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What milligram does cialis come in: Form, strengths, how to use, and more

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Form, strengths, how to use, and more

Cialis (tadalafil) is a brand-name drug that’s prescribed for erectile dysfunction (ED) and benign prostatic hyperplasia (BPH). Cialis comes as an oral tablet that’s typically taken once per day or on occasion as needed. The dosage can vary depending on what condition the drug is used to treat.

Specifically, Cialis is prescribed to treat ED and BPH in adult males.* It belongs to a drug class called phosphodiesterase-5 (PDE5) inhibitors. Cialis is available in a generic version.

Keep reading for specific information about the dosage of Cialis, including its strengths and how to take the medication. For a comprehensive look at Cialis, see this article.

Note: This article describes typical dosages for Cialis provided by the drug’s manufacturer. When taking Cialis, always follow the dosage prescribed by your doctor.

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

Below you’ll find information about dosage instructions and dosage options for Cialis.

Cialis form and strengths (2.5 mg, 5 mg, 10 mg, 20 mg)

Cialis comes as oral tablets that are available in four strengths: 2.5 milligrams (mg), 5 mg, 10 mg, and 20 mg.

Recommended dosage for Cialis

Typically, your doctor will have you start taking a low dosage of Cialis. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Whichever condition Cialis is used to treat, the recommended maximum dose per day is 20 mg. This is the highest dosage that a doctor may prescribe.

Dosage for erectile dysfunction (ED)

For treating erectile dysfunction (ED), Cialis may be used daily or on occasion.

Cialis ED dosage for daily use

For treating ED, the Cialis dosage for daily use is 2.5 mg once per day. You do not have to take Cialis at any specific time before sexual activity when it’s prescribed in this way. You can take your dose at any time of day. But you should try to take it at the same time every day. This helps make sure there’s enough medication in your body for Cialis to be effective.

Your doctor may increase your dose to 5 mg if the 2.5 mg-dose doesn’t work well for you.

Cialis ED dosage for occasional use

The normal dosage of Cialis for occasional use in treating ED is 10 mg taken before sexual activity. If you have side effects with the 10-mg dose, your doctor may prescribe a 5-mg dose. If the 10-mg dose doesn’t work for you, they may increase your treatment to the maximum dosage of 20 mg once per day.

When taken for occasional use to treat ED, the effects of Cialis have been shown to last up to 36 hours.

Regardless of the dose prescribed, you should not take more than one Cialis tablet per day.

Dosage for benign prostatic hyperplasia (BPH)

For treating benign prostatic hyperplasia (BPH), the recommended Cialis dosage is 5 mg taken once per day.

Dosage for ED and BPH

For use as a single medication to treat both ED and BPH, the recommended Cialis dosage is 5 mg taken once per day. You don’t have to take Cialis at any specific time before sexual activity when it’s prescribed in this way. You can take your dose at any time of day. But you should try to take it at the same time every day. This helps make sure there’s enough medication in your body for Cialis to be effective.

Long-term use

Doctors recommend using Cialis as a long-term treatment, even if you take it only on occasion to treat ED. If you and your doctor determine that Cialis is safe and effective for you, you’ll likely take it long term.

Below are some answers to frequently asked questions about Cialis dosages.

Is a 40-mg dose of Cialis safe to take?

No, 40 milligrams (mg) is not a safe dose of Cialis to take. The maximum recommended dosage of Cialis is 20 mg once per day. Taking a dose of Cialis that’s higher than recommended could increase your risk for side effects. These can include serious side effects such as drops in blood pressure or priapism (a painful erection that won’t go away).

It’s important to not take more Cialis than the dose your doctor recommends. You should take Cialis exactly as it’s prescribed for you. If you have other questions about Cialis doses, talk with your doctor or pharmacist.

What’s the Cialis dosage for someone who’s 70 years old?

Cialis dosages for someone who is age 70 years (and older adults in general) are the same as those for other adults. Details about these dosages are in the “Cialis dosage” section above.

Older adults may be more sensitive to the effects of Cialis. Because of this, your doctor may decide to prescribe a lower dose than usual when you start taking Cialis. Then, if needed, they can adjust it over time to reach the amount that’s right for you.

If you have additional questions about the use of Cialis in older adults, talk with your doctor or pharmacist.

It’s important that you do not use more Cialis than your doctor prescribes. For some medications, taking more than the recommended amount may lead to side effects or overdose.

If you take more than the recommended amount of Cialis

Call your doctor right away if you believe you’ve taken too much Cialis. Another option is to call America’s Poison Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.

The Cialis dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using Cialis to treat
  • how often you take Cialis
  • your age
  • other medications you may take
  • side effects that you may have from taking Cialis
  • how well the medication is working for you, if used to treat erectile dysfunction (ED)

Other medical conditions you have can also affect your Cialis dosage.

Dosage adjustments

If you have kidney or liver problems, your doctor may adjust your Cialis dosage. If the kidney or liver problems are mild or moderate, you’ll likely need a lower dose of the drug than usual. Keep in mind that if you have severe liver problems, you should not use Cialis. The drug is also not recommended for daily use if you have severe kidney problems.

Your doctor can determine the severity of your kidney or liver problems and whether Cialis is a safe medication for you to take. Talk with your doctor or pharmacist if you have questions about Cialis dosage adjustments.

Cialis comes as oral tablets. You can take them with or without food.

If you take Cialis for occasional use to treat erectile dysfunction (ED), you should take your dose before sexual activity. When taken for occasional use to treat ED, the effects of Cialis have been shown to last up to 36 hours.

If you take Cialis daily for ED, benign prostatic hyperplasia (BPH), or both ED and BPH, you can take your dose at any time of day. But you should try to take your dose at the same time every day.

You should not take more than one dose of Cialis per day. Be sure not to take more of the drug than your doctor prescribes for you. Doing so may lead to serious side effects from Cialis.

If you have questions about how to take Cialis, talk with your doctor or pharmacist.

If you forget to take a once-daily dose of Cialis, try to take it as soon as you remember. But keep in mind that you should not take more than one Cialis dose per day. So if you missed a dose yesterday, skip that dose and take your next scheduled dose of Cialis.

It’s important that you do not take more Cialis than your doctor prescribes for you. Doing so may lead to serious side effects from the drug.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or timer on your phone or downloading a reminder app. A kitchen timer can work, too.

The dosages in this article are typical dosages provided by the drug manufacturer. If your doctor recommends Cialis for you, they will prescribe the proper dosage for you. Always follow the dosage that your doctor prescribes for you.

As with any drug, never change your dosage of Cialis without your doctor’s recommendation. If you have questions about the dosage of Cialis that’s right for you, talk with your doctor.

Besides learning about dosage, you may want other information about Cialis. These additional articles might be helpful:

  • More about Cialis. For information about other aspects of Cialis, refer to this article.
  • Side effects. To learn about side effects of Cialis, see this article. You can also look at the Cialis prescribing information.
  • Drug comparison. To find out how Cialis compares with Viagra, Levitra, and Stendra, read this article.
  • Interactions. For details about what Cialis interacts with, see this article.
  • Cost. For ways you might save on the cost of Cialis, see this article.
  • Details about your condition. For details about your condition, visit our men’s health hub. You can also see our lists of erectile dysfunction articles and prostate articles.

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.

Strengths, Form, When to Use, and More

Cialis (tadalafil) is prescribed to treat erectile dysfunction and symptoms of benign prostatic hyperplasia. It comes as a tablet that’s taken as needed or once per day, depending on the condition it’s treating.

Cialis is used in adult males.* It belongs to a group of drugs called phosphodiesterase 5 (PDE5) inhibitors. These drugs treat erectile dysfunction (ED) by relaxing blood vessels to increase blood flow into the penis. For symptoms of benign prostatic hyperplasia (BPH), they relax the bladder muscles, allowing urine to flow more easily.

This article describes the dosages of Cialis, including its form, strengths, and how to take the drug. To learn more about Cialis, see this in-depth article.

Note: This article covers typical dosages of Cialis, which are provided by the drug’s manufacturer. But when using Cialis, always take the dosage that your doctor prescribes.

* In this article, we use the term “male” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Get answers to common questions about the dosage of Cialis.

What form does Cialis come in?

Cialis comes as a tablet that you take by mouth.

Available strengths of Cialis (2.5 mg, 5 mg, 10 mg, 20 mg)

Cialis tablets come in four strengths: 2.5 milligrams (mg), 5 mg, 10 mg, and 20 mg.

What are the typical dosages of Cialis?

Typically, your doctor will start you on a low dosage. Then they’ll adjust your dosage over time to reach the right amount for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

If you have certain kidney or liver problems, your doctor may prescribe a low dosage for you. This is because the usual dosage may increase the risk of side effects with your condition.

The information below describes the usual dosage recommendations for Cialis. But be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Dosage for erectile dysfunction (ED)

There are two dosage options when Cialis is used to treat ED: dosage for occasional use and for daily use.

Occasional use for ED

With occasional use, you’ll take Cialis only as needed. You’ll likely take one 10-mg tablet before having sex.

Depending on how well the 10-mg dose works for your ED, your doctor may adjust your dose. It may be decreased to 5 mg or increased to 20 mg. You’ll continue to take it only as needed before sex.

You should not take Cialis more than once per day. You also should not take more than the recommended maximum dosage of Cialis, which is 20 mg per day. Taking higher dosages of Cialis than this, such as 40 mg per day, raises your risk for serious side effects. Examples of these side effects include very low blood pressure and priapism (a painful erection lasting 4 hours or longer).

Daily use for ED

With daily use, you’ll take one dose of Cialis per day. You don’t need to time your dose to be taken before having sex. You should take it around the same time each day.

For daily use of Cialis for ED, the usual starting dosage is 2.5 mg per day. If this dosage isn’t effective for you, your doctor may increase your dosage to 5 mg per day.

Dosage for benign prostatic hyperplasia (BPH)

The usual dosage of Cialis for BPH symptoms is 5 mg once per day for up to 26 weeks. You should take your dose around the same time each day.

Dosage for ED and BPH

If your doctor prescribes Cialis to treat ED along with BPH symptoms, you’ll take Cialis once per day.

For this use, the usual dosage is 5 mg per day. You should not take any additional doses of Cialis for occasional use before sex.

You don’t need to time your dose to be taken before having sex. You should take it around the same time each day.

Is Cialis used long term?

Yes, Cialis is typically used as a long-term treatment. If you and your doctor determine that it’s safe and effective for you, it’s likely that you’ll use Cialis long term.

Dosage adjustments

If you have certain kidney or liver problems, your doctor may prescribe a lower dosage of Cialis for you. This is because, with your condition, the usual dosage may raise your risk for side effects from the drug.

Depending on how severe your kidney or liver problems are, your doctor may recommend occasional dosing instead of daily dosing to treat ED.

How can I get the maximum effect from Cialis?

To get the maximum effect from Cialis, take it exactly as prescribed.

If you’re using once-daily Cialis for either erectile dysfunction (ED) or benign prostatic hyperplasia (BPH), take your dose around the same time each day. This helps keep a consistent amount of the drug in your body to provide the maximum effect. If you forget to take doses, skip doses, or take doses late, the medication won’t work as well.

If you’re prescribed occasional (as needed) Cialis for ED, it’s best to take your dose at least 2 hours before having sex. This is because it takes an average of 2 hours for the drug to reach its highest level in your body.

Because this is an average, you may notice better effects if you have sex a little sooner or a little later than this 2-hour timeframe. In studies, Cialis improved erectile function as soon as 30 minutes to as long as 36 hours after a dose was taken. As long as you do not take more than the maximum daily dose, you can experiment with how long you wait to have sex after taking a dose.

If you have other questions about how to get the most from Cialis, talk with your doctor or pharmacist.

If I take 5 milligrams (mg) of Cialis daily, how long does it take the drug to work?

Cialis starts working quickly. Studies show that the drug begins to work 30 minutes to 6 hours after you take your first dose. But it may take several days for the medication to reach its full effectiveness. If you don’t notice an improvement in your BPH symptoms or ED within a week of daily use, talk with your doctor. They may need to adjust your dosage.

Could I take an 80-mg dose of Cialis?

No, it’s not safe to take an 80-mg dose of Cialis. The maximum recommended daily dosage of Cialis is 20 mg per day if you take it as needed for ED. If you take Cialis daily, the maximum dosage is 5 mg per day.

Taking doses of Cialis above the recommended limit could lead to serious side effects, such as dangerously low blood pressure or priapism (a painful erection lasting 4 hours or longer).

What’s the typical Cialis dosage for a 70-year-old?

Cialis dosage is not based on your age alone. Instead, your doctor will prescribe the dosage that’s best for your condition. Before prescribing Cialis, your doctor may send you for a blood test to check how well your kidneys and liver are working. This is because they’ll take your kidney and liver health into consideration when determining your dosage.

For many people, their kidneys may not work as well as they age. So if you’re an older adult (ages 65 years and older), it may take longer for your body to break down and clear Cialis from your system. Older adults may also be more sensitive in how they react to Cialis, which may increase their risk for side effects.

If you’re 70 years old, your doctor will likely start you on a low dosage of Cialis. If it works well for you, you’ll probably continue taking a low dosage. If it doesn’t work well for you or you develop bothersome side effects, your doctor will adjust your dosage. The goal is to find the lowest dosage that effectively treats your BPH symptoms or ED without causing bothersome side effects.

If you have questions about what your Cialis dosage should be, talk with your doctor.

How do the dosages for Cialis and Viagra compare?

As ED treatments, both Cialis and Viagra can be taken occasionally (as needed) before sexual activity. The usual dosage for occasional Cialis use is one dose 2 hours before having sex. The usual dosage for occasional Viagra use is one dose 1 hour before having sex.

Cialis is also approved for once-daily dosing for ED, but Viagra is not. This is because the effects of Cialis on ED can last much longer than Viagra’s effects. One dose of Cialis can help improve erectile function for up to 36 hours. In comparison, Viagra’s effects can last up to 4 hours. But on average, its effects start to lessen 2 to 3 hours after you take a dose.

The typical dose for once-daily Cialis for ED is 2.5 milligrams (mg) to 5 mg. When used as needed for ED, the usual Cialis dose is 10 mg (with a maximum daily dose of 20 mg). The typical dose of Viagra for ED is 50 mg.

Talk with your doctor about whether Cialis or Viagra may be a better option for you.

You’ll take Cialis by mouth, either once per day or occasionally (as needed before sex).

The Cialis tablet should be swallowed whole. You can take it with or without food.

With once-daily Cialis, be sure to take it around the same time each day. When you’re taking Cialis once a day, there isn’t a best time to take Cialis. But taking your dose around the same time each day helps to keep a steady level of the drug in your body.

With occasional (as needed) use of Cialis, it’s recommended that you take your dose about 2 hours before having sex. This is because it takes an average of 2 hours for the drug to reach its highest level in your body.

Because this is an average, you may notice better effects if you have sex a little sooner or a little later than this 2-hour timeframe. In studies, Cialis improved erectile function as soon as 30 minutes to as long as 36 hours after a dose was taken.

If you have questions about taking Cialis, talk with your doctor or pharmacist.

Do not use more Cialis than your doctor prescribes. Using more than this can lead to serious side effects.

What to do in case you take too much Cialis

Call your doctor right away if you think you’ve taken/used too much Cialis. You can also call 800-222-1222 to reach the American Association of Poison Control Centers, or use its online resource. But if you have severe symptoms, call 911 (or your local emergency number) immediately or go to the nearest emergency room.

The dosage of Cialis you’re prescribed may depend on several factors. These include:

  • the type and severity of the condition you’re using Cialis to treat
  • your age
  • other conditions you may have, such as kidney or liver problems (see “Dosage adjustments” under “What is Cialis’s dosage?”)

If your doctor prescribes once-daily Cialis for your condition, it’s best to take it around the same time each day. If you miss a dose, take it as soon as possible.

However, you should not take more than one dose of Cialis per day. Doing so could raise your risk for side effects, such as low blood pressure or priapism (a painful erection lasting 4 hours or longer).

If you need help remembering to take your dose of Cialis on time, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone. A kitchen timer can work, too.

The sections above describe the typical dosages provided by the drug’s manufacturer. If your doctor recommends Cialis for you, they’ll prescribe the dosage that’s right for you.

Remember, you should not change your dosage of Cialis without your doctor’s recommendation. Only take Cialis exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.

Here are some examples of questions you may want to ask your doctor:

  • How long should I give Cialis a chance to work before talking with my doctor about adjusting my dosage?
  • Is once-daily or occasional dosing of Cialis more effective for erectile dysfunction?
  • How can I tell if my Cialis dosage might need to be lowered?
  • Would a different dosage raise or lower my risk for side effects from this drug?

To learn more about Cialis, see these articles:

  • Cialis (tadalafil)
  • Cialis and Cost: What You Need to Know
  • Cialis Interactions: Alcohol, Medications, and Others

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Q:

My doctor prescribed 10 mg of Cialis for occasional use to treat my erectile dysfunction (ED). I took one dose 2 hours before trying to have sex, but I still couldn’t get an erection. Should I try the same dose again before asking my doctor to increase my dose? Or if it didn’t help the first time, will this drug not work for me at all?

Anonymous

A:

Even though Cialis didn’t work this time, it doesn’t mean the drug won’t work at all or that the dose is too low. You can try taking the same dose but waiting longer before having sex.

The 2-hour timeframe is an average, so some people may notice better effects by having sex a little sooner or a little later after taking their dose. In studies, Cialis improved ED as soon as 30 minutes to as long as 36 hours after a dose was taken.

If the drug still doesn’t work after several attempts, or if you have questions or concerns about using Cialis, talk with your doctor.

The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

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Disclaimer: Healthline 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 substance
  • 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 instructions for use: indications, contraindications, side effects – description Cialis tab.

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(Cialis ® )

The scientific information provided is general and cannot be used to make decisions.
decisions about the use of a particular drug.

Update date: 2020.05.25

Marketing authorization holder:

ELI LILLY VOSTOK, S. A.
(Switzerland)

Manufactured:

LILLY DEL CARIBE Inc.

(Puerto Rico)

Packed:

LILLY, S.A.

(Spain)

ATX code:

G04BE08

(Tadalafil)

Active substance:
tadalafil
(tadalafil)

Rec.INN

WHO registered

Dosage form

Cialis ®

Tab., coated film-coated, 5 mg: 14 or 28 pcs.

reg. No.: LP-000133
dated 11.01.11
– Indefinitely

Release form, packaging and composition
Cialis

®

Film-coated tablets light yellow, almond-shaped, engraved “C 5” on one side.

Excipients : lactose monohydrate – 109.65 mg, lactose monohydrate (spray dried) – 17.50 mg, giprolose – 1.22 mg, giprolose (extra fine) – 2.80 mg, sodium lauryl sulfate – 0.49 mg, microcrystalline cellulose – 26.25 mg, croscarmellose sodium – 11.20 mg, magnesium stearate (vegetable) – 0.88 mg.

Composition of the film shell: Opadry yellow (Y-30-12863-A) – 8.75 mg (lactose monohydrate – 3.72 mg, hypromellose – 2.59 mg, titanium dioxide – 1.54 mg, triacetin – 0.74 mg, iron dye yellow oxide – 0.16 mg).

14 pcs. – blisters (1) – packs of cardboard.
14 pcs. – blisters (2) – packs of cardboard.

Clinical and pharmacological group:

Drug for the treatment of erectile dysfunction. PDE5 inhibitor

Pharmacotherapeutic group:

Erectile dysfunction treatment – PDE5 inhibitor

Pharmacological action

An agent for the treatment of erectile dysfunction, is a reversible selective inhibitor of specific PDE5 cGMP. When sexual arousal causes local release of nitric oxide, PDE5 inhibition by tadalafil results in an increase in cGMP levels in the corpus cavernosum of the penis. The consequence of this is the relaxation of the smooth muscles of the arteries and the flow of blood to the tissues of the penis, which causes an erection. Tadalafil is ineffective in the absence of sexual stimulation.

In vitro studies have shown that tadalafil is a selective PDE5 inhibitor. PDE5 is an enzyme found in the smooth muscles of the cavernous body, in the smooth muscles of the vessels of internal organs, in skeletal muscles, platelets, kidneys, lungs, and cerebellum.

The effect of tadalafil on PDE5 is more active than on other phosphodiesterases. Tadalafil is 10,000 times more active against PDE5 than against PDE1, PDE2, PDE4, which are localized in the heart, brain, blood vessels, liver and other organs. Tadalafil is 10,000 times more active at blocking PDE5 than PDE3, an enzyme found in the heart and blood vessels. This selectivity for PDE5 over PDE3 is important because PDE3 is an enzyme involved in cardiac muscle contraction. In addition, tadalafil is approximately 700 times more potent against PDE5 than against PDE6, which is found in the retina and is responsible for phototransmission. Tadalafil is also 10,000 times more active against PDE5 than its effect on PDE7-PDE10.

Effective for 36 hours. The effect appears already 16 minutes after ingestion in the presence of sexual arousal.

Tadalafil in healthy individuals does not cause a significant change in systolic and diastolic pressure, compared with placebo in the supine position (mean maximum decrease is 1.6/0.8 mm Hg, respectively) and standing (mean maximum decrease is 0.2/4.6 mm Hg, respectively). Tadalafil does not cause a significant change in heart rate.

Tadalafil does not cause changes in color recognition (blue/green) due to its low affinity for PDE6. In addition, there is no effect of tadalafil on visual acuity, electroretinogram, intraocular pressure and pupil size.

There was no clinically significant effect on sperm characteristics in men taking daily doses of tadalafil for 6 months.

Pharmacokinetics

Tadalafil is rapidly absorbed after oral administration. C max is reached after an average of 2 hours. The rate and degree of absorption do not depend on food intake. The pharmacokinetics of tadalafil in healthy individuals is linear with respect to time and dose. In the dose range from 2.5 to 20 mg AUC increases in proportion to the dose. C ss in plasma are achieved within 5 days when taking the drug 1 time / day.

The pharmacokinetics of tadalafil in patients with erectile dysfunction is similar to the pharmacokinetics of the drug in individuals without erectile dysfunction.

V d is about 63 liters, which indicates that tadalafil is distributed in body tissues. At therapeutic concentrations, 94% of tadalafil binds to plasma proteins. In healthy individuals, less than 0.0005% of the administered dose was found in semen.

Metabolized with the participation of the CYP3A4 isoenzyme. The main circulating metabolite is methylcatecholglucuronide, which is 13,000 times less potent against PDE5 than tadalafil, so this metabolite is unlikely to be clinically relevant.

In healthy individuals, the average clearance of tadalafil when taken orally is 2.5 l / h, and the average T 1/2 is 17. 5 hours. Tadalafil is excreted mainly in the form of inactive metabolites, mainly with feces (about 61%) and to a lesser extent with urine (about 36%).

In patients with mild renal insufficiency (CC from 51 to 80 ml / min) or moderate severity (CC from 31 to 50 ml / min), AUC is greater than in healthy individuals.

Indications of the active substances of the drug

Cialis

®

Erectile dysfunction.

Open list of ICD-10 codes

F52.2 Lack of genital response (psychogenic impotence)
N48.4 Organic impotence

Dosage regimen

The method of administration and dosing regimen of a particular drug depends on its form of release and other factors. The optimal dosage regimen is determined by the doctor. Compliance of the dosage form of a particular drug with indications for use and dosing regimen should be strictly observed.

Middle-aged men are recommended to take a dose of 20 mg at least 16 minutes before expected sexual activity, regardless of food intake. Patients may attempt intercourse at any time within 36 hours after ingestion in order to establish an optimal response time to tadalafil. The maximum frequency of admission is 1 time / day.

Side effects

Most common: headache, dyspepsia.

Possible: back pain, myalgia, nasal congestion, flushing of the face.

Rare: eyelid edema, eye pain, conjunctival hyperemia, dizziness.

Contraindications for use

Simultaneous use of drugs containing any organic nitrates; children and adolescents up to 18 years of age; hypersensitivity to tadalafil.

Pregnancy and lactation

The drug is not used in women.

Use in hepatic dysfunction

With extreme caution and only in case of emergency, it is possible to use tadalafil in patients with severe hepatic insufficiency.

Use for impaired renal function

With extreme caution and only in case of emergency, it is possible to use tadalafil in patients with severe renal insufficiency (CC ≤ 30 ml / min).

During treatment with tadalafil, patients with moderate renal insufficiency (CC from 31 to 50 ml / min) were more likely to experience back pain compared with patients with mild renal insufficiency (CC from 51 to 80 ml / min) or healthy volunteers. In patients with CC ≤50 ml/min, tadalfil should be used with caution

Use in children

Contraindicated in children and adolescents under 18 years of age.

Special instructions

With extreme caution and only in case of emergency, it is possible to use tadalafil in patients with severe renal insufficiency (CC≤30 ml / min) and severe hepatic insufficiency.

During treatment with tadalafil, patients with moderate renal insufficiency (CC from 31 to 50 ml / min) were more likely to experience back pain compared with patients with mild renal insufficiency (CC from 51 to 80 ml / min) or healthy volunteers. In patients with CC≤50 ml/min, tadalafil should be used with caution.

Therefore, the treatment of erectile dysfunction, incl. with the use of tadalafil should not be performed in men with heart conditions in which sexual activity is not recommended.

The potential risk of developing complications during sexual activity in patients with diseases of the cardiovascular system should be considered: myocardial infarction within the last 90 days; unstable angina or angina that occurs during intercourse; chronic heart failure (functional class II and above according to the NYHA classification) that has developed within the last 6 months; uncontrolled heart rhythm disturbances; arterial hypotension (BP less than 90/50 mm Hg) or uncontrolled arterial hypertension; stroke within the last 6 months.

Tadalafil should be used with caution in patients with a predisposition to priapism (eg, sickle cell anemia, multiple myeloma, or leukemia) or in patients with an anatomical deformity of the penis (eg, 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 loss of potency may occur.

No cases of priapism have been reported during the use of tadalafil.

Tadalafil is not recommended in combination with other treatments for erectile dysfunction.

Drug interactions

Tadalafil is mainly metabolized by the CYP3A4 enzyme. The selective CYP3A4 inhibitor ketoconazole increases AUC by 107%, while rifampicin reduces it by 88%.

Although specific interactions have not been studied, protease inhibitors such as ritonavir and saquinavir, as well as CYP3A4 inhibitors such as erythromycin and itraconazole, may increase the activity of tadalafil.

While taking an antacid (magnesium hydroxide / aluminum hydroxide) and tadalafil, the rate of absorption of the latter decreases without changing its AUC.

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