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    Cialis risks


    Indicated for treatment of erectile dysfunction (ED) Cialis or generic equivalent only PRN use: 10 mg PO initially before sexual activity, with or without food; may be increased to 20 mg or reduced to 5 mg on basis of efficacy and tolerability; in most patients, maximum dosing frequency is once daily Once-daily use: 2.5 mg/day PO in single daily dose, without regard to timing of sexual activity, with or without food; may be increased to 5 mg/day on basis of efficacy and tolerability Indicated for treatment of signs and symptoms of benign prostatic hyperplasia (BPH); daily use also indicated for treatment of patients with both BPH and erectile dysfunction Cialis or generic equivalent only BPH: 5 mg PO once daily BPH with ED: 5 mg PO once daily, taken at approximately same time each day without regard to timing of sexual activity Coadministration with finasteride for BPH: Tadalafil 5 mg plus finasteride 5 mg PO once daily for ≤26 weeks; incremental benefit of tadalafil decreases from 4 weeks until 26 weeks, and the benefit beyond 26 weeks is unknown Indicated for pulmonary arterial hypertension (PAH) (WHO Group 1) to improve exercise ability; studies establishing effectiveness included predominately patients with NYHA Functional Class II – III symptoms and etiologies of idiopathic or heritable PAH (61%) or PAH associated with connective tissue diseases (23%) Adcirca, Alyq, or generic equivalent only 40 mg PO once daily; dividing dose for more frequent dosing is not recommended Patients also taking ritonavir: 20 mg PO once daily initially for ≥1 week; may be increased to 40 mg/day on basis of tolerability Use caution in patients with anatomic deformation of penis, cardiovascular disease, left ventricular outflow obstruction, myocardial infarction in preceding 90 days, unstable angina, angina occurring during sexual intercourse, NYHA class 2 or greater heart failure in preceding 6 months, uncontrolled arrhythmias, hypotension, uncontrolled hypertension, cerebrovascular accident in preceding 6 months, bleeding disorders, active peptic ulcer disease, liver disease, renal impairment, conditions predisposing to priapism, concomitant use of CYP3A4 inhibitors May cause dose-related impairment of color discrimination; use caution in patients with retinitis pigmentosa Evaluate underlying causes of erectile dysfunction or BPH before initiating therapy May increase risk of sudden vision loss attributed to nonarteritic ischemic optic neuropathy; if vision problems arise, discontinue, and contact physician Risk of sudden hearing loss CYP3A4 inhibitors (eg, erythromycin, ketoconazole, itraconazole, indinavir, ritonavir) may significantly increase tadalafil serum levels CYP3A4 inducers (eg, rifampin, St John’s wort) may decrease tadalafil serum levels Potentiates hypotensive effect of nitrates (see Contraindications) Concomitant use with alpha blockers (other than tamsulosin 0.4 mg/day) should be stabilized before initiation of phosphodiesterase (PDE)-5 inhibitors; patients with instability on alpha-blocker therapy alone are at increased risk for symptomatic hypotension with concurrent PDE-5 inhibitor therapy Not to be taken with other PDE-5 inhibitors (eg, sildenafil, vardenafil) Not recommended in patients with pulmonary veno-occlusive disease Advise patients to seek emergency treatment if an erection lasts Not indicated for use in females; there are no data in pregnant women to inform any drug-associated risks for adverse developmental outcomes; in animal reproduction studies, no adverse developmental effects observed with oral administration of tadalafil to pregnant rats or mice during organogenesis at exposures up to 11 times the maximum recommended human dose (MRHD) of 20 mg/day Not indicated for use in females; there is no information on presence of tadalafil and/or metabolites in human milk; effects on breastfed child, or on milk production; drug and/or its metabolites are present in milk of lactating rats at concentrations approximately 2.4-fold greater than found in plasma Erectile dysfunction: Inhibits PDE-5, increasing cyclic guanosine monophosphate (c GMP) to allow smooth-muscle relaxation and inflow of blood into corpus cavernosum Pulmonary arterial hypertension (PAH): Inhibits PDE-5, increasing c GMP to allow relaxation of pulmonary vascular smooth-muscle cells and vasodilation of pulmonary vasculature The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. where to buy cialis in hong kong -kə, and Tadacip for the treatment of pulmonary arterial hypertension. It initially was developed by the biotechnology company ICOS, and then again developed and marketed worldwide by Lilly ICOS, LLC, the joint venture of ICOS Corporation and Eli Lilly and Company. Food and Drug Administration (FDA) approved Cialis for treating the signs and symptoms of benign prostatic hyperplasia (BPH) as well as a combination of BPH and erectile dysfunction when the conditions coincide. Cialis tablets, in 2.5 mg, 5 mg, 10 mg, and 20 mg doses, are yellow, film-coated, and almond-shaped. The approved dose for pulmonary arterial hypertension is 40 mg (two 20 mg tablets) once per day (OD). On November 21, 2003 the FDA approved tadalafil (as Cialis) for sale in the United States as the third ED prescription drug pill (after sildenafil citrate (Viagra) and vardenafil (Levitra)). Like sildenafil and vardenafil, tadalafil is recommended as an 'as needed' medication. Tadalafil was approved in May 2009 in the United States for the treatment of pulmonary arterial hypertension and is under regulatory review in other regions for this condition. In late November 2008, Eli Lilly sold the exclusive rights to commercialize tadalafil for pulmonary arterial hypertension in the United States to United Therapeutics for an upfront payment of $150 million.

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    Cialis tablets contain the active ingredient tadalafil, which is a type of medicine called a phosphodiesterase type 5 inhibitor. If you suffer from erectile dysfunction, tadalafil helps you to achieve and maintain an erection by helping more blood get into your penis when you are sexually aroused. An erection is produced via a complex chain of events, involving signals from the nervous system and the release of chemical messengers within the tissues of the penis. One of the messengers released when you're aroused is called cyclic GMP. Cyclic GMP relaxes and widens the blood vessels in the penis, allowing more blood to enter. Cyclic GMP is normally broken down by an enzyme in the body called phosphodiesterase type 5 (PDE5). Tadalafil works by stopping this enzyme from breaking down the cyclic GMP. This allows the blood vessels in the penis to stay dilated for longer, which improves blood flow to the penis and helps produce and maintain an erection. This leaflet answers some common questions about CIALIS. It does not take the place of talking to your doctor or pharmacist. Your doctor has weighed the risks of you taking CIALIS against the benefits they expect it will have for you. Your doctor may have prescribed you CIALIS to treat either, or both of these conditions. If you have any concerns about taking this medicine, talk to your doctor or pharmacist. Ask your doctor if you have any questions about why CIALIS has been prescribed for you. Your doctor may have prescribed it for another reason. CIALIS is available only with a doctor's prescription. CIALIS is not intended for use by women, or by children under the age of 18 years. The active ingredient in CIALIS tablets, tadalafil, belongs to a group of medicines called phosphodiesterase type 5 inhibitors. Do not take CIALIS if you are currently taking any nitrates or amyl nitrite.

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