Contraindications for cialis. Comprehensive Guide to Cialis (Tadalafil): Contraindications and Usage

03.09.202322.06.2023 by alexxlab

What is Cialis used for? How does Cialis work? What are the side effects of Cialis? Who should not take Cialis? Get the answers to these and more questions about the erectile dysfunction medication Cialis.

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Understanding Cialis (Tadalafil)

Cialis, also known by its generic name tadalafil, is a medication approved for the treatment of erectile dysfunction (ED) in men. It works by enhancing the effects of one of the chemicals the body normally releases during sexual arousal, allowing for increased blood flow to the penis and resulting in an erection.

How Cialis Differs from Other ED Treatments

Cialis stands out from other approved ED medications in that it remains in the body for a longer duration. However, there have been no direct clinical comparisons of the efficacy and safety of Cialis to other ED treatments.

Taking Cialis

Cialis is taken orally before sexual activity, but no more than once daily. It can be taken with or without food, and the dosage may be adjusted based on individual patient needs. Patients should always consult their healthcare provider for specific instructions on taking Cialis.

Potential Side Effects of Cialis

Like any medication, Cialis may cause side effects. The most commonly reported side effects include headache, indigestion, back pain, muscle pain, flushing, and stuffy nose. Patients may also experience abnormal vision. Most muscle aches and back pain associated with Cialis go away within 48 hours.

Important Safety Considerations

Cialis can cause a dangerous drop in blood pressure if taken with nitrate medications, such as nitroglycerin. Patients should inform their healthcare providers of all medications they are taking, including over-the-counter and herbal supplements. Cialis is not recommended for patients with certain heart conditions, severe liver disease, or retinal eye problems, as it has not been studied in these populations.

Contraindications and Interactions

Cialis should not be used by patients taking nitrate medications, as the combination can significantly lower blood pressure. The safety and effectiveness of Cialis when used with other impotence treatments has not been studied, so combined use is not recommended.

Availability and Prescription Status

Cialis will be available as an oral tablet in 5mg, 10mg, and 20mg strengths. It will be a prescription-only medication, not available over-the-counter. The decision on when Cialis will be available in pharmacies is up to the manufacturer, not the FDA.

In summary, Cialis is an effective treatment for erectile dysfunction that works by increasing blood flow to the penis. While it has a longer duration of action than some other ED medications, it also carries important safety considerations, including the risk of dangerously low blood pressure when combined with nitrate drugs. Patients should always consult their healthcare providers to determine if Cialis is the right treatment option for their individual needs.

What are the key differences between Cialis and other ED medications?Cialis is unique among ED treatments in that it stays in the body for a longer duration compared to other approved medications. However, there have been no direct clinical comparisons of the efficacy and safety of Cialis versus other ED therapies.

How should Cialis be taken?Cialis is taken orally before sexual activity, but no more than once daily. It can be taken with or without food. The dosage may be adjusted based on individual patient needs, so patients should always follow the instructions provided by their healthcare provider.

What are the most common side effects of Cialis?The most commonly reported side effects of Cialis include headache, indigestion, back pain, muscle pain, flushing, and stuffy nose. Patients may also experience abnormal vision. Most muscle aches and back pain associated with Cialis go away within 48 hours.

Who should not take Cialis?Cialis should not be used by patients taking nitrate medications, as the combination can significantly lower blood pressure and lead to dangerous side effects. It is also not recommended for patients with certain heart conditions, severe liver disease, or retinal eye problems, as Cialis has not been studied in these populations.

Can Cialis be used with other impotence treatments?The safety and effectiveness of using Cialis in combination with other impotence treatments has not been studied. Therefore, combined use of Cialis with other ED therapies is not recommended, as it could lead to additional lowering of blood pressure.

When will Cialis be available in pharmacies?The decision on when Cialis will be available for purchase in pharmacies is up to the manufacturer, not the FDA. Patients should contact their pharmacist or healthcare provider for the most up-to-date information on Cialis availability.

Questions and Answers for Cialis (tadalafil)

1. What is Cialis used to treat?

Cialis is approved for the treatment of men who experience difficulty having and maintaining an erection (impotence).

2. How does Cialis work?

Cialis works by enhancing the effects of one of the chemicals the body normally releases into the penis during sexual arousal. This allows an increase of blood flow into the penis. An erection is the result of an increase in blood flow into certain internal areas of the penis.

3. How is Cialis different from the currently approved products for erectile dysfunction (ED)?

Cialis is different from other currently approved products for ED in that it stays in the body longer. However, there were no studies that directly compared the clinical efficacy and safety of Cialis to other products.

4. How do I take Cialis?

Cialis is taken orally before sexual activity, not more than once daily. Cialis may be taken with or without food. In some patients, the dose strength and maximum frequency of use may be adjusted. For more detailed information consult with your health care provider.

5. Are there any side effects with Cialis?

As with any drug product, there may be side effects. The most commonly reported side effects in patients treated with Cialis during the testing of the product were:

headache
indigestion
back pain
muscle pain
flushing
stuffy nose

Patients who get back pain and muscle aches usually get them 12 to 24 hours after taking Cialis and these usually go away by themselves within 48 hours. A small number of patients taking Cialis also reported abnormal vision.

6. What important information should you know about Cialis?

CIALIS can cause your blood pressure to drop suddenly to an unsafe level if it is taken with any nitrate medication. You could get dizzy, faint or have a heart attack or stroke.
Tell your healthcare provider that you take Cialis. If you need emergency medical care for a heart problem, it will be important for your health care provider to know when you last took Cialis.
After taking a single tablet, some of the active ingredient of Cialis remains in your body for more than 2 days. The active ingredient can remain longer if you have problems with your kidneys or liver, or you are taking certain other medications.
Physicians should discuss with patients the potential for CIALIS to augment the blood-pressure-lowering effect of alpha-blockers and antihypertensive medications.

7. What should I talk to my doctor about when considering if Cialis is right for me?

Because sexual activity can increase the work of the heart, your doctors should talk to you about your heart’s general condition and if Cialis is right for you. Patients who have a condition called “left ventricular outlet obstruction” from valvular problems or heart muscle enlargement may get side effects such as fainting or light-headedness. Because patients with recent heart attacks or stroke, heart pains (angina), heart failure, uncontrolled blood pressure or uncontrolled irregular heart beats, severe liver disease, and retinal eye problems were not studied with Cialis, Cialis is not recommended for these patients. There may be rare occurrences of priapism or painful, prolonged erections. This is a serious condition that requires immediate medical attention. Patients should seek prompt medical attention if their erection lasts longer than four hours.

8. Who should not take Cialis?

Cialis should not be used by patients taking nitrates (such as nitroglycerin tablets or patches) because the combination of these with Cialis could significantly lower blood pressure and lead to fainting or even death in some men.

9. Can Cialis be used with other treatments for impotence?

The safety and effectiveness of Cialis when used with other treatments for impotence has not been studied. Combined use could lead to additional lowering of blood pressure, possibly to unsafe levels. Therefore the use of such treatments in combination with Cialis is not recommended.

10. What if I am taking other drugs?

Always discuss with your health care practitioner ALL of the medications you are taking (prescription and over-the-counter) that way, you can receive the best advice for your own situation. Cialis is not recommended for people taking any form of nitroglycerin because the combination may lower blood pressure to an unsafe level.

11. How will Cialis be supplied?

Cialis will be available as oral tablets in 5mg, 10mg and 20mg strengths.

12. Will Cialis be prescription or OTC (over-the-counter)?

Cialis will be available by prescription only.

13. When will Cialis be available to pharmacies?

FDA has no control over when products are available in pharmacies after FDA approval for marketing. The decision of availability is completely up to the company marketing the product. For further information contact your pharmacist or Eli Lilly and Company directly.

14. How can I report a serious side effect with Cialis to FDA?

FDA encourages anyone aware of a serious side effect, including consumers or patients, to make a MedWatch report.

You can report an adverse event either online, by regular mail or by fax, using the contact information at the bottom of this page.

Cialis (tadalafil) Information

Other medications, alcohol, and more

Cialis (tadalafil) is a brand-name prescription drug used in males* to treat erectile dysfunction and symptoms of benign prostatic hyperplasia.

As with other medications, Cialis can interact with certain other drugs, foods, and alcohol. An interaction occurs when one substance causes another substance to have a different effect than expected.

For details about Cialis’s interactions, keep reading. For additional information about Cialis, see this article.

* Sex and gender exist on spectrums. Use of the term “male” in this article refers to sex assigned at birth.

In some cases, a factor or condition could prevent your doctor from prescribing Cialis due to the risk of harm. This is known as a contraindication. The contraindications of Cialis include:

Taking a guanylate cyclase stimulator

Doctors are not likely to prescribe Cialis with guanylate cyclase (GC) stimulators. These medications are used to treat pulmonary arterial hypertension. (This is a form of high blood pressure in the arteries of the lungs.)

Both Cialis and GC stimulators may lower blood pressure. Taking Cialis in combination with a GC stimulator could lower your blood pressure further.

Examples of GC stimulators that can interact with Cialis include vericiguat (Verquvo) and riociguat (Adempas).

If you’re taking a GC stimulator, talk with your doctor before taking Cialis. They can recommend a treatment other than Cialis for your condition.

Taking a nitrate

Doctors are not likely to prescribe Cialis with nitrates. These medications are used to help prevent or treat angina (a type of chest pain).

Both Cialis and nitrates can lower blood pressure. Taking Cialis in combination with a nitrate may lower blood pressure further. A sudden drop in blood pressure can lead to fainting and dizziness. In severe cases, it may lead to heart attack or stroke.

Examples of nitrates that can interact with Cialis include:

isosorbide mononitrate (Monoket)
isosorbide dinitrate (Isordil)
nitroglycerin (Nitro-Dur, NitroMist, Nitrostat)

In addition to the medications above, nitrates also include a group of drugs called poppers. An example of a popper is amyl nitrate.

If you’re taking a nitrate, talk with your doctor before taking Cialis. They can advise you on treatments other than Cialis for your condition.

Having had an allergic reaction to Cialis or any of its ingredients

If you have had an allergic reaction to Cialis or any of its ingredients, your doctor will likely not prescribe Cialis. Taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices.

Note: Before you start treatment with Cialis, it’s important to tell your doctor if any of these contraindications apply to you. They can determine whether to prescribe Cialis.

Doctors may recommend limiting the amount of alcohol you consume while taking Cialis. This is because both alcohol and Cialis can lower blood pressure. Drinking alcohol during Cialis treatment could lower blood pressure further.

If you drink alcohol, talk with your doctor before taking Cialis. They can recommend an amount, if any, that’s safe to consume during your treatment.

Before you start treatment with Cialis, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a chart of drugs that can interact with Cialis. Due to the risk of interactions, doctors may not prescribe Cialis with these medications. Keep in mind that this chart does not include all drugs that may interact with Cialis. Some of these interactions are described in detail just below in “Drug interactions in depth.”

Drug class or drug name	Drug examples	Interaction result with Cialis
guanylate cyclase (GC) stimulators*	• vericiguat (Verquvo) • riociguat (Adempas)	can increase the effect of GC stimulators
nitrates*	• isosorbide dinitrate (Isordil) • isosorbide mononitrate (Monoket) • nitroglycerin (Nitro-Dur, NitroMist, Nitrostat)	can increase the effect of nitrates
alpha-blockers	• tamsulosin (Flomax) • terazosin • alfuzosin (Uroxatral)	can increase the effect of alpha-blockers
blood pressure drugs	• angiotensin receptor blockers, such as losartan (Cozaar) • angiotensin converting enzyme inhibitors, such as enalapril (Epaned, Vasotec) • calcium channel blockers, such as amlodipine (Norliqva, Norvasc) • beta-blockers, such as metoprolol (Lopressor, Toprol XL)	can increase the effect of blood pressure drugs
PDE5 inhibitors	• avanafil (Stendra) • vardenafil (Staxyn) • sildenafil (Viagra, Revatio) • other forms of tadalafil (Adcirca, Alyq)	can increase the risk of side effects from Cialis†
certain protease inhibitors	• ritonavir (Norvir) • atazanavir (Reyataz) • darunavir (Prezista)	can increase the risk of side effects from Cialis†
certain antifungal drugs	• itraconazole (Sporanox, Tolsura) • levoketoconazole (Recorlev) • ketoconazole • voriconazole (Vfend)	can increase the risk of side effects from Cialis†
certain antibiotic drugs	• clarithromycin • erythromycin (E. E.S., EryPed, Ery-Tab, others) • rifampin (Rifadin, Rimactane)	can increase the risk of side effects from Cialis†
certain antiseizure drugs	• carbamazepine (Carbatrol, Epitol, Tegretol, others) • phenobarbital • phenytoin (Dilantin, Phenytek)	can make Cialis less effective than usual

* For details about this interaction, see “When to avoid Cialis” above.
† To learn about possible side effects of Cialis, see this article.

Here’s a closer look at certain drug interactions of Cialis.

PDE5 inhibitors

Phosphodiesterase 5 (PDE5) inhibitors are medications used to treat conditions such as pulmonary arterial hypertension and erectile dysfunction.

Interaction result. Taking a PDE5 inhibitor with Cialis can increase the risk of low blood pressure.

Interaction explained. Cialis belongs to a class of drugs called PDE5 inhibitors. Medications in this class, including Cialis, can lower blood pressure. Taking Cialis with other drugs in the same drug class can increase the risk of low blood pressure further.

Examples of PDE5 inhibitors. PDE5 inhibitors that may interact with Cialis include the following:

avanafil (Stendra)
vardenafil (Staxyn)
sildenafil (Viagra, Revatio)
other forms of tadalafil (Adcirca, Alyq)

Steps you or your doctor may take. Due to this risk, doctors typically will not prescribe Cialis in combination with other PDE5 inhibitors. Before taking Cialis, it’s important to tell your doctor if you’re already taking a PDE5 inhibitor. They’ll likely prescribe a treatment other than Cialis for your condition.

Certain antibiotic drugs

Antibiotic drugs are used to treat infections caused by bacteria.

Interaction result. Taking Cialis with certain antibiotics can increase the risk of side effects of Cialis. (To learn more about the side effects of Cialis, see this article.)

Interaction explained. Certain antibiotics can prevent your body from breaking down Cialis. This can result in a higher level of the drug in your body than usual. A high level of the drug in your system could increase risk of side effects from Cialis.

Examples of antibiotic drugs. Below are a few antibiotics that may interact with Cialis:

clarithromycin
erythromycin (E.E.S., EryPed, Ery-Tab, others)
rifampin (Rifadin, Rimactane)

Steps you or your doctor may take. If you’re taking an antibiotic, talk with your doctor before starting Cialis treatment. They can advise you on whether it’s safe for you to take Cialis with these medications.

Certain antiseizure drugs

Antiseizure drugs are used to treat seizure disorders such as epilepsy.

Interaction result. Taking Cialis with certain antiseizure drugs can make Cialis less effective than usual.

Interaction explained. Certain antiseizure drugs may cause your body to break down Cialis more quickly than usual. This could result in a lower level of the drug in your body than usual, which could make the drug less effective for treating your condition.

Examples of antiseizure drugs. Antiseizure drugs that may interact with Cialis include those listed below:

carbamazepine (Carbatrol, Epitol, Tegretol, others)
phenobarbital
phenytoin (Dilantin, Phenytek)

Steps you or your doctor may take. Before taking Cialis, tell your doctor if you’re taking antiseizure drugs. They can advise you on whether these medications may interact with Cialis.

Cialis may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below.

Cialis and supplements

It’s possible for drugs to interact with supplements such as vitamins and herbs.

Cialis and herbs

Taking Cialis with an herb called St. John’s wort can decrease how well Cialis works. The herb is sometimes used to treat depression.

Be sure to talk with your doctor about taking both St. John’s wort and Cialis. Your doctor may be able to provide you with alternative treatment options.

Cialis and vitamins

No vitamin interactions have been reported with Cialis. You should still check with your doctor or pharmacist before taking any vitamins during Cialis treatment.

Cialis interactions with food

Drinking grapefruit juice or eating grapefruit while taking Cialis could raise the level of Cialis in your body. A higher level of the drug could increase your risk of side effects. (To learn about possible side effects of Cialis, see this article.)

If you have questions about taking Cialis with other foods or drinks, such as coffee, talk with your doctor or pharmacist.

Cialis and vaccines

Vaccines have not been reported to interact with Cialis. If you have questions about getting certain vaccines during your Cialis treatment, talk with your doctor or pharmacist.

Cialis and lab tests

There are no specific reports of lab tests interacting with Cialis. For more information about having certain lab tests while taking Cialis, talk with your doctor or pharmacist.

Cialis interaction with cannabis or CBD
Cannabis (marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Cialis.
The exact effect of cannabis products on Cialis may vary from person to person. In some cases, cannabis products may decrease the level of Cialis in the body, which could cause the drug to be less effective than usual.
In other cases, cannabis products may raise the level of Cialis in the body. This could increase your risk of side effects from Cialis. (To learn about possible side effects of Cialis, see this article.)
Before you start treatment with Cialis, tell your doctor and pharmacist if you take cannabis. By sharing this information with them, you may help prevent possible interactions.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Cialis. Before you take Cialis, be sure to talk with your doctor about your health history. Cialis may not be the right treatment option for you if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Cialis include the following:

Misshaped penis. Before starting treatment with Cialis, tell your doctor if you have a condition that affects the shape of your penis, such as Peyronie’s disease. Such conditions can increase your risk of priapism as a side effect. Your doctor can help determine whether Cialis is a safe treatment option for you.

Heart problems or stroke. Doctors typically will not prescribe Cialis if you have a heart problem or have had a stroke. Examples of heart problems include having heart failure in the past 6 months or a heart attack in the past 90 days.

Cialis is also not recommended in people with problems such as:

untreated low or high blood pressure
untreated abnormal heart rhythm
chest pain that occurs during sex

It’s not known whether Cialis is safe if you have any of these conditions. If you do, your doctor will likely prescribe a treatment other than Cialis.

Liver or kidney problems. If you have a liver or kidney problem, be sure to tell your doctor before taking Cialis. Examples of these problems include liver failure and kidney failure. Your doctor may give you a lower dosage of Cialis than what’s typically prescribed. (For details about the dosage of Cialis, see this article.)

Bleeding problems. Before taking Cialis, tell your doctor if you have a bleeding problem. An example is hemophilia. Your doctor can advise you on whether Cialis is a safe treatment option for you.

Blood cancers or blood cell problems. Before taking Cialis, tell your doctor if you have a blood cancer. Examples include multiple myeloma and leukemia. Also tell them if you have certain blood cell problems, such as sickle cell anemia. These conditions could increase your risk of priapism as a side effect. Your doctor can help determine if Cialis is right for you.

Peptic ulcers. If you have a peptic ulcer, talk with your doctor before taking Cialis. You may have an increased risk of bleeding with the drug. Your doctor can advise you on whether Cialis is safe to take.

Eye problems. In rare cases, Cialis can cause vision loss or other serious eye problems. If you already have an eye problem, you may have an increased risk of eye side effects with the drug. Before taking Cialis, tell your doctor if you have a problem with your retina or optic nerve. This includes conditions such as retinitis pigmentosa. They can help determine whether it’s safe for you to take Cialis.

Allergic reaction. If you’ve had an allergic reaction to Cialis or any of its ingredients, your doctor will likely not prescribe Cialis. For details, see “When to avoid Cialis” above.

Pregnancy. Cialis is not approved for use in females.* It’s not known if the drug is safe to use during pregnancy. You can talk with your doctor to learn more.

Breastfeeding. Cialis is not approved for use in females.* It’s not known if Cialis passes into breast milk. For additional information about Cialis and breastfeeding, talk with your doctor.

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

Here are some frequently asked questions about Cialis and possible interactions.

Does Cialis interact with NSAIDs, such as ibuprofen or meloxicam?

There’s no known interaction between Cialis and nonsteroidal anti-inflammatory drugs (NSAIDs). Although NSAIDs are typically used to treat pain, they can also be used for inflammation.

Examples of NSAIDs include:

ibuprofen (Advil, Motrin, others)
meloxicam (Anjeso, Mobic)
naproxen (Aleve, Naprosyn)
celecoxib (Celebrex, Elyxyb)
diclofenac (Cambia, Cataflam, Zipsor, others)

If you’re interested in treating inflammation or pain while taking Cialis, talk with your doctor or pharmacist.

Can I drink coffee while taking Cialis?

Coffee and Cialis are not known to interact with each other.

Coffee often contains high amounts of caffeine. The results of one study found that consuming caffeine may lower the risk of erectile dysfunction (ED), which Cialis is used to treat. However, it’s unknown whether coffee or caffeine is effective for treating this condition.

If you’d like to learn more about Cialis and coffee, talk with your doctor.

Do Cialis and finasteride interact?

Cialis is not known to interact with the drug finasteride (Propecia, Proscar). Finasteride is used to treat conditions such as baldness and benign prostatic hyperplasia.

Finasteride may cause ED as a side effect. Cialis is used to treat ED. If you develop ED while taking finasteride, your doctor may prescribe medication to ease the side effect. This may include Cialis. Your doctor can tell you more.

Is there an interaction between Cialis and Xanax?

There’s no known interaction between Cialis and alprazolam (Xanax).

Xanax may cause sexual side effects, including changes in libido (sex drive). Having a low libido could result in ED. Therefore, it’s possible that taking Xanax could result in ED. If you have ED due to Xanax, your doctor may prescribe Cialis to treat your condition.

If you have other questions about Cialis and Xanax, talk with your doctor or pharmacist.

Can I take Cialis with omeprazole?

Cialis and omeprazole (Prilosec) are not known to interact with each other. Omeprazole is used to treat certain digestive problems, such as acid reflux.

The results of one report suggest that ED is a possible side effect of omeprazole. If you have ED that’s related to omeprazole, your doctor can recommend the right treatment option for you. This may include taking Cialis.

You can take certain steps to help prevent interactions with Cialis. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan the following:

Let them know if you drink alcohol or take cannabis.
Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the label of Cialis and other paperwork that comes with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the prescribing information, may contain details about interactions. If this information is difficult to understand, ask your doctor or pharmacist to help explain it.

You can also help prevent interactions with Cialis by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Cialis. These resources might help:

Overview of Cialis. For a general overview of Cialis, read this article.
Side effects. If you’re interested in the side effects of Cialis, see this article. Another option is to refer to the Cialis prescribing information.
Dosage specifics. You can refer this article to learn about the dosage of Cialis.
Drug comparison. Find out how Cialis compares with Viagra, Levitra, and Adcirca.
Facts about your condition. To learn more about your condition, see our men’s health hub.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Cialis instructions for use, price: Side effects, composition, dosage

THERE ARE CONTRAINDICATIONS. POSSIBLE SIDE EFFECTS. A SPECIALIST’S CONSULTATION IS REQUIRED. For men For potency

Author of the article

Zotina Natalya Igorevna,

Diploma of pharmaceutical education: 105924 1197876, reg. number 30353

All authors

Contents of the article

Cialis: composition
Cialis: active ingredient
Cialis: side effects
Cialis: contraindications
Cialis or Viagra
Tadalafil or Cialis: which is better?
Cialis or Levitra: which is better?
Zidena or Cialis: which is better?
Executive summary
Ask an expert about the topic of the article

The first effective drug for the treatment of erectile dysfunction (ED) appeared in 1998 and literally “blew up” the market. It was Viagra, which in 2000 accounted for 90% of sales of drugs to improve potency. But by 2007, this figure had dropped to 50% “thanks” to the analogue of Cialis, which appeared in 2003.

We asked pharmacist Natalya Zotina to tell us more about Cialis: what active ingredient is included in the composition, what side effects and contraindications it has. And also compare the drug with other drugs that are prescribed for ED.

Cialis: composition

Cialis is produced in tablets containing the active substance and excipients. The active substance in the preparation is tadalafil, lactose, hyprolose, sodium lauryl sulfate, cellulose, magnesium stearate are added as auxiliary.

Cialis preparations for men containing tadalafil 5 mg and 20 mg are registered in Russia.

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Cialis: active substance

The active substance of Cialis tadalafil inhibits the enzyme phosphodiesterase (PDE-5). As a result, in the presence of nitric oxide, the walls of the vessels of the cavernous bodies are relaxed and filled with blood. This ensures an erection in response to sexual arousal.

The drug itself does not increase sexual desire. If there is no attraction to a partner, then the medicine will not help.

Cialis for men: instructions

Cialis 5 mg is used to treat erectile dysfunction, including lower urinary tract symptoms in benign prostatic hyperplasia.

Cialis 20 mg is used only for ED 30 minutes before intercourse, regardless of food intake. This dosage is not recommended for daily use. With frequent sexual activity, it is better to take Cialis at a dose of 5 mg or even 2.5 mg once a day at the same time. The dose depends on individual sensitivity.

Cialis side effects

The most frequently reported side effects of Cialis are:

headache
dyspepsia
back and muscle pain

Moreover, the frequency of adverse reactions increased with the dose of Cialis. They are transitory. So, a headache with daily use of the drug lasts the first 10-30 days, then it goes away.

Cialis and alcohol are compatible. Simultaneous administration of the drug and ethyl alcohol does not affect the concentration of both substances, does not reduce pressure, and does not affect cognitive functions.

Cialis: contraindications

Cialis should not be administered or taken to patients in the following cases:

hypersensitivity to drug components
treatment with organic nitrates (nitroglycerin) – pressure reduction possible
children under 18 years of age
diseases of the cardiovascular system, suggesting restriction of sexual activity: myocardial infarction, unstable angina, chronic heart failure, uncontrolled arrhythmia, hypotension, stroke in the last six months
loss of vision in one eye due to optic neuropathy
concomitant use of doxazosin and other drugs for the treatment of ED
severe renal failure

Cialis or Viagra

Viagra is the first and still popular drug for ED. The drug has two main differences from Cialis: the active substance and the duration of action.

Viagra contains sildenafil, which begins to “work” 30 minutes after taking it for 4 hours. A man can feel the effect of tadalafil in Cialis earlier – after 16 minutes. In this case, the drug maintains an erection for 36 hours. In addition, Cialis achieves the desired effect at a lower dosage: its maximum daily dose is 20 mg versus 100 mg for Viagra. At a lower dose, the risk of developing negative reactions is lower.

The absorption and rate of action of Viagra is affected by food intake. Cialis is devoid of this drawback.

Thanks to its benefits, Cialis quickly became popular in many countries.

Viagra and Cialis are available by prescription. The selection of the optimal remedy should be carried out by the doctor, taking into account the age of the patient, the severity of the condition, concomitant diseases, and medications taken.

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Tadalafil or Cialis: which is better?

Drugs with the name Tadalafil are generics of the original Cialis of Russian, Polish, Indian and other countries of origin.

Indications, contraindications, side effects are identical for analogues. The difference is that among Tadalafils you can find dosages of 2.5 mg, 5 mg, 10 mg and 20 mg. This makes it easier for the doctor to select the optimal treatment regimen and saves the patient’s money.

Substances for the production of Tadalafil tablets, mainly of Indian and Chinese origin. The Swiss manufacturer of Cialis uses pharmaceutical raw materials from the USA and Puerto Rico. The cost of Tadalafil is lower than Cialis. The patient can substitute these drugs for each other based on their preferences.

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Cialis or Levitra: which is better?

Levitra tablets contain 5, 10 and 20 mg vardenafil. The mechanism of action of Levitra is similar to that of Cialis. Indications for use – erectile dysfunction. Cialis is also prescribed for the treatment of benign prostatic hyperplasia.

The main difference between the drugs is the duration of action. Cialis works up to 36 hours, Levitra 8-12 hours. But the recommended dose for Levitra is less and equal to 10 mg, for Cialis – 20 mg. Therefore, Levitra is preferred to be prescribed to men with chronic diseases to reduce the risk of side effects.

In the case of Cialis, dose adjustment for elderly patients is not required. But if men over 65 plan to take the maximum dose of Levitra 20 mg, it is better to consult a doctor.

Fatty food affects the speed of action of Levitra. Alcohol also impairs erection. Both drugs have their own benefits. The doctor will tell you which of these drugs is suitable for a particular patient.

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Zidena or Cialis: which is better?

Zydena is one of the new drugs for the treatment of ED with the active ingredient udenafil. It was registered in Russia in 2008. Zidena is indicated for the treatment of ED only. Unlike Cialis, she has only two contraindications: hypersensitivity and taking nitrate drugs.

Zidena has one dosage form: 100 mg tablets. The maximum daily dosage is 200 mg. The drug begins to act 30 minutes after taking the pill. The period of effectiveness of one dose of Zidena is up to 24 hours (in the presence of sexual arousal). Cialis works faster and longer at a lower dose.

Zidena has a high security profile. The drug does not have such side effects as myalgia and back pain, characteristic of Cialis. The intake of alcohol and fatty foods does not affect the action of udenafil, which makes taking Zydena as convenient as possible for patients.

We recommend that you discuss Zidena or Cialis with your doctor. These drugs are prescription drugs, self-medication and self-administration can harm your health.

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Summary

Cialis contains the active ingredient tadalafil. The drug is produced in tablets of 5 and 20 mg.
Cialis active ingredient tadalafil increases blood flow to the cavernous bodies and provides an erection in the presence of sexual arousal.
Cialis is well tolerated, side effects include headache, dyspepsia, back and muscle pain.
First of all, Cialis is contraindicated in patients under 18 years of age and those with serious diseases of the cardiovascular system, as well as those taking nitrate drugs.
The choice of drug for the treatment of ED (Cialis, Viagra, Zidena, Levitra) should be entrusted to the doctor. The efficacy and safety of these drugs for the treatment of patients with ED has been confirmed in numerous clinical studies.

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Cialis – Side effects and contraindications

Cialis is one of the most effective drugs for increasing potency, increasing blood flow to the penis. The “Weekend Pill”, as it is also called, provides a man’s sexual readiness for 36 hours.

However, we should not forget that, despite all the advantages, this is a medicine with potentially serious side effects. More about this will be discussed in this article.

Product description

Cialis is the brand name for tadalafil, a drug used to treat erectile dysfunction. The tool is included in the same group of PDE5 inhibitors as the closest analogues – Viagra and Levitra.

Tadalafil was approved by the US Food and Drug Administration (FDA) in 2003 as an oral treatment for erectile dysfunction.

Under the name Adcirca, tadalafil is also used for pulmonary arterial hypertension. In addition, this drug in a reduced, so-called “daily” dosage, successfully treats benign prostatic hyperplasia – a condition in which the prostate enlarges, causing problems with urination.

How Cialis works

An erection occurs due to the fact that the blood vessels that provide blood flow to the penis expand, increasing the blood supply to the organ. At the same time, the blood vessels that drain blood from the penis contract. As a result, blood accumulates in the penis, causing it to become erect.

The described mechanism is carried out due to certain biochemical reactions occurring in the body. When a man is sexually stimulated, nitric oxide is released in the tissues of the penis. Nitric oxide produces the enzyme cGMP, which controls the expansion and contraction of the blood vessels that carry blood to and from the penis.

Another substance, PDE5, destroys cGMP. When this happens, the blood vessels return to their normal size and the erection ends, sometimes before it even starts. The most important role of tadalafil is that it does not allow the PDE5 enzyme to neutralize cGMP. This allows you to prolong the erection.

As for the other diseases mentioned above, the walls of the pulmonary arteries also contain PDE5, so tadalafil also helps in the treatment of pulmonary hypertension.

Dosage – How to take

Cialis is available in yellow, elliptical-shaped film-coated tablets in dosages of 5, 10 and 20 mg. On sale there is also a generic Indian-made Cialis with an active ingredient content of 40 mg.

The initial recommended dose of Cialis is 10 mg. The tablet is taken 30 minutes before intimacy with water. For the medicine to work, the man must be sexually aroused. It is important to understand that the drug does not provide an erection without sexual stimulation.

Further dosage may be adjusted depending on the effect obtained. The maximum allowable amount of Cialis taken is 20 mg as a single daily dose. Patients with erectile dysfunction can take Cialis as needed, but it should not be used more than once every 24 hours.

Doses of 10 to 20 mg each day are not recommended. This is due to the fact that the half-life of tadalafil is 17.5 hours. Even after a day, a significant part of the drug remains in the body, and with such a risky regimen, an overdose is very likely to occur.

Due to the long half-life of tadalafil, men who are sexually active (at least twice a week) can take a daily dose of Cialis 5 mg, and can even be reduced to 2. 5 mg once a day, depending on individual reaction.

Cialis and its tadalafil-based analogues are for use by adult males 18 years of age and older only.

Side effects

Manufacturer Eli Lilly warns that if you experience any of the following symptoms after taking Cialis, they may be a sign of a serious complication and seek immediate medical attention:

dizziness
nausea
numbness, tingling, or pain in the jaw, arms, chest, or neck
priapism – if an erection lasts more than 4 hours, it can damage the penis

9000 2 In rare cases, Cialis can disrupt the blood supply to the optic nerve eyes, causing sudden loss of vision. This is more likely in patients with hypertension, diabetes, high cholesterol, pre-existing vision problems, or heart disease.

The FDA has issued a warning of isolated cases of sudden hearing loss experienced by men using tadalafil and similar agents.

In 2016, the FDA announced that they were “evaluating the need for regulatory action” on the basis that the use of Cialis and similar drugs may increase the risk of melanoma skin cancer. However, this risk has not yet been sufficiently studied.