Cialis is one of the most widely used drugs for erectile dysfunction in 2023. This drug appeared on the pharmaceutical market in 2003, when its active ingredient Tadalafil under the Cialis brand, produced by the American pharmaceutical company Eli Lilly, received FDA approval and began to be used first in the United States, and soon in most other countries of the world. The drug belongs to the category of phosphodiesterase type 5 inhibitors (PDE-5).
Indications of Cialis
Indications for the use of Cialis, in addition to erectile dysfunction, include benign prostatic hyperplasia. The property of Cialis to reduce the volume of the prostate gland and reduce the level of its inflammation was not immediately noted. The FDA approved the use of Cialis as a treatment for BPH in 2012, 9 years after the drug was patented as an anti-ED drug. Since both disorders - erectile dysfunction and benign prostatic hyperplasia, also known as prostate adenoma - often go hand in hand, the drug has proven to be very popular among older men. It is in the category of men over 55 years of age that the most common combination of these diseases and such an etiology of problems with potency. Thus, indications for the use of Cialis, in addition to complaints of insufficiently stable and prolonged erection, are symptoms of the lower urinary tract in patients with BPH and erectile dysfunction in patients with symptoms of the lower urinary tract against the background of benign prostatic hyperplasia.
Admission Restrictions
Absolute contraindications to the use of Cialis are the simultaneous use of drugs that contain any organic nitrates, age up to 18 years and hypersensitivity to Tadalafil, which usually manifests itself in the form of a severe allergic reaction. In addition, it is strongly not recommended to take Cialis in patients with severe hepatic insufficiency, as well as with severe renal insufficiency. Cialis should not be combined with other drugs for the treatment of erectile dysfunction, especially from the category of PDE-5 inhibitors. The joint use of drugs in this category doesn't lead to an increase in their effect on the male reproductive system, but to unpleasant and potentially dangerous side effects and overdose phenomena, which are accompanied by excessive stress on the cardiovascular system.
Patients with diseases of the cardiovascular system can take Cialis only after consulting a cardiologist or therapist who is well acquainted with their medical history. If, due to disorders of the cardiovascular system, a man is recommended to limit sexual activity, taking Cialis and any of its analogues is also excluded. Cialis is contraindicated within six months after a myocardial infarction or stroke, as well as in heart rhythm disorders such as unstable angina, uncontrolled arrhythmia, severe hypotension and uncontrolled chronic heart failure.
Despite the fact that Cialis is much better tolerated by the body than all other drugs used in the treatment of erectile dysfunction, you should be careful when taking this medication and pay due attention to following the instructions for use.
In the case of a disease such as optic neuropathy, which may be accompanied by temporary or permanent loss of vision (most often in one eye), the action of Tadalafil, despite its high selectivity for the PDE-5 enzyme, doesn't exclude its potential effect on vision and color perception.
Cialis should be used with caution in men with a predisposition to priapism (for example, with sickle cell anemia, multiple myeloma or leukemia) or men with anatomical deformity of the penis (for example, with angulation, cavernous fibrosis or Peyronie's disease). The patient should be informed of the need for immediate medical attention in the event 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 or permanent loss of potency may occur.
Side effects
Many consumers make their choice in favor of Cialis, as well as its generics, because Tadalafil is much better tolerated by the body than other drugs belonging to the category of PDE-5 inhibitors. It causes a significantly smaller number of side effects, which, as a rule, are most pronounced the first two or three times after taking the medicine, and then practically disappear. Some patients experience no side effects at all. However, one should not assume that Cialis is a medicine that will never cause any discomfort.
The most common side effects from taking it include headache, indigestion, nasal congestion, and flushing of the face. Dizziness, back pain are somewhat less common. Even less frequently, patients experience eyelid edema, eye pain, and conjunctival hyperemia. Allergic reactions (like https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4030346/) are also possible, although the drug itself is not a strong allergen, and a hypersensitivity reaction to it usually occurs in those patients who, in principle, often show allergic reactions to various drugs.
It is noteworthy that such a side effect as a decrease in pressure is more often observed when Tadalafil is used in patients already taking antihypertensive drugs.
Among patients receiving Tadalafil once a day, a slightly higher frequency, compared with placebo, of abnormal ECG parameters, primarily sinus bradycardia, is reported. Most of these deviations are not accompanied by undesirable clinical manifestations. Unfortunately, clinical trial data on patients over 65 receiving Cialis for the treatment of erectile dysfunction or BPH are limited. In clinical studies with the use of Tadalafil on demand for the treatment of erectile dysfunction, diarrhea is more common among patients over the age of 65 than among younger patients. In clinical studies with the daily use of Tadalafil at a dose of 5 mg for the treatment of BPH, cases of dizziness and diarrhea are more common among patients over the age of 75 years.
Tips for Use and Dosage Regimen
The way Cialis is used and the dosage regimen depends on the form of release of the drug, as well as on a number of other factors, including the state of the patient's cardiovascular system, the severity of potency disorders, the degree of benign prostatic hyperplasia, and much more.
The optimal dosage regimen is determined by the doctor. Compliance of the dosage form of a particular drug with the indications for use and the dosing regimen in general should be strictly observed. As a rule, middle-aged men are recommended to take Cialis at a dosage of 20 mg at least 15 minutes before the expected sexual activity, regardless of food intake. This type of reception is called on-demand reception. It is also available with a dosage of 10 mg. Patients can attempt intercourse at any time within 30-36 hours after taking the medication. This allows you to set the optimal response time for taking Tadalafil, depending on the individual sensitivity of the body to this drug. The maximum frequency of administration is once a day.
For patients with frequent sexual activity (more than 4 times a week), the recommended frequency of administration is daily, 1 time per day, in the dosage of 5 mg, at approximately the same time, regardless of food intake.
When using the drug Cialis according to the indication of BPH, the recommended dose of the drug when used 1 time per day is 5 mg; the drug should be taken at approximately the same time of day, regardless of the time of sexual activity. The duration of treatment is determined by the doctor individually. In patients with mild to moderate renal insufficiency, dose adjustment is not required. In patients with severe renal insufficiency, the use of Cialis is contraindicated. In diabetes, a dosage change is not required.
If we are talking about the classic brand Cialis pills or its absolute analogues, it is recommended to drink the pill down with water. If the patient takes non-standard forms of generics, such as oral gel sachets or soft tablets, they don't require drinking water.
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