Apcalis (Tadalafil) Oral Jelly Price

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Apcalis (Tadalafil) Oral Jelly Coupons and discounts

The drug Tadalafil has been designed and produced the British pharmaceutical company Elly Lilly. This drug is an agent for the treatment of erectile dysfunction of various men. Tadalafil exerts its effect by relaxing the blood vessels, which increases blood circulation in the tissues of the penis of men, which is the result of a good erection.

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Pharmacological action

Means of improving potency. It is an effective, reversible, selective inhibitor of specific PDE5 (an enzyme found in corpus cavernosum smooth muscle, blood vessels of the internal organs, skeletal muscle, platelets, kidney, lung, and cerebellum) cGMP. The effect on PDE5 is 10,000 times more potent than FDE1-4 FDE7-10 and are localized in the heart, brain, blood vessels, liver, and others. Bodies, and about 700 times more active against PDE5 than FDE6 found in the retina and is responsible for the transmission of photos. Against the background of sexual arousal and local release of NO inhibition of PDE5 tadalafil leads to increased levels of cGMP in the cavernous body of the penis. The result is relaxation of smooth muscles of arteries and blood flow to the tissues of the penis, accompanied by an erection. Tadalafil has no effect in the absence of sexual stimulation. Improved erection and the possibility of successful sexual intercourse appears within 16 minutes, and can be observed for 36 hours after taking the drug.

Indications

Erectile dysfunction.

Contraindications

Hypersensitivity, simultaneous reception of nitrates (in any form), age 18 years. With caution. CVD (myocardial infarction within the last 90 days, unstable angina or angina occurring during sexual intercourse; NYHA II class and higher evolved in the past 6 months; uncontrolled cardiac arrhythmias, hypotension (blood pressure less than 90/50 mm Hg), or uncontrolled hypertension, stroke, myocardial in the last 6 months; severe renal insufficiency (creatinine clearance less than 30 ml / min), chronic renal failure (creatinine clearance less than 50 ml / min), severe hepatic insufficiency predisposition to priapism (with sickle cell anemia, multiple myeloma, or leukemia) , anatomical deformation of the penis (angulation, cavernous fibrosis or Peyronie’s disease).

Side effects

Headache (11%), dyspepsia (7%) — transient, slightly pronounced, declining with continued use of the drug. Back pain, myalgia, nasal congestion and «tides» of blood to the face. Seldom — swelling of the eyelids, eye pain, conjunctival hyperemia, dizziness. Overdose . Symptoms: increased severity of side effects. Treatment: standard supportive measures for indications.

Dosage and administration

Inside, 20 mg, regardless of the meal, at least 16 minutes before anticipated sexual activity. Patients can perform attempt intercourse at any time within 36 hours after dosing in order to determine the optimal response time to the drug. The maximum recommended frequency of administration — one time per day. In renal / hepatic insufficiency and in the elderly dose adjustment is required.

Special instructions

Sexual activity is potentially dangerous for patients with diseases of the cardiovascular system, and therefore the treatment of erectile dysfunction, including using tadalafil, there should be men with heart disease, in which sexual activity is not recommended. During clinical trials are not reported cases of priapism. However, there are reports of occurrence of priapism using others. PDE5 inhibitor — sildenafil. Patients should be informed of the need for immediate treatment for medical assistance in the event of an erection, continued for 4 hours or more. Delays in treatment of priapism leads to tissue damage in the penis, resulting in a loss may occur long-term potency. The therapy in patients with renal insufficiency moderately (CC 31-50 ml / min) was more common side effects such as back pain (as compared with patients with mild renal impairment or healthy individuals). In patients with severe renal impairment (creatinine clearance less than 30 ml / min) Tadalafil has not been studied. Although the incidence of dizziness in the placebo and tadalafil is the same in the period of treatment must be careful when driving and other lesson. Potentially hazardous activities that require high concentration and speed of psychomotor reactions.

Connectivity

It enhances the hypotensive effect of nitrates. Safety and efficacy of combinations of Cialis with other treatments erectile dysfunction have not been studied, so the use of such combinations is not recommended. Tadalafil is metabolized primarily by the enzyme CYP3A4. Selective inhibitor of CYP3A4, Ketoconazole, AUC increases by 107%, and rifampicin reduces by 88%. Despite the fact that the specific interactions has not been studied, it can be assumed that these protease inhibitors (saquinavir and ritonavir), and inhibitors CYP3A4 (itraconazole and erythromycin) increase the activity of tadalafil. No clinically significant interaction with the major classes of antihypertensive drugs (both in monotherapy and in combination). There was no effect of a single dose of tadalafil on the concentration of ethanol in the blood and its effect on cognitive function and blood pressure. No changes in the blood concentration of tadalafil after 3 hours after administration in combination with ethanol. It does not have a clinically significant effect on the pharmacokinetics or pharmacodynamics of theophylline.