Cialis Tablets

What is Cialis?

Active Ingredient and Drug Class: Cialis contains the active substance tadalafil. It belongs to a group of medicines called phosphodiesterase type 5 (PDE5) inhibitors.

Mechanism of Action

Think of the blood vessels in your penis like a hose. When you're sexually aroused, your body sends signals to relax these vessels, allowing blood to flow in and create an erection (like turning on the tap). PDE5 is an enzyme that acts like a "stop valve," breaking down the relaxing signal and ending the erection. Cialis works by temporarily blocking this "stop valve" (PDE5), allowing the natural signal for erection to last longer and be more effective when you are sexually stimulated.

Biological Pathway

During sexual stimulation, the body releases nitric oxide (NO). This activates an enzyme called guanylate cyclase, which leads to increased levels of cyclic guanosine monophosphate (cGMP). cGMP causes the smooth muscles in the penile arteries to relax, enabling blood to flow in. PDE5 breaks down cGMP. Tadalafil inhibits PDE5, thereby preserving cGMP levels and supporting the erectile response.

What is Cialis Used For?

Cialis is used for the treatment of erectile dysfunction (ED) in adult men. Erectile dysfunction is the inability to achieve or maintain a firm erection sufficient for satisfactory sexual performance.

Target Patient Populations

Adult men who experience consistent or recurrent ED. It is not intended for use by men who do not have erectile dysfunction.

Before Using Cialis

Before taking Cialis, it is crucial to discuss your full medical history with your doctor. Be sure to mention if you have or have ever had:

• Heart disease, heart attack (within the last 90 days), or stroke (within the last 6 months)
• Low blood pressure or uncontrolled high blood pressure
• Liver or kidney problems
• Sickle cell anaemia, leukaemia, or multiple myeloma
• Any deformity of the penis (e.g., Peyronie's disease)
• A history of vision loss due to NAION ("stroke of the eye")
• Severe stomach ulcers or bleeding disorders

Cialis Contraindications

Absolute Contraindications (Do NOT take):

• Allergy to tadalafil or any other ingredient in Cialis.
• Patients taking any form of organic nitrates or nitric oxide donors.
• Patients taking riociguat (a medicine for pulmonary hypertension).
• Serious heart disease or recent heart attack (within 90 days).
• Recent stroke (within 6 months).
• Low blood pressure or uncontrolled high blood pressure.
• History of non-arteritic anterior ischemic optic neuropathy (NAION).

Relative Contraindications (Use with caution and medical supervision):

• Significant hepatic impairment.
• Severe renal impairment.
• Conditions predisposing to priapism (e.g., sickle cell anaemia, multiple myeloma).
• Anatomical deformation of the penis.

Special Population Considerations

Elderly:

• Dose adjustment may be necessary.
• Dizziness is reported more frequently in men over 75.

Renal Impairment:

• For patients with severe renal impairment, a lower starting dose of 5mg is recommended.
• Use with caution.

Hepatic Impairment:

• For patients with severe hepatic impairment, a maximum dose of 10mg is recommended.
• Caution is advised.

Children and Adolescents:

• Cialis is not intended for use by individuals under the age of 18.

Cialis and Other Medicines

Always tell your doctor about all other medicines you are taking. Key interactions include:

High-Risk Combinations

• Nitrates: ABSOLUTELY CONTRAINDICATED. Risk of severe hypotension.
• Alpha-blockers (e.g., for blood pressure/prostate): Can increase the risk of low blood pressure and fainting. Your doctor will advise if it is safe to combine them.
• Other Blood Pressure Medications: Cialis can mildly lower blood pressure.
• Riociguat: Contraindicated. Can increase hypotensive effects.
• Strong CYP3A4 Inhibitors (e.g., ketoconazole, ritonavir, clarithromycin): Can increase tadalafil levels. A lower dose of Cialis may be recommended.
• Inducers of CYP3A4 (e.g., rifampicin, carbamazepine, phenobarbital): May reduce the effectiveness of Cialis.

Pregnancy & Breastfeeding

Cialis is not intended for use by women. It must not be taken by women who are pregnant, may become pregnant, or are breastfeeding.

Driving & Machine Operation

Some men experience dizziness during treatment with Cialis. Check how you react to the medicine before driving or operating machinery. If you feel dizzy, do not engage in these activities.

Cialis Ingredients

Active Ingredient

• Tadalafil

Other Ingredients (Excipients)

Allergen Warnings

• This medicine contains lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this product.

How to Use Cialis

Administration Steps

1. Take one tablet by mouth, swallowing whole with a glass of water.
2. It can be taken with or without food.
3. Take it at least 30 minutes before you plan to be sexually active.
4. Remember, sexual stimulation is required for the medicine to work.

Cialis Dosage Guidelines

Standard Dosage Schedule

Dosage Instructions

• Do not take Cialis more than once a day.
• This presentation is for use as needed and is not recommended for continuous daily use.

Administration Instructions

Simply swallow the tablet with water. No special technique is required beyond following the dosage guidelines.

Missed Dose Management

As Cialis is taken on an "as-needed" basis, the concept of a "missed dose" does not apply. Take one tablet when you plan to be sexually active. Do not take a double dose to make up for a forgotten tablet.

Overdose Information

If you take more Cialis than prescribed, contact your doctor or seek medical attention immediately. Symptoms of overdose are likely to be an increase in the side effects listed in Section 15, such as severe headache, dizziness, fainting, or priapism (a prolonged and painful erection).

Possible Side Effects

Like all medicines, Cialis can cause side effects, although not everybody gets them.

Stop taking Cialis and seek medical help immediately if you experience:

• Allergic reactions including rash (Uncommon).
• Chest pain - do not use nitrates, seek immediate assistance (Uncommon).
• Priapism - an erection lasting more than 4 hours (Rare). This is a medical emergency as it can damage the penis.
• Sudden loss of vision in one or both eyes (Rare) or sudden decrease in vision (Frequency not known).
• Sudden decrease or loss of hearing (Frequency not known).

Other Side Effects (by frequency):

Common (1 to 10 in 100 patients):

• Headache
• Back pain
• Muscle aches (myalgia)
• Pain in arms or legs
• Facial flushing
• Nasal congestion
• Indigestion (dyspepsia)

Uncommon (1 to 10 in 1,000 patients):

• Dizziness, stomach ache, nausea, vomiting, acid reflux
• Blurred vision, eye pain
• Difficulty breathing, high or low blood pressure, nosebleeds
• Pounding heartbeat (palpitations), fast heart rate
• Swelling of hands/ankles, feeling tired, ringing in the ears (tinnitus)
• Blood in urine, prolonged erection (not priapistic)

Rare (1 to 10 in 10,000 patients):

• Fainting, seizures, temporary memory loss
• Swelling of the eyelids, red eyes, hives
• Penile bleeding, blood in semen, increased sweating
• Heart attack and stroke (mostly in men with pre-existing heart conditions)

Reporting Side Effects

If you get any side effects, talk to your doctor or pharmacist. You can also report them directly via the UK Yellow Card Scheme.

How to Store Cialis

Storage Guidelines

• Keep out of the sight and reach of children.
• Do not use after the expiry date printed on the pack.
• Store in the original package to protect from moisture.
• Do not store above 30°C.
• Do not throw away medicines via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required.

Pack Information

What Cialis 10mg looks like:

A light yellow, film-coated, almond-shaped tablet marked with "C 10" on one side.

Pack Size:

Blisters packs containing 4 tablets.

Marketing Authorisation Holder:

Eli Lilly Nederland B.V., Utrecht, The Netherlands.

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