Cialis, 20 mg 2 pcs

Sialis is a treatment for erectile dysfunction (impotence, erectile dysfunction) in men and is part of a group of drugs called FDE-5 (phosphodiesterase type 5) inhibitors.

The drug dilates blood vessels of the penis during sexual arousal.

As a result, blood circulation in the penis increases, and this, in turn, contributes to the onset of a stable erection.

Indications

Erectile Dysfunction

Active ingredient

Composition

1 film-coated tablet contains:

Tadalafil 20 mg

Associated substances:

Lactose monohydrate

Hyprolose (hydroxypropyl cellulose)

Croscarmellose sodium

p> Microcrystalline cellulose

Magnesium stearate

Sodium lauryl sulfate

Composition of the shell:

oradgu II yellow – lactose monohydrate, hypromellose, titanium dioxide, triacetin, iron oxide yellow dye.

How to take, the dosage

The drug is taken orally. The recommended maximum dose of the drug is 20 mg. The maximum recommended frequency of administration is 1 time/day. Sialis is taken at least 16 minutes before the intended sexual activity.

Patients may attempt sexual intercourse at any time within 36 h after taking the drug in order to establish the optimal response time to take the drug.

Special Instructions

Patients taking α1-adreno-blockers, such as doxazosin, should be careful when prescribing Cialis because concomitant use may in some cases lead to symptomatic arterial hypotension.

In a clinical pharmacology study, no symptomatic arterial hypotension was observed in 18 healthy volunteers taking a single dose of tadalafil when the α1-adrenoblocker tamsulosin was given concomitantly.

Back pain was more frequently observed in patients with moderate renal impairment (CK of 31 to 50 ml/min) compared to patients with mild renal impairment (CK of 51 to 80 ml/min) or healthy volunteers during treatment with Cialis.

Patients with CK ≤ 50 mL/min should be prescribed the drug with caution. Sexual activity has potential risks for patients with cardiovascular disease. Therefore, treatment of erectile dysfunction, including the use of Cialis, should not be performed in men with heart disease in which sexual activity is not recommended.

The potential risk of complications from sexual activity in patients with cardiovascular disease should be considered: Myocardial infarction within the past 90 days, unstable angina or angina pectoris occurring during sexual activity, chronic heart failure (NYHA functional class II or higher) developed within the past 6 months, uncontrolled heart rhythm disorders, arterial hypotension (BP less than 90/50 mm Hg

Hypertension (BP less than 90/50 mm Hg) or uncontrolled arterial hypertension, stroke within the last 6 months.

Cautions should be used with caution in patients with a predisposition to priapism (e.g., in sickle cell anemia, multiple myeloma, or leukemia) or in patients with an anatomic deformity of the penis (e.g., angulation, cavernous fibrosis, or Peyronie’s disease). Patients should be advised to seek immediate medical attention if an erection persists for 4 hours or more.

Lack of timely treatment of priapism leads to penile tissue damage, as a result of which long-term loss of potency may occur. No cases of priapism have been reported during the use of Sialis. Safety and effectiveness of combinations of Cialis with other types of erectile dysfunction treatment have not been studied. Therefore, the use of such combinations is not recommended.

Like other FDE5 inhibitors, tadalafil has systemic vasodilator properties, which may lead to a transient decrease in BP. Before prescribing Cialis, physicians should carefully consider whether patients with existing cardiovascular disease would be adversely affected by such vasodilating effects.

Patients with hepatic impairment do not require a specific dose adjustment. Since there are no data from controlled clinical studies on the safety and effectiveness of Sialis in patients with severe hepatic impairment, the drug should be used with extreme caution and only if absolutely necessary in this category of patients.

Patients with impaired renal function (CK (creatinine clearance) >30 ml/min) do not require special dose adjustment. During treatment with Cialis, patients with moderate renal impairment (CKR of 31 to 50 ml/min) more often had back pain compared to patients with mild renal impairment (CKR of 51 to 80 ml/min) or healthy volunteers. In patients with CK≤50 ml/min the drug should be administered with caution.

While there are no data from controlled clinical studies concerning safety and effectiveness of the product in patients with severe renal impairment (CK≤30 ml/min), this group of patients should only be treated with caution if absolutely necessary.

The drug Cialis is not used in patients under 18 years of age.

Contraindications

Side effects

The side effects are usually mild to moderate in severity, transient and diminish with continued use of the drug.

Most common:headache (11%), dyspepsia (7%).

Possible: back pain, myalgia, nasal congestion, flushes to the face.

Rarely: eyelid swelling, eye pain, conjunctival hyperemia. dizziness.

Very rare: Hypersensitivity reactions (which included rashes, urticaria and facial edema, Stevens-Johnson syndrome and exfoliative dermatitis), arterial hypotension (in patients who were already taking antihypertensive agents), hypertension and syncope, abdominal pain and gastroesophageal reflux, hyperhidrosis (increased sweating), priapism and delayed erections, blurred vision, nonarterial anterior ischemic optic neuropathy, retinal vein occlusion, visual field disturbances.

Cardiovascular side:In patients with cardiovascular risk factors, myocardial infarction, sudden cardiogenic death, stroke, chest pain, palpitations, and tachycardia, but it cannot be determined for certain whether these phenomena are directly related to these risk factors, to tadalafil, to sexual arousal, or to a combination of these or other factors.

Overdose

Symptoms: When administered once to healthy volunteers at a dose of 500 mg/day and to patients with erectile dysfunction repeatedly up to 100 mg/day, adverse effects were the same as when the drug was used at lower doses.

Treatment:Conducting standard symptomatic therapy. In hemodialysis tadalafil is practically not excreted.

Similarities