Cialis is a treatment for erectile dysfunction (impotence, erectile dysfunction) in men and is part of a group of drugs called PDE-5 (phosphodiesterase type 5) inhibitors.
The drug dilates the blood vessels of the penis during sexual arousal. As a result, blood circulation in the penis increases, and this, in turn, contributes to the onset of a stable erection buy cialis australia over the counter.
Indications
Erectile disfunction.
Lower urinary tract symptoms in patients with benign prostatic hyperplasia.
Erectile dysfunction in patients with lower urinary tract symptoms associated with benign prostatic hyperplasia.
Contraindications
Hypersensitivity to tadalafil or to any substance that is part of the drug.
In the case of taking drugs containing any organic nitrates.
Age up to 18 years.
Diseases of the cardiovascular system: myocardial infarction within the last 90 days, unstable angina pectoris, the occurrence of an angina attack during intercourse, chronic heart failure of II-IV classes according to the NYHA classification, uncontrolled arrhythmias, arterial hypotension (BP less than 90/50 mm Hg. Art.), uncontrolled arterial hypertension, ischemic stroke within the last 6 months buy cialis australia over the counter.
Loss of vision due to non-arterial anterior ischemic optic neuropathy (regardless of the connection with the intake of PDE-5 inhibitors).
Simultaneous administration of doxazosin, as well as drugs for the treatment of erectile dysfunction buy cialis australia over the counter.
Frequent (more than 2 times a week) use in patients with chronic renal failure (creatinine clearance less than 30 ml / min).
Lactase deficiency, lactose intolerance, glucose-galactose malabsorption.
Carefully:
Severe liver failure (Child-Pugh class C).
Patients taking alpha 1-blockers.
Predisposition to priapism (with sickle cell anemia, multiple myeloma or leukemia).
Anatomical deformity of the penis (angular curvature, cavernous fibrosis or Peyronie's disease).
Simultaneous administration with potent inhibitors of the CYP3A4 isoenzyme (ritonavir, saquinavir, ketoconazole, itraconazole, erythromycin), antihypertensive drugs order cialis australia over the counter.
Effect of other drugs on tadalafil
Tadalafil is mainly metabolized with the participation of the CYP3A4 isoenzyme. The selective inhibitor of the CYP3A4 isoenzyme ketoconazole (400 mg per day) increases the exposure of a single dose of tadalafil (AUC) by 312% and C max by 22%, and ketoconazole (200 mg per day) increases the exposure of a single dose of tadalafil (AUC) by 107% and C max by 15% relative to AUC and C max values for only one tadalafil cialis australia online over the counter.
Ritonavir (200 mg twice a day), an inhibitor of CYP3A4, 2C9, 2C19 and 2D6 isoenzymes, increases the exposure of a single dose of tadalafil (AUC) by 124% without changing C max. Although specific interactions cialis australia over the counter have not been studied, it can be assumed that other inhibitors of HIV protease, such as saquinavir, as well as inhibitors of the CYP3A4 isoenzyme, such as erythromycin and itraconazole, increase the activity of tadalafil.
The selective inducer of the CYP3A4 isoenzyme, rifampicin (600 mg per day), reduces the exposure of a single dose of tadalafil (AUC) by 88% and C max by 46%, relative to AUC and C max values for tadalafil alone. It can be assumed that the simultaneous use of other inducers of the CYP3A4 isoenzyme should also reduce plasma concentrations of tadalafil.
Simultaneous administration of an antacid (magnesium hydroxide / aluminum hydroxide) and tadalafil reduces the absorption rate of tadalafil without changing the area under the pharmacokinetic curve for tadalafil.
An increase in gastric pH as a result of taking nizatidine H2-histamine receptor blockers did not affect the pharmacokinetics of tadalafil cialis australia over the counter.
The safety and efficacy of combining tadalafil with other treatments for erectile dysfunction have not been studied, so the use of such combinations is not recommended. Tadalafil does not potentiate the increase in bleeding time caused by taking acetylsalicylic acid buy cialis australia over the counter.
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