Cialis at Canadian Pharmacy: A Comprehensive Guide On The Weekend Pill
Introduction
Tadalafil represents the class of PDE5 inhibitors; it’s the main active ingredient of a lineup of drugs primarily aiming at erectile dysfunction elimination. Cialis is doubtlessly the most widely recognizable tadalafil-based medication; a less popular drug with an identical active ingredient that combats pulmonary arterial hypertension is Adcirca; bothe medications are approved by FDA. Moreover, according to FDA approval Cialis is registered as a drug that eliminates benign prostatic hyperplasia symptoms. When and if BPH is observed in conjunction with erectile dysfunction, the preparation is prescribed to treat both issues.
The active ingredient was discovered by ICOS, the largest biological laboratory in the United States until 2007, when it was acquired by Brand Company. The pharmaceutical giant played a vital role into bringing the pill to the dynamically growing market of PDE-5 drugs; the ‘big pharma’ representative, brand company. took upon itself a costly process of re-release and marketing upon itself to launch a series of 2.5, 5, 10 and 20mg Cialis. The preparation is prescribed at aforementioned dosages to treat erectile dysfunction and appointed at 40mg to deal with pulmonary arterial hypertension.
The medication is also available in a generic form by a range of multinational pharmaceutical companies located in India, paying special attention to generic modifications production and offering a variety of tadalafil-based pills, such as Tadacip (available in 10 and 20mg pills). Both Cialis and Tadacip are allowed to go on sales by FDA in the United States, the price for 2.5mg brand Cialis starts from $4.95 (reaching $20+ per 20mg pill), while Tadacip price takes its start at $1.92 (note, the data is provided basing on Drugbank.ca and Webmd.com data and reviews). Tadalafil is also available in numerous options by licensed abroad companies having no license to sell drugs in the US, and the price range for these tadalafil-based drugs starts from $0.50 per pill.
How it works: considering the mechanisms of action
Tadalafil is primarily appointed to enhance erection in males. The active ingredient produces the impact that touches the core reactions that constitute the process of sexual arousal and bringing penis into erected condition. In a healthy male body with the sexual arousal the blood vessels in male genitalia expand greatly, and an influx in blood to the organ takes place, so the penis becomes firm and erected. A variety of psychological, physiological or combined problems may result into insufficient blood flow to the organ and insufficient filling of vessels with blood. Tadalafil is created to improve the blood flow and thus enhance erection.
An increased blood filling of penis becomes possible due to cGMP substance, which gets rapidly eliminated by PDE-5 enzyme. Tadalafil inhibits (slows down) the development of PDE-5, which allows cGMP to function longer, relaxing the smooth muscles and supplying the blood in the quantities necessary to build and maintain normal erection. By the nature of its effect Cialis is referred to the group of vasolidators (the group of preparation which action is aimed at blood vessels expansion).
This way or the other, the preparation doesn’t act on its own, the onset of action is largely defined by the presence of the sexual arousal. Cialis cannot make the vessels filled with blood and natural excitation is absolutely required. The process is explained by the following fact: cGMP, the substance that enhances vessels expansion, is produced under the influence of nitrous oxide, which in its turn developed in the body with the natural excitation. During sexual arousal the nervous system sends impulses to the appropriate centres of spinal cord and brain which react with by releasing NO.
PDE enzymes are not only concentrated in the blood vessels of the penis and arteries retina, but also in skeletal and cardiac muscle, lungs and etc. PDE ferment in each organ is denoted by a number, such as PDE-5 – is an enzyme functioning in the vessels of the penis, PDE-6 is localized and retina, and PDE-3 – in the heart muscle. Cialis has a high specificity, and therefore acts selectively only on PDE5. That is why it has no such side effects as the influence on pressure, changes of color and etc.; the adverse reactions typical of Viagra and Levitra.
Clinical trials efficiency in scope
A series of studies has confirmed tadalafil significantly reduces or prevents the loss of structures inside the corpus cavernosum of the penis, caused by age-related issues, diabetes or surgery.
In one study it was found that a daily dose of tadalafil leads to higher values of the index of erectile function and increase in the number of successes in the commission of sexual intercourse compared with its reception on request. Two other major studies in which tadalafil was administered for 12 weeks in daily doses of 5 and 10 mg, and 24 weeks at the doses of 2.5 and 5 mg, have revealed that a daily intake significantly improves erectile function (a positive result in 72% and 78% of clinical trial participants). However, these studies didn’t include on demand treatment options.
Another extensive research conducted throughout 1 year in the group of 230 patients and a similar group of patients over the past two years confirmed the effectiveness and decent tolerability of Tadalafil in a dose of 5 mg per day. Therefore, there is an assumption backed up by some clinical evidence that the daily intake of this drug in a dose of 5mg may be considered as an alternative to on demand use. This applies to the treatment of those couples who prefer casual and not planned sex life or resorting to frequent sexual acts. The advantages of this method include the ability to eliminate the time dependence of the sexual activity of the drug. However, in the annual follow-up study in which Tadalafil was administered at a dose of 5 mg, after a month’s break in taking the drug and its elimination from the body, revealed that an erectile function was well preserved in 75% of subjects.
Another study concerned the application of vardenafil in two modes – on demand, every day, but with a month break in therapy. Preclinical studies have been favorable, but, despite this, it was found that in patients with mild to moderate impotence daily intake of 10 mg of vardenafil, followed by termination of this therapy does not provide proof of any effect as compared to its reception on request.
Another study has found that long-term regular tadalafil treatment leads to improved endothelial function and maintains efficiency during the treatment course pauses. Similar results were obtained in the study of long-term use of sildenafil men with diabetes mellitus of the 2nd type. A recent study on men with diabetes and erectile dysfunction found that a daily intake of tadalafil in doses of 2.5 mg and 5 mg within 12 weeks could be enough to achieve positive results in erection.
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How to take Cialis to guarantee the maximum effectiveness
Cialis is designed for perioral use with little water. Unlike Viagra, the medication can be taken regardless of meals. The administration regimen is picked up individually, though the highest average dosage equals 20mg. Cialis is recommended to be taken not earlier than 15 minutes before the anticipated sexual intercourse (ideally, not earlier than 20-25 minutes).
Once consumed, it produces action within up to 36 hours, and the optimal time frame for the onset of action varies. Given the individual reaction on the body, you should adjust the timing as the treatment course goes (the adjustment could be initiated after 3 – 5 receptions). The maximum dosage should not exceed 40mg per 36 hours (note that exceeding the dosage does not lead to an enhanced impact and increases the risk of adverse reactions).
Cialis dosage regimen for the elderly shouldn’t be necessarily adjusted, although it is recommended to start the treatment with small dosages – 5mg each 36 hours. In case of complicated individual tolerability, the dosage can be decreased to 10, 5 or even 2.5mg. If you take CYP3A4 inhibitors, the dosage should be decreased to 10mg and consumed once each 72 hours.
Tadalafil trials didn’t reveal the drug triggers priapism – prolonged, painful erection maintained during long periods of time. However, the undesired effect may be manifested in case of co-administration of Cialis with other PDE-5 inhibitors (like Viagra or Levitra); that’s why you should avoid taking these drugs simultaneously. The decision on treatment course should be made by the doctor in case the patient is taking nitrate medications: despite the fact that the drug is well-tolerated in an overwhelming number of cases, the preparations that stimulate the hypotensive effect should not be taken simultaneously.
Cialis should be appointed to patients with functional kidney disorders with caution. In case of insignificant functional changes, the adjustments are not essential. In fact, the adjustments may not be initiated until the creatinine filtration coefficient is not exceeding 50ml/min. In those suffering from renal insufficiency a dosage of 10mg each 24 hours can be appointed, but only in case of non-acute forms of the disease.
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The preparation is designed for 18+ years old males, and despite certain clinical data on its effectiveness in women, using this preparation in women is not recommended.
Contraindications
Tadalafil has absolute and relative contraindication types: the first type implies that the treatment itself should not be considered, while the second one requires professional consultation to make a decision on the treatment course start and dosage regimen. Thus, the list of absolute contraindications includes hypersensitivity, reception by women and individuals under 18 years old and simultaneous reception of nitrates or/and alpha-adrenoblockers.
The preparation is prescribed with caution (relative contraindications) to those having heart failure of 2nd type and higher, stenocardia (including stenocardia emerging during a sexual intercourse), renal insufficiency, post heart attack or stroke periods, hypotension, other PDE-5 drugs co-administration and etc.
Overdose
A series of clinical trials didn’t reveal any significant overdose effects in consumption of 500mg at once or 1,000 mg in several intakes during 24 hours. The overdose clinical picture didn’t actually differ from the one observed in case of reception of normal drug doses. It is more likely that a patient may collide with acute side effects, and in case the adverse reaction doesn’t pass away during the prolonged periods of time, you should seek for medical assistance ASAP.
Buying Cialis at the right place
With the growing number of online pharmacies offering products of seemingly good quality, you should better purchase Cialis at time-tested, reliable online stores. Drop in at Canadian Pharmacy website for original and generic Cialis – the best price as well as simply stunning customer service are guaranteed.
