Cialis Professional Over The Counter. The optimal (safe) dose of 20 mg.

Over The Counter Cialis Professional

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Excipients:
Lactose monohydrate – 109.65 mg.
Lactose monohydrate – 17.50 mg.
Giprolose – 1.22 mg.
Giprolose (extra thin) – 2.80 mg.
Sodium lauryl sulfate – 0.49 mg.
Microcrystalline cellulose – 26.25 mg.
Croscarmellose sodium – 11.20 mg.
Magnesium stearate (vegetable) – 0.88 mg.

Composition of the film shell:
Yellow (Y-30-12863-A) – 8.75 mg.
Lactose monohydrate – 3.72 mg.
Hypromellose – 2.59 mg.
Titanium dioxide – 1.54 mg.
Triacetin – 0.74 mg
Iron oxide oxide yellow – 0.16 mg.

THIS INFORMATION IS NOT THE MANUAL ON THE APPLICATION OF THE MEDICINAL DRUGS “Cialis Professional”

For men (without contraindications) from 18+, tadalafil is an extremely effective, reversible selective inhibitor of specific phosphodiesterase type 5 (PDE5) cyclic guanosine monophosphate (cGMP). When sexual arousal causes local release of nitric oxide, the inhibition of PDE5 by tadalafil leads to an increase in cGMP levels in the cavernous body of the penis. The consequence of this is the relaxation of the smooth muscles of the arteries and the flow of blood to the tissues of the penis, which causes an erection. Tadalafil has no effect in the absence of sexual stimulation.
In vitro studies have shown that tadalafil is a selective inhibitor of PDE5. PDE5 is an enzyme found in the smooth muscles of the cavernous body, in the smooth muscles of the vessels of internal organs, in skeletal muscles, platelets, kidneys, lungs and the cerebellum. The effect of tadalafil on PDE5 is more active than on other phosphodiesterases.
Tadalafil (Cialis Professional) is 10,000 times more potent for PDE5 than for PDE1, PDE2 and PDE4, which are localized in the heart, brain, blood vessels, liver and other organs. Tadalafil 10,000 times more actively blocks PDE5 than PDE3 – an enzyme that is found in the heart and blood vessels. This selectivity for PDE5 in comparison with FDHD is important, as FDEZ is an enzyme involved in the contraction of the heart muscle. In addition, tadalafil is approximately 500-700 times more active against PDE5 than with respect to PDE6, found in the retina and is responsible for photo transmission. Tadalafil also exhibits an effect of 10,000 times more potent on PDE5 than its effect on PDE7-PDE10.
Tadalafil improves the erection and the possibility of a successful sexual intercourse in any situation. The drug is valid for 36 hours. The effect is manifested as early as 16 minutes after taking the drug in the presence of sexual arousal.
Tadalafil in healthy individuals does not cause a significant change in systolic and diastolic pressure in comparison with placebo in the lying position (the average maximum decrease is 1, 6/0, 8 mm Hg, respectively) and in the standing position (the average maximum decrease is 0, 2/4, 6 mm Hg, respectively). Tadalafil 20 mg does not cause a significant change in the heart rate.
Tadalafil does not cause changes in color recognition (blue / green), which is explained by its low affinity for PDEB. In addition, there is no effect of tadalafil on visual acuity, electroretinogram, intraocular pressure and pupil size.
In the study of tadalafil in men in a daily dose of 20 mg no clinically significant effect of the drug on the number and concentration of sperm, motility and morphology of spermatozoa.

Pharmacokinetics Cialis Professional:

After taking Cialis inside, the tadalafil is rapidly absorbed. The average maximum concentration (C max) in plasma is achieved on average 2 hours after ingestion.
The speed and degree of absorption of tadalafil does not depend on the intake of food, so the preparation Cialis Professional 20 mg can be taken regardless of the intake of food. The time of reception (in the morning or in the evening) had no clinically significant effect on the rate and degree of absorption.
The pharmacokinetics of tadalafil in healthy individuals is linear with respect to time and dose. In the dose range of 2, 5 to 20 mg, the area under the concentration-time curve (AUC) increases in proportion to the dose. Equilibrium concentrations in the plasma are achieved within 5 days after taking the drug once a day.
The pharmacokinetics of tadalafil in patients with impaired function of erection is similar to the pharmacokinetics of the drug in persons without a violation of the function of erection.
The average volume of distribution is about 63 liters, which indicates that Tadalafil (Cialis Professional) is distributed in the tissues of the body. In therapeutic concentrations, 94% of tadalafil in plasma binds to proteins. Binding to proteins does not change with impaired renal function.
In healthy individuals, less than 0, 0005% of the dose administered was found in semen.
Tadalafil is mainly metabolized with the participation of the cytochrome P450 isoenzyme (CYP) 3A4. The main circulating metabolite is methyl catechol glucuronide. This metabolite is at least 13,000 times less active against PDE5 than Tadalafil. Consequently, it can hardly be assumed that this metabolite at the observed concentrations is clinically significant.
In healthy individuals, the average clearance of tadalafil with oral administration is 2.5 l / h, and the average half-life is 17.5 hours. Tadalafil is excreted mainly in the form of inactive metabolites, mainly with feces (about 61% of the dose) and, to a lesser extent, with urine (about 36% of the dose).
Healthy elderly people (65 years and over) had a lower clearance of tadalafil when ingested, which was expressed in an increase in the area under the concentration-time curve by 25% compared with healthy individuals aged 19 to 45 years. This difference is not clinically significant and does not require dose selection.
In persons with a mild (creatinine clearance 51 – 80 ml / min) or moderate (creatinine clearance31-50 ml / min) renal failure, the area under the “concentration-time” curve was larger than in healthy individuals. In individuals with severe renal insufficiency (creatinine clearance 30 ml / min), Tadalafil has not been studied.
The pharmacokinetics of tadalafil in people with mild to moderate liver failure is comparable to that of healthy individuals. In these patients, dose selection is not required.
In patients with diabetes mellitus against the background of the use of tadalafil can cause a critical concentration – NEVER MORE – 19%. This feature requires dose selection.

P.S. Cialis Professional 20 mg – is one of the most commonly used drugs in the world and in the US to solve the problem of impotence and enhance erection. After the European Union approved the clinical application of tadalafil, a new anti-impotence drug developed by US companies Ely Lilly and Icos, the drug appeared in early 2003 in European pharmacies under the commercial name Cialis. This drug is considered an analogue of Viagra, but the effect is achieved faster and lasts 2-3 times longer (up to 36 hours).

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