Description

Product Details

• Tadalafil 20mg is the generic version of the brand-name drug Cialis, used to treat erectile dysfunction (ED) and benign prostatic hyperplasia (BPH) in men.
• Some retailers like Sildenafil.com, DiRxHealth.com, and HealthWarehouse.com offer 20mg tadalafil tablets at lower per-tablet prices when buying in larger quantities.
• BlueChew offers a 6mg tadalafil tablet for $30 plus $7.55 shipping.
• UltraPharmRX sells 20mg tadalafil tablets for $69 plus $40 shipping.
• MintRx offers 20mg tadalafil tablets for $2 each plus $4 shipping
  

  Key Benefits:

  • Treats erectile dysfunction (ED) by increasing blood flow to the penis, allowing for firmer, longer-lasting erections 
  • Also treats benign prostatic hyperplasia (BPH) by relaxing the smooth muscles in the prostate and bladder 
  • Available as an “as-needed” medication taken before sexual activity or a daily low-dose option 
  • Can improve erectile function for up to 36 hours after taking a dose 
  • Generally well-tolerated with mild side effects like headache, indigestion, and back pain 

  Key Ingredients:

  • The active ingredient in Cialis is tadalafil, a phosphodiesterase type 5 (PDE5) inhibitor 
  • PDE5 inhibitors work by blocking the enzyme that breaks down cyclic guanosine monophosphate (cGMP), a substance that promotes smooth muscle relaxation and increased blood flow 
  • This increased blood flow to the penis allows for improved erectile function in men with ED 

  The Main Purpose of Cialis (Tadalafil) 20mg

  The main purpose of Cialis (tadalafil) 20mg is to treat two common conditions in men:

  1. Erectile Dysfunction (ED):
     • Cialis works by increasing blood flow to the penis, allowing for firmer, longer-lasting erections.
     • It can improve erectile function for up to 36 hours after taking a dose.
     • Cialis is available as an “as-needed” medication taken before sexual activity or a daily low-dose option.
  2. Benign Prostatic Hyperplasia (BPH):
     • Cialis can also be used to treat the symptoms of BPH, a condition where the prostate gland becomes enlarged.
     • By relaxing the smooth muscles in the prostate and bladder, Cialis can improve urine flow and reduce other BPH-related symptoms.

  The active ingredient in Cialis is tadalafil, a phosphodiesterase type 5 (PDE5) inhibitor. PDE5 inhibitors work by blocking the enzyme that breaks down cyclic guanosine monophosphate (cGMP), a substance that promotes smooth muscle relaxation and increased blood flow.This increased blood flow to the penis and prostate gland is the primary mechanism by which Cialis effectively treats both erectile dysfunction and benign prostatic hyperplasia in men.

  

  Tadalafil

  Medication used to treat erectile dysfunction, benign prostatic hyperplasia, and pulmonary arterial hypertension

  More

  Trade Names

  Cialis, Adcirca, others

  Uses

  Treatment of erectile dysfunction, benign prostatic hyperplasia, pulmonary arterial hypertension

  Onset of Action

  30 minutes

  Mechanism of Action of Cialis (Tadalafil) 20mg

  The primary mechanism of action for Cialis (tadalafil) 20mg is as a phosphodiesterase type 5 (PDE5) inhibitor:Erectile Dysfunction (ED)

  • When a man is sexually stimulated, nitric oxide is released, leading to the production of cyclic guanosine monophosphate (cGMP).
  • cGMP causes the smooth muscles in the corpus cavernosum (spongy tissue in the penis) to relax, allowing increased blood flow and resulting in an erection.
  • PDE5 is the enzyme that breaks down cGMP, counteracting its effects.
  • Tadalafil inhibits PDE5, leading to higher levels of cGMP and greater relaxation of the smooth muscles. This increased blood flow allows for firmer, longer-lasting erections.

  Benign Prostatic Hyperplasia (BPH)

  • The exact mechanism by which tadalafil treats BPH is not fully understood, but it is thought to involve:
    1. Relaxation of the smooth muscles in the prostate and bladder, improving urine flow.
    2. Potential effects on cell proliferation that contribute to prostate enlargement.

  Pulmonary Arterial Hypertension (PAH)

  • For PAH, tadalafil inhibits PDE5 in the smooth muscle cells of the pulmonary vasculature, leading to vasodilation and reduced blood pressure in the lungs.

  

  Effects of Cialis on Blood Flow

  Erectile Dysfunction (ED):

  • Cialis works as a phosphodiesterase type 5 (PDE5) inhibitor, which relaxes the smooth muscles in the blood vessels of the penis .
  • This increased vasodilation and blood flow to the penis allows for firmer, longer-lasting erections in men with erectile dysfunction .

  Pulmonary Arterial Hypertension (PAH):

  • Tadalafil, the active ingredient in Cialis, can also have a greater effect on lowering pulmonary blood pressure (the blood pressure in the lungs) .
  • This is why Cialis is sometimes used under the brand name Adcirca to treat pulmonary hypertension by improving blood flow through the lungs .

  General Blood Pressure Effects:

  • Cialis can cause a modest decrease in blood pressure, with average drops of up to 1.6 mmHg in systolic blood pressure and 0.8 mmHg in diastolic blood pressure in healthy men .
  • However, these blood pressure reductions are generally considered safe at the doses used to treat ED .
  • Cialis may pose a greater risk of dangerous blood pressure drops in certain individuals, such as those with heart conditions, low blood pressure, or who are also taking nitrate medications .

  Cialis and Other ED Medications

  • Cialis should not be taken with other PDE5 inhibitor medications used to treat ED, such as Viagra (sildenafil) or Levitra (vardenafil). This can lead to dangerously low blood pressure.
  • The search results indicate there are 309 known drug interactions with Cialis, including 33 major interactions.
  • Some key interactions to be aware of include:
    • Nitrates (e.g. nitroglycerin): Contraindicated, can cause severe hypotension.
    • Alpha-blockers: May require dose adjustments or not recommended for combined use.
    • CYP3A4 inhibitors (e.g. ketoconazole, ritonavir): May require Cialis dose reduction.

  Recommendations

  • Patients should always inform their healthcare provider about all medications they are taking, including prescription, over-the-counter, and supplements.
  • Doctors will need to carefully evaluate potential drug interactions and adjust Cialis dosing or consider alternative ED treatments as appropriate.
  • Patients should never discontinue a prescribed medication or start a new one without consulting their doctor first.
  • Buying Cialis without a prescription is not recommended, as it increases the risk of dangerous drug interactions and side effects.

  Dangerously Low Blood Pressure

  • Cialis should not be used with nitrates, which are medications commonly prescribed for chest pain (angina) or used recreationally (like amyl nitrite or butyl nitrite “poppers”). Combining Cialis with nitrates can cause a dangerous drop in blood pressure.
  • Cialis also interacts with guanylate cyclase stimulators like riociguat (Adempas), used to treat pulmonary hypertension. Using these drugs together can lead to severely low blood pressure.

  Increased Risk of Side Effects

  • Cialis may cause small reductions in blood pressure on its own. Using it with other blood pressure medications (antihypertensives) can increase the risk of low blood pressure.
  • Combining Cialis with substantial amounts of alcohol (e.g. 5 glasses of wine or 5 shots of whiskey) can also increase the risk of low blood pressure.

  Dosage Adjustments May Be Needed

  • For patients taking certain CYP3A4 inhibitor medications that can increase Cialis levels, like ketoconazole or ritonavir, the maximum recommended Cialis dose is lower (10 mg not more than once every 72 hours for as-needed use, or 2.5 mg daily for once-daily use).
  • When using Cialis for ED, patients should be on stable alpha-blocker therapy before starting Cialis, which should be initiated at the lowest recommended dose. Cialis is not recommended for combined use with alpha-blockers for BPH treatment.

  Key Precautions for Taking Cialis (Tadalafil)

  Before Taking Cialis

  • Allergies: Inform your doctor or pharmacist if you are allergic to tadalafil or any other substances in the medication.
  • Medical Conditions: Discuss any medical conditions you have, including heart disease, high blood pressure, kidney disease, liver disease, or eye problems.
  • Medications: List all medications you are taking, including prescription, nonprescription, and herbal products, as Cialis may interact with other drugs.

  During Treatment

  • Dosage: Follow your doctor’s instructions on the dosage and frequency of taking Cialis. The dosage may vary based on your medical condition and other medications you are taking.
  • Timing: Take Cialis as directed, usually at least 30 minutes before sexual activity for ED or once daily for BPH or ED.
  • Food: Cialis can be taken with or without food.
  • Alcohol: Avoid excessive alcohol consumption, as it can lower blood pressure and decrease sexual performance.

  Important Considerations

  • Combination with Nitrates: Do not take Cialis with nitrates (e.g., nitroglycerin) or recreational drugs like “poppers,” as this can cause severe hypotension.
  • Kidney and Liver Disease: Adjust the dosage if you have kidney disease. For severe liver disease, Cialis is not recommended.
  • Prolonged Erections: Seek immediate medical attention if you experience a prolonged erection lasting more than four hours.
  • Vision Changes: Report sudden vision loss in one or both eyes, as this can be a sign of non-arteritic anterior ischemic optic neuropathy (NAION).
  • Heart Conditions: Cialis may not be suitable for men with heart conditions, and sexual activity can place stress on the heart.

  Additional Tips

  • Storage: Store Cialis at room temperature, away from light and moisture.
  • Counterfeit Products: Ensure you buy Cialis from a reputable supplier to avoid counterfeit products.
  • Lifestyle Factors: Address lifestyle factors such as smoking, drinking, and stress, as these can impact erectile dysfunction.

  Dietary Restrictions with Cialis (Tadalafil)

  There are a few key dietary considerations when taking Cialis (tadalafil):

  Alcohol Intake

  • Avoid excessive alcohol consumption while taking Cialis, as it can increase the risk of side effects like headache, dizziness, increased heart rate, and lowered blood pressure.
  • The manufacturer recommends limiting alcohol to no more than 4 drinks in a short period of time while being treated with Cialis.

  Food Intake

  • Cialis can be taken with or without food. Food intake does not significantly impact the absorption or effectiveness of tadalafil.
  • However, fatty meals may slightly delay the time to maximum concentration of tadalafil in the body.

  Grapefruit Juice

  • Avoid drinking grapefruit juice while taking Cialis, as it may increase the blood levels of tadalafil and potentially lead to more side effects.

  Marijuana Use

  • Patients should talk to their doctor if they are using marijuana (cannabis) while taking Cialis, as the effects may be increased.
  

  Dosage

  • Cialis (Tadalafil) Dosages: Available in 2.5, 5, 10, and 20 mg tablets.
  • ED Treatment: For ED, Cialis can be taken either daily (2.5 mg to 5 mg) or as needed (10 mg to 20 mg).
  • BPH Treatment: For BPH, the recommended dosage is 5 mg daily.
  • Combination Therapy: For both ED and BPH, a daily dose of 5 mg is often suggested.

  Storage

  • Storage Conditions: Cialis should be stored at room temperature, away from direct sunlight and moisture.
  • Handling: Keep Cialis out of reach of children and avoid exposing it to extreme temperatures.

  Reviews

  • Average Rating: Cialis has an average rating of 8.5 out of 10 from 539 reviews on Drugs.com.
  • Positive Experience: 83% of reviewers reported a positive experience with Cialis.
  • Negative Experience: 9% reported a negative experience.

  Key Points

  • Duration of Action: Cialis can last up to 36 hours after taking the medication.
  • Prolonged Erections: Seek immediate medical attention if an erection lasts more than 4 hours.
  • Combination with Nitrates: Avoid taking Cialis with nitrates, as this can cause severe hypotension.
  • Kidney and Liver Impairment: Adjust the dosage for individuals with kidney or liver issues.