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Cialis

Cialis
Cialis is a drug for the treatment of erectile dysfunction in men.

Brand: Tadalafil

Availability: In Stock
Average Delivery Time: 9 Days
Exp. Date: December 2023
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Package Price Per pill Save Order
Cialis 80 mg
270 pills - 80 mg
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$809.95 $3.00 $694.76 Add to cart
180 pills - 80 mg
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$553.23 $3.07 $449.91 Add to cart
120 pills - 80 mg
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$381.14 $3.18 $287.62 Add to cart
90 pills - 80 mg
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$295.61 $3.28 $205.96 Add to cart
60 pills - 80 mg
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$213.25 $3.55 $121.13 Add to cart
30 pills - 80 mg
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$125.95 $4.20 $41.24 Add to cart
20 pills - 80 mg $95.95 $4.80 $15.51 Add to cart
10 pills - 80 mg $55.73 $5.57 No Add to cart
Cialis 60 mg
360 pills - 60 mg
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$533.95 $1.48 $971.21 Add to cart
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$445.99 $1.65 $682.88 Add to cart
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$328.55 $1.83 $424.03 Add to cart
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$245.88 $2.05 $255.84 Add to cart
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$202.83 $2.25 $173.46 Add to cart
60 pills - 60 mg
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$151.92 $2.53 $98.94 Add to cart
30 pills - 60 mg $85.93 $2.86 $39.50 Add to cart
20 pills - 60 mg $65.93 $3.30 $17.69 Add to cart
10 pills - 60 mg $41.81 $4.18 No Add to cart
Cialis 40 mg
360 pills - 40 mg
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$517.95 $1.44 $920.25 Add to cart
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$425.99 $1.58 $652.66 Add to cart
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$315.51 $1.75 $403.59 Add to cart
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$235.79 $1.96 $243.61 Add to cart
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$193.34 $2.15 $166.21 Add to cart
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$143.21 $2.39 $96.49 Add to cart
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10 pills - 40 mg $39.95 $4.00 No Add to cart
Cialis 20 mg
360 pills - 20 mg
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$445.75 $1.24 $883.73 Add to cart
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$148.11 $1.65 $184.26 Add to cart
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$106.68 $1.78 $114.90 Add to cart
30 pills - 20 mg $64.41 $2.15 $46.38 Add to cart
20 pills - 20 mg $50.95 $2.55 $22.91 Add to cart
10 pills - 20 mg $36.93 $3.69 No Add to cart
Cialis 10 mg
360 pills - 10 mg
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$385.23 $1.07 $907.89 Add to cart
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$130.95 $1.46 $192.33 Add to cart
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30 pills - 10 mg $59.95 $2.00 $47.81 Add to cart
20 pills - 10 mg $47.34 $2.37 $24.50 Add to cart
10 pills - 10 mg $35.92 $3.59 No Add to cart
Cialis 5 mg
360 pills - 5 mg
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$353.99 $0.98 $886.21 Add to cart
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$287.26 $1.06 $642.89 Add to cart
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$112.93 $1.25 $197.12 Add to cart
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Cialis 2.5 mg
360 pills - 2.5 mg
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$250.05 $0.69 $265.35 Add to cart
270 pills - 2.5 mg
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$205.99 $0.76 $180.56 Add to cart
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$143.28 $0.80 $114.42 Add to cart
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$103.93 $0.87 $67.87 Add to cart
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Product description

Pharmacokinetics of Cialis

Buy Cialis in Canada

The pharmacokinetics of tadalafil in patients with erectile dysfunction is similar to the pharmacokinetics of the drug in patients without erectile dysfunction. Absorption After taking the drug inside, tadalafil is rapidly absorbed. Average Cmax in plasma is achieved on average 2 hours after oral administration. The speed and degree of absorption of tadalafil do not depend on food intake, therefore Cialis can be used regardless of food intake. The time of intake (morning or evening) had no clinically significant effect on the rate and extent of absorption. The pharmacokinetics of tadalafil in healthy individuals is linear with respect to time and dose. In the dose range from 2.5 to 20 mg, AUC increases in proportion to the dose. The distribution of Css in plasma is achieved within 5 days when the drug is taken 1 time / day. The average Vd is about 63 liters, which indicates that tadalafil is distributed in body tissues. The plasma protein binding of tadalafil at therapeutic concentrations is 94%. In healthy individuals, less than 0.0005% of the administered dose is found in semen. Metabolism Tadalafil is mainly metabolized with the participation of the isoenzyme CYP3A4. The main circulating metabolite is methylcatechol glucuronide. This metabolite is at least 13,000 times less active against PDE5 than tadalafil. Therefore, the concentration of this metabolite is not clinically relevant. Excretion In healthy individuals, the average clearance of tadalafil when taken orally is 2.5 l / h, and the average T1 / 2 is 17.5 hours. Tadalafil is excreted mainly in the form of inactive metabolites, mainly with feces (about 61% of the dose) and, to a lesser extent with urine (about 36% of the dose). Pharmacokinetics in special clinical situations Protein binding is not altered by impaired renal function. Healthy elderly patients (65 years and more) had a lower clearance of tadalafil when taken orally, which was expressed in an increase in AUC by 25% compared to healthy individuals aged 19 to 45 years. This difference is not clinically significant and does not require dose adjustment. No dose adjustment is required in patients with mild to moderate renal impairment. Due to the increased exposure of tadalafil (AUC), patients with severe renal insufficiency are not recommended to use Cialis. The pharmacokinetics of tadalafil in patients with mild and moderate hepatic impairment is comparable to that in healthy individuals. For patients with severe hepatic impairment (Child-Pugh class C), no data are available. When prescribing Cialis to patients with severe hepatic impairment, it is necessary to first assess the risk and benefit of using the drug. In patients with diabetes mellitus during the use of tadalafil, the AUC was approximately 19% less than in healthy individuals. This difference does not require dose adjustment.

Indications of Cialis drug

Erectal dysfunction treatment with Cialis

Treatment of the manifestations and symptoms of benign prostatic hyperplasia in adult men.

Cialis is not indicated for use in women.

Method of administration and dosage 

Appearance of Cialis Tadafil tablets

For oral administration. For the recommended dosage, you should take the drug with the appropriate content of the active ingredient in the tablet.

Adult men.

The recommended dose is 10 mg before anticipated sexual activity, with or without food. Patients in whom tadalafil at a dose of 10 mg does not have the desired effect, a dose of 20 mg can be used.

Tadalafil 10 mg and 20 mg is intended for use before intended sexual activity and is not recommended for daily use.

In the case of the expected frequent use of Cialis (at least twice a week), a daily regimen of lower doses of Cialis may be more appropriate, based on the patient's choice and the doctor's decision. For these patients, the recommended dose is 5 mg / day at approximately the same time. The dose can be reduced to 2.5 mg / day, based on the individual tolerance of the drug. The feasibility of long-term daily use should be periodically re-evaluated.

Benign prostatic hyperplasia in adult men.

For daily use, the recommended dose is 5 mg / day at approximately the same time, regardless of food intake. For the treatment of adult men with erectile dysfunction and the manifestations and symptoms of benign prostatic hyperplasia, the recommended daily dose is 5 mg / day at approximately the same time.

 


Overdose

Symptoms: with a single appointment of tadalafil to healthy individuals at a dose of up to 500 mg and patients with erectile dysfunction - repeatedly up to 100 mg / day, the undesirable effects were the same as when using the drug at lower doses. Treatment: in case of overdose, it is necessary to carry out standard symptomatic treatment. With hemodialysis, tadalafil is practically not excreted.

Interaction with other drugs

Tadalafil is mainly metabolized with the participation of the CYP3A4 enzyme. The selective CYP3A4 inhibitor ketoconazole increases the AUC by 107%, and rifampicin reduces it by 88%. Despite the fact that specific interactions have not been studied, it can be assumed that protease inhibitors such as ritonavir and saquinavir, as well as CYP3A4 inhibitors such as erythromycin and itraconazole, increase the activity of tadalafil. With the simultaneous administration of an antacid (magnesium hydroxide / aluminum hydroxide) and tadalafil, the rate of absorption of the latter decreases without changing its AUC. Tadalafil enhances the hypotensive effect of nitrates. This is due to the additive effect of nitrates and tadalafil on the metabolism of nitric oxide and cGMP. Therefore, the use of tadalafil in patients receiving nitrates is contraindicated.

Special instructions

With extreme caution and only if absolutely necessary, it is possible to use tadalafil in patients with severe renal failure (CC≤30 ml / min) and severe hepatic failure. During treatment with tadalafil, patients with moderate renal insufficiency (CC from 31 to 50 ml / min) were more likely to have back pain compared with patients with mild renal insufficiency (CC from 51 to 80 ml / min) or healthy volunteers ... In patients with CC ≤50 ml / min, tadalafil should be used with caution. Therefore, the treatment of erectile dysfunction, incl. with the use of tadalafil should not be carried out in men with heart diseases in which sexual activity is not recommended. The potential risk of complications during sexual activity in patients with diseases of the cardiovascular system should be taken into account: myocardial infarction within the last 90 days; unstable angina or angina that occurs during intercourse; chronic heart failure (II functional class and higher according to the NYHA classification), which has developed within the last 6 months; uncontrolled heart rhythm disturbances; arterial hypotension (blood pressure less than 90/50 mm Hg) or uncontrolled arterial hypertension; a stroke in the past 6 months. Tadalafil should be used with caution in patients with a predisposition to priapism (for example, with sickle cell anemia, multiple myeloma or leukemia) or in patients with anatomical deformity of the penis (for example, with angulation, cavernous fibrosis or Peyronie's disease). The patient should be informed about the need to immediately consult a doctor in case of an erection lasting 4 hours or more. Untimely treatment of priapism leads to damage to the tissues of the penis, as a result of which a long-term loss of potency may occur. No cases of priapism have been reported with tadalafil. It is not recommended to use tadalafil in combination with other treatments for erectile dysfunction

 


Side Effects

Summary of the safety profile of the medicinal product.

The undesirable effects that are most often reported in the treatment of erectile dysfunction or benign prostatic hyperplasia are headache, dyspepsia, back pain, myalgia, the frequency of which increased with increasing doses of Cialis. Adverse reactions were short-term, mild to moderate. Most cases of headache with daily intake of Cialis in doses of 2.5 mg, 5 mg were observed during the first 10-30 days after the start of treatment.