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What is Generic Cialis Online?

Cialis is drug directed to eliminate any manifestations of erectile dysfunction. It is possible to treat this disorder due to effective medication. The main Cialis component is tadalafil 20 mg.

Other additive agents are:

  • lactose monohydrate;
  • cross-carmellose sodium;
  • hydroxypropyl cellulose;
  • Micro crystalline cellulose;
  • sodium laurel sulfate;
  • magnesium stearate;
  • Opadry II;
  • talc.

Pharmacological Cialis Effect

Cialis is erectile dysfunction treatment drug. Cialis is a reversible selective inhibitor of specific phosphodiesterase type 5 (PDE5). When sexual stimulation causes local nitric oxide release, inhibition of PDE5 leads to increased levels of cGMP in cavernous body. The result is relaxation of smooth muscles of arteries and blood flow to penile tissues that causes erection. Cialis Canadian Pharmacy (tadalafil) has no effect in absence of sexual stimulation.

Studies in vitro have shown that Cialis drug is selective inhibitor of PDE5. PDE5 – enzyme found in:

  • corpus cavernosum smooth muscle;
  • blood vessels internal organs smooth muscle;
  • skeletal muscle;
  • platelets;
  • kidneys;
  • lungs;
  • cerebellum.What is Cialis?

Generic Cialis action on PDE5 is more active than other phosphodiesterase. Cialis is 10 000 times more active against PDE5 than against FDE1, PDE2, PDE4, which are located in heart, brain, blood vessels, liver and other organs. Cialis blocks 10 000 times more active PDE5 than PDE3 – enzyme that is found in heart and blood vessels.

This selectivity for PDE5 compared to PDE3 is important because PDE3 is an enzyme participating in heart muscle reduction. In addition, Cialis online approximately 700 times is more potent for PDE5 than for PDE6, found in retina and is responsible for photographic transmission. Cialis drug is also 10 000 times more active against PDE5 compared with its effect on FDE7-FDE10.

Cialis improves erection and possibility of successful sexual intercourse.

Cialis effect lasts up to 36 hours. The effect is already apparent after 16 minutes after taking drug in presence of sexual excitement.

Generic Cialis in healthy individuals does not cause significant changes in systolic and diastolic blood pressure compared with placebo in prone position (mean maximum decrease of 1.6 / 0.8 mm Hg, respectively) and standing (mean maximum decrease of 0.2 / 4.6 mm Hg, respectively). Tadalafil does not cause significant changes in heart rate. Cialis does not cause changes in color perception (blue / green), due to its low affinity for PDE6.

In addition, there were no observed such effects as:

  • visual acuity;
  • electroretinogram;
  • intraocular pressure;
  • pupil size change.

In applying this medicament, Cialis daily dose is 10 mg. There is no clinically significant effect on the drug and number of sperm concentration, motility and morphology of spermatozoa.

Cialis Pharmacokinetics

Cialis Absorption

After Cialis oral administration, Cialis is rapidly absorbed. Average Cmax is achieved after 2 hours. The rate and extent of absorption is independent of food intake. Time of Cialis intake (morning or evening) had no clinically significant effect on rate and absorption extent.

Cialis pharmacokinetics in healthy individuals is linear with respect to time and dose. In the dose range from 2.5 mg to 20 AUC increases proportionally with dose. Css plasma is reached within 5 days of taking drug at 1 time / day.

Cialis pharmacokinetics in patients with erectile dysfunction is similar to pharmacokinetics in patients without erectile dysfunction.

Cialis Distribution

Vd is about 63 liters, indicating that Cialis is distributed in body tissues. At therapeutic concentrations, 94% of tadalafil is bound to plasma proteins. In healthy persons less than 0.0005% of administered dose was found in semen.

Cialis Metabolism

Cialis is metabolized with participation of isoenzyme – CYP3A4. The major circulating metabolite is catechol-methyltransferase inhibitor. It is 13,000 times less active against PDE5 than tadalafil.

Therefore, this metabolite is unlikely to be clinically significant.

Cialis Excretion

In healthy individuals, average clearance of Cialis ingestion is of 2.5 l / h and average T1 / 2 -. 5.17 hours. Cialis excretes primarily as inactive metabolites, mainly with feces (about 61%) and to a lesser extent with urine (about 36%).

Pharmacokinetics in Special Clinical Situations

Healthy elderly people (65 and over) have a low clearance, which was reflected in increase of AUC by 25% compared with healthy people aged 19 to 45 years. This difference is not clinically significant and does not require Cialis dosage adjustment.

In patients with mild renal insufficiency (creatinine clearance 51-80 ml / min) or moderate (creatinine clearance = 31-50 ml / min), AUC is greater than in healthy individuals. Protein binding is not changed when impaired renal function. In patients with severe renal insufficiency (creatinine clearance <= 30 mL / min), use of Cialis has not been studied.

The pharmacokinetics of Cialis in patients with mild hepatic impairment is comparable with that in healthy individuals.

Patients with diabetes mellitus during Cialis treatment AUC was lower by about 19%, than in healthy individuals. This difference is not clinically significant and dose not require changes.