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Buy Cialis film-coated tablets 20mg No. 1 (Tadalafil) in the online pharmacy Zhivika in Chelyabinsk at a low price.
Indications: Erectile dysfunction.
Contraindications: Use during treatment with drugs containing any organic nitrates; the presence of contraindications to sexual activity in patients with 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), uncontrolled arterial hypertension, ischemic stroke within the last 6 months; loss of vision due to non-arterial anterior ischemic buy tadalafil 5mg online optic neuropathy (regardless of the connection with the intake of PDE5 inhibitors); concomitant use of doxazosin, as well as drugs for the treatment of erectile dysfunction; frequent (more than 2 times a week) use in patients with chronic renal failure; lactase deficiency, lactose intolerance, glucose-galactose malabsorption; use in children and adolescents under 18 years of age; hypersensitivity to the components of the drug.
Cialis is not intended for use in women.
Caution should be used in patients with severe hepatic impairment (Child-Pugh class C), because data on the use of the drug in this category of patients is not available; in patients taking alpha-blockers, since simultaneous use can lead to symptomatic arterial hypotension; in patients with a predisposition to priapism (with sickle cell anemia, multiple myeloma or leukemia) or in patients with anatomical deformity of the penis (angular curvature, cavernous fibrosis or Peyronie’s disease); simultaneously with potent inhibitors of the CYP3A4 isoenzyme (ritonavir, saquinavir, ketoconazole, itraconazole, erythromycin), with antihypertensive drugs.
Active ingredient: Tadalafil.
Release form: 1. Film-coated tablets, 20 mg No. 1; 2. Film-coated tablets, 20 mg No. 2; 3. Film-coated tablets, 20 mg No. 4; 4. Film-coated tablets, 20 mg No. 8.
The drug is taken orally.
For patients with frequent sexual activity (more than 2 times a week), the recommended frequency of administration is 5 mg 1 time / day daily, at the same time, regardless of food intake. The daily dose may be reduced to 2.5 mg depending on individual sensitivity..
For patients with infrequent sexual activity (less than 2 times a week), it is recommended to prescribe Cialis at a dose of 20 mg, immediately before sexual activity..
The maximum daily dose of Cialis is 20 mg..
Interactions: Ketoconazole, Ritonavir increases exposure to a single dose of tadalafil.
Rifampin reduces the effects of a single dose of tadalafil.
Simultaneous administration of an antacid (magnesium hydroxide / aluminum hydroxide) and tadalafil reduces the absorption rate of tadalafil.
Tadalafil enhances the hypotensive effect of nitrates. Therefore, the use of tadalafil against the background of the use of nitrates is contraindicated..
Tadalafil does not increase the duration of bleeding caused by acetylsalicylic acid.
Tadalafil has systemic vasodilating properties and may enhance the action of antihypertensive drugs aimed at lowering blood pressure. Additionally, in patients treated with multiple antihypertensive agents, in whom hypertension was poorly controlled, slightly greater reductions in blood pressure were observed. In the vast majority of patients, these decreases were not associated with hypotensive symptoms. Patients treated with antihypertensive drugs and taking tadalafil should be given appropriate clinical advice..
There was no significant decrease in blood pressure when using tadalafil by persons taking the selective alpha[1A]-blocker, tamsulosin.
When using tadalafil to healthy volunteers who took doxazosin (8 mg per day), an alpha [1] adrenoblocker, an increase in the hypotensive effect of doxazosin was observed. Some patients experienced dizziness. There were no cases of syncope. Lower doses of doxazosin have not been studied. Tadalafil did not affect the concentration of alcohol, nor did buy viagra online cheap alcohol affect the concentration of tadalafil. At high doses of alcohol (0.7 g/kg), taking tadalafil did not cause a statistically significant decrease in mean blood pressure. Some patients experienced postural dizziness and orthostatic hypotension. With the introduction of tadalafil in combination with lower doses of alcohol (0.6 g / kg), hypotension was not observed, and dizziness occurred at the same frequency as when taking alcohol alone.
Side effects: The most commonly reported adverse events are headache and dyspepsia (11% and 7% of cases, respectively). Adverse events associated with taking tadalafil were usually minor or moderate in severity, transient and decreased with continued use of the drug..
Other common adverse effects were back pain, myalgia, nasal congestion, and flushing of the face..
Rarely – swelling of the eyelids, eye pain, conjunctival hyperemia and dizziness.
Very rarely – hypersensitivity reactions (including rashes, urticaria and swelling of the face, Stevens-Johnson syndrome and exfoliative dermatitis); hypotension (in patients already taking antihypertensive agents); hypertension and syncope; abdominal pain and gastroesophageal reflux; hyperhidrosis (excessive sweating); priapism and delayed erection; blurry vision; non-arterial anterior ischemic optic neuropathy; retinal vein occlusion; visual field impairment.
Myocardial infarction, sudden cardiogenic death, stroke, chest pain, palpitations, and tachycardia have been observed in patients with prior cardiovascular risk factors. However, it is not possible to determine with certainty whether buy sildenafil 100mg online these events are related directly to these risk factors, to tadalafil, to sexual arousal, or to a combination of these or other factors..
Special instructions: Sexual activity has a potential risk for patients with cardiovascular disease. Therefore, the treatment of erectile dysfunction, including with the use of Cialis, should not be carried out in men with heart diseases in which sexual activity is not recommended. The potential risk of complications during sexual activity in patients with cardiovascular diseases should be considered: myocardial infarction within the last 90 days; unstable angina or angina that occurs during intercourse; NYHA class 2 or higher heart failure within the past 6 months; uncontrolled cardiac arrhythmias, hypotension (with BP <90/50 мм рт. ст.) или неконтролируемая артериальная гипертензия; инсульт, перенесённый в течение последних 6 месяцев.
Cialis should be used with caution in patients with a predisposition to priapism (for example, with sickle cell anemia, multiple myeloma and leukemia) or in patients with anatomical deformity of the penis (for example, with angular curvature, cavernous fibrosis or Peyronie’s disease). There are reports of the occurrence of priapism with the use of PDE5 inhibitors, including tadalafil. Patients should be informed of the need to seek immediate medical attention in the event of an erection lasting 4 hours or more. Untimely treatment of priapism leads to damage to the tissues of the penis, resulting in a long-term loss of potency..
The safety and efficacy of the combination of Cialis with other treatments for erectile dysfunction has not been studied. Therefore, the use of such combinations is not recommended..
Like other PDE5 inhibitors, tadalafil has systemic vasodilating properties, which can lead to a transient decrease in blood pressure. Before prescribing Cialis, physicians should carefully consider whether patients with pre-existing cardiovascular disease would be adversely affected by such vasodilating effects..
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