- Nosebleeds
- Stomach pain
- Dermatitis
- Presence of blood in the urine
- Chest pain
- Sudden death due to cardiac block
