Tadalafil: Everything You Need to Know

Tadalafil is a well-known medication created to eliminate symptoms of erectile dysfunction. As this medication is so popular Canadian Health&Care Mall http://aboutcanadianhealthcaremall.com/ makes up its mind to explain its essence in details.

The drug Tadalafil has been designed and produced by British pharmaceutical company Elly Lilly. This drug is an agent for various disorders of male erectile function treatment. Tadalafil exerts its effect by relaxing blood vessels, which increases blood circulation in penile tissues, the result of which is a good erection. British corporation releases a drug with tadalafil as an active ingredient under the trade name “Cialis.”

Products Containing Tadalafil

Nowadays, there is one original drug containing tadalafil, which is called Cialis. Also, Cialis has a fairly wide range of products containing tadalafil as an active ingredient, which are considered to be generic. In principle, all of these drugs will have the same therapeutic effect, so pharmacists consider them synonymous. Today in the pharmaceutical market provides the following products containing tadalafil as an active ingredient:

• Cialis 2.5 mg, 5 mg and 20 mg;
• Cialis Soft 20 mg;
• Tadalafil 40 mg (high-power);
• Tadalafil;
• Tadlif;
• Tadasoft;
• Cialis Tadarise;
• Tadagra softgel;
• Tadadel.

The above drugs are drugs-synonyms, so they have the same effect. Dosages of Cialis in them as the same. Drugs manufactured by various pharmaceutical companies, and therefore have different names. In general, Cialis is considered as to the original drug, and all other drugs are referred to generic ones.

Generic Cialis

Tadalafil is a chemical substance, meaning it is synthesized in tubes. In nature, it does not exist, so this substance cannot be found in any food or medicinal plants. These methods of tadalafil preparation and chemical synthesis were carried out by experts of British Pharmaceutical Corporation Elly Lilly in 2003. On the basis of the substance, pharmacologists created an original drug – Cialis. All other drugs are created on the basis of Cialis. Let’s consider the basic differences and characteristics of generic and original medicines.

In developing the original drug, pharmaceutical company synthesizes and releases certain chemicals that will be considered as the active constituent. Then experimentally optimal dosage of a substance is identified in which it has the best positive effects with minimal side reactions. Optimum additive components are also installed. Then developing agent synthesis technology and methods for purification of various impurities are carried out, which often causes allergic reactions and side effects. After successful completion of all development phases of the finished product is tested and released to the market under a specific name, invented especially for it.

Thus, there are original pharmaceutical preparations which are international patents. However, a patent for the drug is valid for a limited time, after which any pharmaceutical company can take part in original drug (written in each instruction) and made according to specified dosages own medicine. That this drug will be called generics. In rare cases, generics are coming up with a new name. And often it is referred to simply as a generic international name for an active ingredient. For example, with respect to active ingredient tadalafil is as follows: original drug is called Cialis, and most of the generic – Tadalafil. That is, in Generics contain the same active ingredient as the original drug. Generics usually cost much cheaper than the original drugs but quality is the same especially when ordered via Canadian Health and Care Mall.

In spite of the same active ingredient in generics and original products, the composition of additive components can vary significantly. Often the only generic resemblance to original drug – it’s just the same active substance. Thus, as a rule, they are taken to generate generic active substances in chemical laboratories produced industrially, which do not undergo serious and thorough cleaning of contaminants. That is a larger number of impurities are referring to pharmacists, speaking about any drug that it is rather “messy”. Therefore, Cialis has a large number of generic drugs, which belong to the tadalafil group. Most generic drugs made by Indian pharmaceutical corporations, which in principle are specialized in this area of the pharmaceutical market. The Indians released the following unusual generics:

1. Cialis Soft – a tablet that can be chewed or dissolved without drinking water;
2. Tadalafil 40 mg – a tablet which contains a large “shock” active ingredient dose;
3. Gel Cialis – tadalafil in the form of a gel, which is applied locally.

Today, saying “Tadalafil”, people often assume Cialis drug, which is the second most popular after Canadian Viagra. That is why in future, in description of properties of various drugs called “Tadalafil”, we mean Cialis and its generic analogues.

Cialis Composition

Today Tadalafil is available in the tablet dosage form of active ingredient – 2.5 mg, 5 mg, 20 mg and 40 mg. As an active ingredient “Tadalafil” is a chemical substance with the same title – tadalafil. As auxiliary components, Tadalafil include the following materials:

• lactose;
• hyprolose;
• croscarmellose sodium;
• macrocrystalline cellulose;
• magnesium stearate;
• sodium lauryl sulfate;
• titanium dioxide;
• triacetin.

Tadalafil tablets are almond-shaped with a film cover, painted in yellow or red. On one side of the tablet are engraved numbers denoting to dosage – ie 2.5, 5, 20 or 40. Tadalafil tablets in 20 mg and 40 mg are available in packages of 1,2, 4 or 8 pieces. Tablets in doses of 2.5 mg and 5 mg are available in packages of 14 and 28 units.

Therapeutic Action and Effects

Tadalafil is a drug that enhances male erectile function. The drug has the capability to influence key reactions that constitute a single process of sexual excitement and provoke an erection. Generally, when a man is sexually excited, penile vessels strongly increase, there is a large inflow of blood volume, causing penis hardness, i.e. an erection occurs. At various erectile dysfunction, there is a defect of blood filling of penile vessels. Tadalafil is a drug that increases blood circulation in the penis, resulting in a stable and a good erection.

Increased blood circulation in the penis is happened due to blood vessels expansion under the influence of special substances – cGMP. But cGMP enzyme is rapidly destroyed by special – cGMP-specific phosphodiesterase type 5 (PDE – 5). Tadalafil inhibits (slows down) performance of PDE – 5, and as a result, does not break down cGMP and acts over a longer period of time by relaxing blood vessels and helping penis to fill with blood for normal erection development.

However, generic Cialis does not perform independently, for the manifestation of its effect requires sexual stimulation and natural sexual excitement. The drug can not just make blood vessels expand, filled with blood and thus make the penis erected. The fact is that cGMP required for penile vessels expansion, is produced under the influence of nitric oxide (NO). A nitric oxide is released from precursors only when the male sexual excitement begins. It is a normal sexual stimulation leads to sending pulses to the relevant centers in the brain and spinal cord, where nerve fibers transmit the command to release of nitric oxide. Thus, the release of nitric oxide results in operating time of cGMP, which dilates blood vessels and makes directly penis erected. And Tadalafil can only strengthen and prolong effects of cGMP, which is to be formed under the influence of natural sexual excitement through nitric oxide.

Prolonging effect of second cGMP messenger, Tadalafil makes erection more pronounced and prolonged. But for drug effect manifestation it is necessary to cause molecule cGMP operating, which is enough to be excited at the level of simple natural sexual desire. In this case, male Tadalafil supports activity and gives a good erection, which is enough for a full sexual intercourse. But in the absence of sexual stimulation, Tadalafil will not cause an erection, because drug only intensifies and prolongs the natural process. Self medication can not fully create artificial sexual excitement and erection in men.

PDE enzymes are not only in penile blood vessels and eye retina arteries, skeletal and cardiac muscle, lung, etc. PDE is indicated in each organ, there is a specific number, such as PDE-5 – is an enzyme functioning in penile vessels, PDE-6 – localized in the retina, and PDE-3 – in cardiac muscle. Tadalafil has a high specificity, and therefore performs selectively only on PDE-5. That is why there are no drug side effects such as the influence of pressure, change of color, etc. these side effects are less common and usually they are not observed.

Tadalafil effect lasts within 36 hours after administration of one tablet. Paced action of the drug within 16 minutes after taking a pill with good sexual excitement. Tadalafil has no effect on blood pressure or lying down, or standing. Also, a medicine, unlike Viagra, does not change heart rate, does not affect color perception, visual acuity, intraocular pressure and pupil size. Tadalafil, in addition, improving erection, does not affect sperm quality.

Indications for Use

Nowadays, only one tadalafil indication is present – it is erectile dysfunction treatment, ie, a condition in which the penis does not become sufficiently dense and excited for a full intimate intercourse. The drug causes the development of good erection only in conjunction with sexual stimulation.

Tadalafil is indicated for use with a weak erection due to the following factors:

• psycho-emotional disorders;
• organic erectile dysfunction;
• diabetes;
• removed prostate gland;
• obesity;
• hypertension;
• spinal cord injury.

Contraindications

Tadalafil has absolute and relative contraindications. In the presence of absolute contraindications drug use is prohibited under any circumstances. And if you have relative contraindications Tadalafil can be used in compliance with care and under careful monitoring of human health state. The relative and absolute contraindications are reflected in the table below:

Absolute Contraindications to Tadalafil Intake	Relative Contraindications to Tadalafil Intake
Hypersensetivity, allergy or intolerance to tadalafil and other components	Cardiac Insufficiency of the second and higher class, which was developing during half a year
Age older that 18	Hepatic Insufficiency
Pregnancy and Lactation Period	Unstablestenocardia
Simultaneous application of medications containing nitrates: Nitroglycerine, Nitrosorbide, Tivortin, Vasotropin and etc.)	Stenocardia, appearing during sexual activity
Simultaneous application of alpha-adrenoblocker (for example, Tropaphenum, Phentolamine, Phenoxybenwmine, Pyrroxanum, Alphuzosin, Butyroxan, Ditamin, Doxazosinum, Nicergolinum, Prazosin and etc.)	Renal insufficiency with creatine clearance less than 50 ml/min according to Test of Reberg
	Hypotension lower that 90/50 mm Hg
	Myocardial infarction or previous blood stroke
	Eye retina degenerative disorder, for example, pigmented retinitis
	Sickle-cell anemia
	Multiple myeloma
	Leukaemia
	Penis deformation (deflection, fibrosis, Peyronie’s disease)
	Simultaneous application with other inhibitors of PDE-5 (Viagra)
	Uncontrolled arrythmia or hypertension

Tadalafil – Instructions for Use

Tadalafil tablets must be taken orally, washing down with a little water. A tablet may be taken without regard to meals. Average recommended a single dose of the drug is 20 mg. A tablet with an appropriate dose should be taken no earlier than 16 minutes before planned sexual intercourse.
After taking tadalafil it is possible to have sexual intercourses within 36 hours. Thus it is possible to set optimum time during which drug effect develops. Then man will be able to choose individual for himself time at which you need to take a pill, to hold a successful sexual intercourse. Do not abuse frequent drug use. Tadalafil is recommended to take no more than once per day.

Elderly people older than 65 years should take Cialis online at usual doses recommended for middle-aged men. That is, there is no need to adjust the dosage of drug on the basis of older men only.

20 mg tadalafil dosage is possible to be reduced to 10 mg, 5 mg or 2.5 mg. If there is an urgent need to feel safe, it is allowed to take 40 mg Cialis at one time. In this case, it should be remembered that 40 mg is the maximum daily drug dose.

If a person takes drugs, which are inhibitors of enzyme CYP3A4, such as ketoconazole, itraconazole, ritonavir, erythromycin, saquinavir, clarithromycin, telithromycin, nefazodone, and others, Tadalafil is permitted to be used in a dosage of 10 mg, and take no more than once within 72 hours ( 3 days).

For tadalafil, there is not revealed a tendency causing priapism – a phenomenon of painful erection that lasts for a long time (several hours). However, it is theoretically possible, especially with simultaneous use of tadalafil with other drugs from a group of PDE-5 inhibitors such as Viagra. In the case of erection that lasts 4 hours or longer, you should consult a doctor immediately, as untimely treatment of this condition can lead to loss of potency in the future for a long period of time. Due to the high risk of side effects or priapism, it is not recommended combined use of various drugs from a group of PDE-5 inhibitors such as Viagra + Cialis.

Tadalafil Taken by Patients with Renal Failure

If functional disorders of kidneys is minor, the drug is taken in normal doses. Dosage compensation is not required for patients up until the filtration rate of creatinine (CC) is greater than 50 ml / min according to the Test of Reberg.

In patients with moderate renal insufficiency, when spacecraft is 31 – 50 ml / min, recommended starting dose of tadalafil is dosage of 5 mg. In this case, maximum allowable dosage for this category of people is 10 mg over 48 hours. In severe renal failure, the maximum allowable daily dose is 5 mg tadalafil. It should be remembered that in the presence of renal insufficiency with CC 31 – 50 ml / min is a more common side effect in the form of back pain.

Tadalafil Taken by Patients with Hepatic Insufficiency

If liver failure is average or light, the drug can be administered at a dosage of 10 mg per day. If hepatic failure – severe, it is recommended to refrain from all tadalafil medications at all.

Overdose

Volunteers receiving the drug at a dose of 500 mg at a time, or 1000 mg for several times within one day were not observed overdose symptoms. That is, severity or frequency of side effects were the same as in conventional tadalafil in low therapeutic doses. However, you need to use products that will eliminate health problems appeared in negative, strongly pronounced side effects development.

Tadalafil Interactions with other Drugs

If necessary, take Tadalafil with other medications, should be aware of their influence on each other. If drugs weaken the effect of tadalafil, is necessary to increase the dosage of the latter. If the medicine – by contrast, it amplifies the effect, the dosage should be reduced, or even refrain from such combinations. There are drugs that do not affect the effect of tadalafil – in this case does not require any adjustment to its dosage. Drugs that increase, decrease and do not affect the effect of tadalafil are reflected in the table below:

Strengthening Tadalafil Effect	Reducing Tadalafil Effect	Have no Influence on Tadalafil Effect
Inhibitors of enzyme – CYP3A4: tetracycline, ketoconazole, itraconasole, erythromycin, cimetidine, sacvinavir, ritonavir, clarithromycin, telithromycin, nefazodone and etc.)	Rifampicin	nonsteroidal antiinflammatory drug (NAD): ibuprofen, nise and etc.)
Donators of nitric oxide (nitroglycerine, sodium nitroprussiate, molsidomine, isosorbide dinitrate, Tivortin, Vasotropin and etc.)	H2 – histamine antagonists	Alpha-adrenoblocker (Tropaphenum, Phentolaminum, Pyrroxanum, Alphuzosin, Butyroxan, Ditamin, Doxazosinum, Nicergolinum, Prazosin and etc.)
Alcohol		Tolbutamide
Viagra (Sildenafil) and generics		Antiacid agents: Almagel, Gastal, Rennie and etc.)
		Antidepressants
		Urinative
		Azithromycin
		Tamsulosin
		Theophylline
		Midazolam
		Lovastatin
		Bendrofluazide
		Amlodipine
		Metoprolol
		Enalapril
		Warfarin

Side Effects

Tadalafil has a fairly wide range of side effects that develop at different rates. Thus, the most common adverse drug effects (occurring in 5 – 15% of men taking such pills) are the following states:

• headache;
• dyspeptic symptoms (belching, abdominal pain, heartburn, diarrhea, etc.);
• backache;
• muscle pain;
• nasal congestion;
• hot flashes;
• pain in extremities;
• blepharoedema;
• eyes pain;
• redness of eye conjunctiva;
• dizziness.

Back pain or muscle usually develop within 12 – 24 hours after administration of one tablet, and independently tested within 2 days. These pains often appear at bottom of waist, buttocks, hips, tailbone or sacrum. Particularly strong muscle pain and back pain is felt in the supine position. Pain is expressed little or medium. In rare cases, severe pain develops, which is well stopped by taking paracetamol.

In addition to these side effects, which are caused precisely by tadalafil intake, there are a number of symptoms that appear when using the drug. But the causal relationship of symptoms with tadalafil has not been proven. That is why these symptoms belong to a group of possible side effects, that is, it is not known whether they are caused by tadalafil, or just their appearance coincides with taking pills. Such theoretically possible side effects may be related to various organs and systems and are presented in the table below:

Organ System	Theoretically possible tadalafil side effect
The whole body	Asthenia
Facial edema
Excess fatigue
Pain syndrome
Cardiovascular system	Stenocardia
Chest pain
Decrease or Increase in blood pressure
Myocradial infarction
Rapid heartbeat
Syncopal attack
Digestive tract system	Changes in activity of AST и ALT
Diarrhea
Mouth dryness
Odynophagia
Esophagitis
Gastritis
Increase in activity of gamma-glutamyl transpeptidase
Nausea
Vomiting
Stomach ache
Locomotor apparatus	Painful joints
neck ache
Nervous System	Dizziness
Skin hypersensitivity
Insomnia
Drowsiness
Paresthesia
Respiratory System	Nasal hemorrhage
Pharyngitis
Breathing Disorders
Skin	Rash
Itch
Sweating
Eyes	Vision acuity disorder
Color perception disorder
Conjunctivitis
Eye ache
Tearing
Blepharoedema
Genitourinary system	priapism
Spontaneous erection

Analogs

thecanadianhealthcaremall.com selects the most popular analogs of Tadalafil at reasonable terms:

• Viagra;
• Levitra;
• Capsules Furunbao Super;
• Sealeks;
• Tribestan;
• Tongkat Ali Platinum;
• Loveron;
• Stalon Neo;
• Yohimbine;
• Himcolin.

Reviews about Preparation

Tadalafil reviews are mostly positive, and it applies both to original Cialis and various generics. Tablets are taken by elderly men, and young men, but they both provide good effect of tadalafil, which manifests itself in form of a firm erection sufficient for sexual intercourse that lasts for several days – from 2 to 4.

In addition to good erection development, men underline lengthening sexual intercourse, that is Tadalafil significantly prolongs it. Also, some men notice changes in sensation during sex, which they regard as a just unusual. Such an interesting fact from a male point of view is that sensation leads to a bright and long orgasm.

In the background, of course, the positive effect of tadalafil, may provoke minor side effects such as headache and strong twisting extremities. However, men believe that these phenomena can provoke minor discomfort to endure because pleasure in sex, which allows you to get Tadalafil, immeasurably higher and higher. Therefore, the side effects of male figures consider a small price to pay for great sex, reviews in general, are positive about the drug.

There is also a small amount of negative feedback about tadalafil, which are caused by the development of hot flushes, strong back pain, nasal congestion and headache instead of erection. That is, there is side effects formation that completely overshadow the main action of tadalafil. In this situation, even at a firm and good erection, it is impossible to make love, which greatly disappoints, and makes writing negative feedback about the drug.

Some men point out sexual intercourse slowness, as during treatment with tadalafil it is more difficult to achieve ejaculation. One representative of the stronger sex like it because it allows longer enjoy the pleasure of sexual intercourse, and others – on the contrary, cause negative emotions. This phenomenon also has an impact on opinion about the drug. Those men who love sex long, consider it a plus and leave a positive review. And those men who do not like long-term sexual intercourse, according to inability to achieve relatively quick ejaculation therefore leave negative feedback on tablets intake.

Category: ED Drugs from Canadian Pharmacy

Tags: Generic Cialis, tadalafil