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 The following information is a summary about
Cialis® .
It is not intended to replace a doctor's instructions.
(Tadalafil - Oral)
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Viagra, or CIALIS is used to treat erectile
dysfunction, also known as impotence. This is when a man cannot get, or keep, a
hard erect penis suitable for sexual activity.
The active ingredient in CIALIS tablets, tadalafil, belongs to a group of
medicines called phosphodiesterase type 5 inhibitors. Following sexual
stimulation CIALIS helps the blood vessels in your penis to relax which allows
the blood flow into your penis. The result is the improved erectile function.
CIALIS will not help you if you do not have erectile dysfunction. Read
more about Cialis side
effects.
Actions
 Pharmacotherapeutic group: medicines used in erectile dysfunction. Tadalafil is
a potent, selective, reversible inhibitor of cyclic guanosine monophosphate (cGMP)-specific
phosphodiesterase type 5 (PDE5). When sexual stimulation causes the local
release of nitric oxide, inhibition of PDE5 by tadalafil produces increased
levels of cGMP in the corpus cavernosum. This results in smooth muscle
relaxation and inflow of blood into the penile tissues, thereby producing an
erection. Tadalafil has no effect if there is no sexual stimulation.
Pharmacodynamics
Studies in vitro have shown that tadalafil is a selective inhibitor of PDE5.
PDE5 is an enzyme found in corpus cavernosum smooth muscle, vascular and
visceral smooth muscle, skeletal muscle, platelets, kidney, lung, and
cerebellum. The effect of tadalafil is more potent on PDE5 than on other
phosphodiesterases. Tadalafil is > 10,000-fold more potent for PDE5 than for
PDE1, PDE2, and PDE4, enzymes which are found in the heart, brain, blood
vessels, liver, and other organs. Tadalafil is > 10,000-fold more potent for
PDE5 than for 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 contractility. Additionally, tadalafil is approximately 700-fold more
potent for PDE5 than for PDE6, an enzyme which is found in the retina and is
responsible for phototransduction. Tadalafil is also > 10,000-fold more potent
for PDE5 than for PDE7 through PDE10.
Two clinical studies were conducted in 571 patients in an at-home setting to
define the period of responsiveness to CIALIS. CIALIS demonstrated statistically
significant improvement in erectile function and the ability to have successful
sexual intercourse up to 36 hours following dosing, as well as patients' ability
to attain and maintain erections for successful intercourse compared to placebo
as early as 16 minutes following dosing. Sexual Encounter Profile (SEP) diary
data collected in clinical studies supports this period of responsiveness. In
these studies patients were free to choose the time interval between dose
administration and the time of sexual attempts.
CIALIS administered to healthy subjects produced no significant difference
compared to placebo in supine systolic and diastolic blood pressure (mean
maximal decrease of 1.6/0.8 mm Hg, respectively), in standing systolic and
diastolic blood pressure (mean maximal decrease of 0.2/4.6 mm Hg, respectively),
and no significant change in heart rate. When tadalafil and certain oral
antihypertensive medications were assessed in medicine interaction studies,
tadalafil did not result in clinically significant augmentation of the
antihypertensive effects of those medications (see
Interactions).
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Adverse Effects
CIALIS should be used with caution in patients who have conditions that might
predispose them to priapism (such as sickle cell anaemia, multiple myeloma, or
leukaemia), or in patients with anatomical deformation of the penis (such as
angulation, cavernosal fibrosis or Peyronie's disease). The evaluation of
erectile dysfunction should include a determination of potential underlying
causes and the identification of appropriate treatment following an appropriate
medical assessment.
The safety and efficacy of combinations of CIALIS and other treatments for
erectile dysfunction have not been studied. Therefore, the use of such
combinations is not recommended.
Treat Erectile Dysfunction
 A
wide variety of options exist for treating erectile
dysfunction. They include everything from medications
and simple mechanical devices to surgery and
psychological counseling. The cause and severity of your
condition are important factors in determining the best
treatment or combination of treatments for you. You and
your doctor may also want to consider how much money
you're willing to spend and the personal preferences of
you and your partner. If erectile dysfunction is the
result of a medical condition, the cost of treatment may
be covered by insurance.
Oral medications
Oral medications available to treat ED include:
Sildenafil (Viagra)
Tadalafil (Cialis)
Vardenafil (Levitra)
The Food and Drug Administration (FDA) approved Viagra
in 1998, and it became the first oral medication for
erectile dysfunction on the market. Since then, Levitra
and Cialis have been approved, providing more options
for oral therapy.
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