Other Ingredients:
Lactose monohydrate, croscarmellose sodium, hydroxypropylcellulose, microcrystalline cellulose, sodium lauryl sulfate, magnesium stearate, Opadry II dye mixture, talc.
Propharmacystores of the drug Cialis:
Cialis drug absorption.
After ingestion, tadalafil 40mg for sale is rapidly absorbed. Cmax is reached on average after 2 hours. The rate and extent of absorption are not dependent on food intake. The time of taking Cialis (morning or evening) has no clinically significant effect on the rate and extent of absorption.
The propharmacystores of the drug Cialis in healthy individuals is linear with respect to time and dose. In the dose range of 2.5 to 20 mg, the AUC increases in proportion to the dose. Css in the plasma are reached in 5 days with the administration of the drug 1 time / day.
The propharmacystores of the drug tadalafil in patients with impaired erection function is similar to the propharmacystores of the drug in individuals without a violation of erectile function.
The distribution of the drug Cialis:
Vd is about 63 liters, which indicates that Cialis is distributed in the tissues of the body. At therapeutic concentrations, tadalafil is 94% bound to plasma proteins. In healthy individuals, less than 0.0005% of the administered dose is found in sperm.
Metabolism of the drug Cialis:
Metabolized with the participation of the CYP3A4 isoenzyme. The main circulating metabolite is methylcatechol glucuronide. It is 13,000 times less active against PDE5 than tadalafil.
Therefore, this metabolite is unlikely to be clinically significant.
Excretion of the drug Cialis:
In healthy individuals, the average elimination of the drug Cialis for ingestion is 2.5 l / h, and the average T1 / 2 is 17.5 h. Cialis is excreted primarily as inactive metabolites, primarily with feces (approximately 61%) and to a lesser extent with urine (approximately 36%).
Propharmacystores in special clinical situations of the drug Cialis:
Healthy older people (65 years of age and older) have a lower clearance of the drug Cialis, which is expressed by a 25% increase in AUC compared to healthy individuals between 19 and 45 years of age. This difference is not clinically significant and does not require dose selection.
In patients with mild (KK 51-80 ml / min) or moderate severity (CK = 31-50 ml / min) renal impairment, the AUC is higher than in healthy individuals. Protein binding does not change if kidney function is impaired. In patients with severe renal insufficiency (KK <= 30 ml / min), the use of tadalafil has not been studied.
The propharmacystores of the drug Cialis in patients with mild or moderate disorders of liver function is comparable to that in healthy individuals.
In patients with diabetes mellitus, when the drug was used, the AUC of Cialis was lower by approximately 19% than in healthy individuals. This difference is not clinically significant and does not require a dose change.
Indications for the use of the drug Cialis:
- Erectile dysfunction.
Cialis drug dosage regimen:
Middle-aged men are recommended to take the drug Cialis in a dose of 20 mg. Cialis is taken at least 16 minutes before the supposed sexual activity, regardless of food intake.
Patients may attempt intercourse any time within 36 hours of taking the medication to establish the optimal turnaround time for taking the medication.
The maximum recommended reception frequency is 1 time / day.
For older men, no special dosage is required. Recommendations for taking medication for middle-aged men are also applicable for elderly patients.
Patients with impaired renal function (CK> = 30 ml / min) and special dose selection are not required.
Cialis Drug Side Effect:
- Very often: headache (11%), dyspepsia (7%).
- Cialis side effects are generally mild or moderate in severity, transient, and subside with continued use of the drug.
- Perhaps: pain in the back, myalgia, nasal congestion, flush of blood on the face.
- Rarely: edema of the eyelids, pain in the eyes, congestion, hyperemia, dizziness.
Contraindications to the use of the drug tadalafil:
- simultaneous administration of drugs containing organic nitrates;
- children and adolescents under 18 years of age;
- Established hypersensitivity to tadalafil and other components of the drug.
Pregnancy and breast-feeding
Cialis should not be used in women.
Special instructions for the use of the drug Cialis:
Since there are no data from controlled clinical trials on the safety and efficacy of Cialis in patients with severe renal insufficiency (CC <= 30 ml / min) and severe hepatic insufficiency, the drug should be used in this category of patients with extreme caution and only in an emergency. Against the background of treatment with Cialis in patients with moderate renal insufficiency (CK 31-50 ml / min), back pain was more frequent compared to taking cialis with patients with mild renal insufficiency (KK 51-80 ml / min) or healthy volunteers. Patients with CC <= 50 mL/min should exercise caution.
Sexual activity has a potential risk for patients with cardiovascular disease. Therefore, the treatment of erectile dysfunction, incl. with the use of generic cialis , it should not be done in men with heart disease in which sexual activity is not recommended.
The potential risk of developing complications associated with sexual activity should be considered in patients with cardiovascular diseases:
- myocardial infarction in the last 90 days;
- unstable angina or angina arising during sexual intercourse;
- Chronic heart failure (functional class II and higher according to the NYHA classification), developed during the last 6 months;
- Uncontrolled heart rhythm disturbances;
- arterial hypotension (blood pressure less than 90/50 mm Hg) or uncontrolled hypertension;
- A stroke that has been postponed for the past 6 months.
Cialis should be used with caution in patients with a predisposition to priapism (eg, sickle cell anemia, multiple myeloma, or leukemia) or in patients with anatomical deformation of the penis (eg, with angulation, cavernous fibrosis, or Peyronie’s disease).
The patient should be informed of the need to seek immediate medical attention in the event of an erection lasting 4 hours or more. Untimely treatment of priapism causes damage to the tissues of the penis, as a result of which long-term loss of potency may occur.
In the context of tadalafil use, no cases of priapism have been reported.
The safety and efficacy of Cialis combined with other treatments for erectile dysfunction have not been studied. Therefore, the use of such combinations is not recommended.
- Use in Pediatrics
- Cialis is not used in patients under 18 years of age.
- Impact on ability to drive and operate machinery No
- Specific recommendations.
Tadalafil drug overdose:
With a single appointment with healthy volunteers at a dose of 500 mg / day and patients with erectile dysfunction – repeatedly up to 100 mg / day, the unwanted effects were the same taking Cialis as with the use of the drug in patient’s dose
Treatment: conventional symptomatic therapy.
