What is Cialis?(Tadalafil)

Cialis, pronounced see-Alice, is a brand name given by the drug company GlaxoSmithKline for tadalafil, which they discovered while in a partnership with the Bothell, Washington biotechnology company, ICOS Corporation. After an agreement lapsed between Glaxo and ICOS, Eli Lilly and Company formed a joint venture called Lily ICOS, LLC and in 2003, the U.S. Food and Drug Administration (FDA) approved Cialis. Often commonly known asTadalafil

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Cialis treats erectile dysfunction (ED), or an inability for a man to develop or maintain an erection of the penis during sex. The main advantage of Cialis over other ED drugs, such as Viagra (sildenafil) or Levitra (vardenafil), is its characteristic of lasting up to 36 hours, which earned it a nickname of “the weekend pill.” Cialis begins working within 15 to 30 minutes after it is taken.

Men with the symptoms of a Benign Prostatic Hyperplastic (BPH), or an enlarged prostate gland, can be treated with Cialis. A common symptom of BPH is increased urinary problems.

Besides going by the name Cialis, tadalafil is also called Adcirca, which is used to treat pulmonary arterial hypertension, the term doctors use for uncharacteristically high blood pressure of the arteries in the lungs. Pulmonary hypertension is sometimes shortened to PHT. Adcirca treats PHT in both men and women, which improves their exercise capability.

The FDA approved the use of tadalafil for treating PHT in 2011. At the same time, the FDA approved the use of Cialis for treating both BPH and ED, when both conditions exist in men.

How Does Cialis Work?

An erection of the penis during sexual stimulation takes place with an increase of blood flow after penile arteries relax in the smooth muscle of the penis, called the corpus cavernosum. Nitric oxide released from nerve endings starts this arterial relaxation. When the nitric oxide is released, cyclic nucleotide guanosine monophosphate (cGMP) is created in the smooth muscle cells. This cGMP relaxes the smooth muscle and increases blood flow.

When Cialis is taken, it stops the enzyme called phosphodiesterase type 5, or PDE5. When there’s less of the PDE5 enzyme, there’s more cGMP, hence, there’s more of a chance for an erection of the penis. Since sexual stimulation is necessary to start the release of nitric oxide, the deterring effect of Cialis on the PDE5 enzyme doesn’t work if there is no sexual stimulation. So, there’s no chance of unexpected or embarrassing results due to taking Cialis.

For women and men who suffer from PHT, the blood vessels in the lungs are constricted in size. This, in turn, produces abnormally high blood pressure in the lungs. In a worse-case scenario, the right side of the heart fails, due to PHT. Tadalafil allows the smooth muscles of the lung’s arteries to relax, which in turn opens up these blood vessels and lowers what once was high blood pressure in the lungs.

So, in plain English, when a person takes Cialis, they’re taking a pill that results in the relaxation of blood arteries. So, whether the individual is a man who wants to have sex or a woman or a man who’s having difficulty breathing, this drug lets blood arteries open up to allow more blood to flow. And, in the case for solving ED issues, Cialis is effective for over four times as long as other ED drugs.

It is not known how Cialis works in relieving men who exhibit symptoms of BPH, but it is thought that the ability to relax smooth muscles that are in the prostate and bladder may improve blood flow to the urinary tract, thereby widening the opening of the neck in the bladder and improving the problem of not emptying the bladder properly upon urination, which is a symptom of men suffering from BPH.

Cialis is 10,000 times more effective on limiting PDE5 levels, as compared to provoking a change in PDE1, PDE2, PDE4 and PDE7 enzymes, which are found in blood vessels, brain, liver and in the skeleton.

Effectiveness of Cialis

Using Cialis doesn’t work for all men who suffer from ED. In tests, 62 to 77 percent of patients with ED complaints were able to use a 20 milligram sample of Cialis and initiate sexual intercourse, compared to 39 to 43 percent who received a placebo. In these same tests, 50 to 64 percent of the Cialis users maintained their erection, compared to 23 to 25 percent of the patients who were on the placebo. These same tests proved that Cialis started working 15 to 30 minutes after it was taken and lasted 36 hours, compared to Viagra, which began working 30 to 60 minutes after it was taken and lasted approximately four hours.

Men who took five milligrams of Cialis for BPH noticed a reduction of 5.6 in symptoms, compared to a drop of 3.6 in symptoms with those who took a placebo.

Cialis Side Effects and Warnings

The most common side effects witnessed from over 8 million men who have taken Cialis worldwide are as follows:

  • Cialis can increase the width of blood vessels that results in a stuffy or runny nose, a markedly red face, muscle aches, indigestion, headaches and back pain. Muscle aches and pains in the back usually happen between 12 and 24 hours after taking Cialis and often go away after 48 hours. A doctor should be contacted if symptoms just outlined do not go away, or if side effects are too much to withstand. In clinical studies involving over 9,000 men, headaches ranged from 11 percent of those taking 5 and 10 milligram tablets to 15 percent taking 20 milligram tablets. An upset stomach happened with four percent who took a 5 milligram dosage of Cialis, 8 percent taking 10 milligrams and 10 percent taking 20 milligrams. Three percent of those who took 5 milligrams of Cialis had back pain, compared to five percent taking 10 milligrams and six percent ingesting 20 milligram Cialis tablets. Muscle aches occurred with one percent of those who took 5 milligrams of Cialis, four percent who had a 10 milligram tablet and three percent on a 20 milligram pill. Nasal congestion and flushing occurred with two percent of those on a 5 milligram Cialis tablet and for three percent on a 10 or a 20 milligram tablet.
  • Taking Cialis can lead to impaired vision with insufficient blood levels reaching the optic nerve of the eye. This usually happens with men who are over 50, who have a low cup to disc ratio in the eye, have diabetes, have high blood pressure, have coronary artery disease, have hyperlipidemia as a result of high cholesterol or high triglyceride levels, or who smoke. Color vision changes, such as noticing a bluish hue to all objects, or finding it hard to distinguish between the colors blue and green, might indicate vision issues related to taking Cialis. If visual impairment comes in one or both eyes after taking Cialis, taking the drug should cease, since it’s the sign of NIAON, or Nonarteritic Anterior Ischemic Optic Neuropathy, which can result in permanent loss of vision or decreased vision.
  • Cialis users can experience a sudden loss of hearing. Sometimes, a ringing of the ears can be noticed. If such an event happens while taking Cialis, medical attention should immediately be sought.
  • If a patient takes nitrate medication for heart conditions, the organic nitrate medications should be avoided at least 48 hours after taking Cialis. Combining nitrates with Cialis leads to hypotension, or abnormally low blood pressure, which can drop blood pressure to unsafe levels, causing dizziness, fainting, heart attack, or a stroke. Anyone who uses organic nitrates, such as glyceryl trinitrate spray, to relieve angina, or severe chest pain, should refrain from mixing the trinitrate spray with Cialis and get immediate medical attention. In a medical emergency, paramedics and physicians need to be made aware of Cialis doses taken within the past 48 hours. Names of drugs that shouldn’t be mixed with Cialis include recreational drugs, such as nitrate “poppers,” or amyl nitrate; isosorbide mononitrate with the brand names of Monoket, ISMO, or Imdur; isosorbide dinitrate with common names such as Isochron, Isordil, or Dilatrate; and nitroglycerin, named as Transderm Nitro, Nitrostat, Nitrolingual, or Nitro Dur.
  • Patients who are allergic to Cialis or Adcirca should refrain from taking the drug. Allergic reactions include an inflammation of the throat, tongue or lips, trouble in swallowing or breathing, a rash, or hives. A doctor should be contacted immediately if any of these symptoms arise after taking Cialis.
  • When Cialis is administered with blood-pressure-lowering or antihypertensive medications, such as enalapril, amlodipine, bendrofluazide, angiotensin II receptor blockers, or metoprolol, small drops in blood pressure result. In some cases, a significant blood pressure drop is possible.
  • Patients who have a history of heart disease or heart rhythm problems, a heart attack within the past 90 days, a stroke or congestive heart failure in the past six months, chest pain, high or low blood pressure, liver disease, kidney disease, a blood cell disorder such as multiple myeloma, sickle cell anemia, or leukemia, retinitis pigmentosa, a bleeding disorder, a stomach ulcer, a deformity of the penis, or those told not to have sexual intercourse for health reasons might require adjustments to their dosage of Cialis.
  • Men who suffer from prolonged erections, or priapism, an often painful erection that lasts four hours, or longer, which is not associated with sexual activity and not relieved by an orgasm in which blood fails to drain from the penis, should not take Cialis. If an erection won’t go away after using Cialis, or lasts longer than four hours, medical attention should be sought. An erection that doesn’t subside needs to be treated quickly or lasting damage can occur, including the lack of having an erection in the future.
  • Cialis taken with certain alpha-blocking medications to treat prostrate issues can produce sudden drops in block pressure, resulting in dizziness or fainting. Such medicines include Hytrin (terazosin HCL), Minipress (prazosin HCL), Flomax (tamsulosin HCL), Cardura (doxazosin mesylate), Uroxatral (alfuzosin HCL), Jalyn (dutasteride and tamsulosin HCL), and Rapaflo (silodosin).
  • Combining Cialis with large quantities of alcohol can result in a lightheaded feeling and even lead to fainting when one stands up quickly. Doctors call this orthostatic hypotension. Large quantities of alcohol and Cialis can also result in an increased heart rate, a decrease in blood pressure and a headache. An example of too much alcohol is five glasses of wine or five shots of strong liquor, such as whiskey.
  • Cialis should not be mixed with other PDE5 inhibitors, such as Viagra or Levitra. Likewise, Cialis should not be taken at the same time as Adcirca is taken, since both are brand names for the same tadalafil drug and the combined dose would result in a tadalafil overdose.
  • Grapefruit juice, ketoconazole, ritonavir, erythromycin, itraconazole, or any protease inhibitor (antiviral drugs used to treat HIV/AIDS and hepatitis cause by the hepatitis C virus) should be avoided when taking Cialis. Examples of such drugs include ritonavir (Norvir and Kaletra).
  • Some forms of oral antifungal agents, such as Nizoral (ketoconazole) and Sporanox (itraconazole), should be avoided while taking Cialis. Also, some varieties of antibiotics, such as Biaxin (clarithromycin) and Ketek (telithromycin) and the many brands of erythromycin shouldn’t be used while taking Cialis.
  • Concurrently taking an antacid of magnesium hydroxide or aluminum hydroxide with Cialis reduces the rate of absorption of Cialis.