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For the Central Asian kingdom, see. Tadalafil iNN ) 2 is a, pDE5 inhibitor marketed in pill form for tadalafil or cialis treating erectile dysfunction (ED) under the name, cialis /sils/ see-AL-iss, and under the name. Adcirca /dsrk/ ad-SUR-k for the treatment of pulmonary arterial hypertension. In October 2011 the,.S. Food and Drug Administration (FDA) approved Cialis for treating the signs and symptoms of benign prostatic hyperplasia (BPH) as well as a combination of BPH and erectile dysfunction when the conditions coincide. It initially was developed by the biotechnology company, iCOS, and then again developed and marketed worldwide by Lilly icos, LLC, the joint venture of icos Corporation and. Eli Lilly and Company. Cialis tablets,.5 mg, 5 mg, 10 mg, and 20 mg doses, are yellow, film-coated, and almond-shaped. The approved dose for pulmonary arterial hypertension is 40 mg (two 20 mg tablets) once daily. Tadalafil is also manufactured and sold under the name. Tadacip by the Indian pharmaceutical company, cipla in doses of 10 mg and 20 mg. On November 21, 2003 the FDA approved tadalafil (as Cialis) for sale in the United States as the third ED prescription drug pill (after sildenafil citrate (Viagra) and vardenafil (Levitra). Like sildenafil and vardenafil, tadalafil is recommended as an 'as needed' medication. Cialis is also offered as a once-daily medication. Tadalafil was approved in May 2009 in the United States for the treatment of pulmonary arterial hypertension 3 and is under regulatory review in other regions for this condition. In late November 2008, Eli Lilly sold the exclusive rights to commercialize tadalafil for pulmonary arterial hypertension in the United States. United Therapeutics for an upfront payment of 150 million. Contents Side effects edit Tadalafil has been used by approximately 15,000 men participating in clinical trials, and over eight million men worldwide (primarily in the post-approval/post-marketing setting). The most common side tadalafil or cialis effects when using tadalafil are headache, stomach discomfort or pain, indigestion, burping, acid tadalafil or cialis reflux, back pain, muscle aches, flushing, and stuffy or runny nose. These side effects reflect the ability of PDE5 inhibition to cause vasodilation (cause blood vessels to widen and usually go away after a few hours. Back pain and muscle aches can occur 12 to 24 hours after taking the drug, and the symptom usually disappears after 48 hours. In May 2005, the.S. Food and Drug Administration found that tadalafil (along with other PDE5 inhibitors) was associated with vision impairment related to naion ( non-arteritic anterior ischemic optic neuropathy ) in certain patients taking these drugs in the post-marketing (outside of clinical trials) setting. Most, but not all, of these patients had underlying anatomic or vascular risk factors for development of naion unrelated to PDE5 use, including: low cup to disc ratio crowded disc age over 50, diabetes, hypertension, coronary artery disease, hyperlipidemia and smoking. Given the small number of naion events tadalafil or cialis with PDE5 use (fewer than one in one million the large number of users of PDE5 inhibitors (millions) and the fact that this event occurs in a similar population to those who do not take these medicines, the. However, the label of all three PDE5 inhibitors was changed to alert clinicians to a possible association. In October 2007, the FDA announced that the labeling for all PDE5 inhibitors, including tadalafil, requires a more prominent warning of the potential risk of sudden hearing loss as the result of postmarketing reports of deafness associated with use of PDE5 inhibitors. 4 Drug interactions edit Since PDE5 inhibitors such as tadalafil may cause transiently low blood pressure ( hypotension alkyl nitrites ( poppers ) should not be taken for at least 48 hours after taking the last dose of tadalafil. Using poppers (such as the sex drug amyl nitrite ) within this timeframe may increase the risk of life-threatening hypotension. Since people who have taken tadalafil within the past 48 hours cannot take organic nitrates to relieve angina (such as glyceryl trinitrate spray these patients should seek immediate medical attention if they experience anginal chest pain. 5 In the event of a medical emergency, paramedics and medical personnel should be notified of any recent doses of tadalafil. Tadalafil is metabolized predominantly by the hepatic CYP3A4 enzyme system. The presence of other drugs which induce this system can shorten tadalafil half-life and reduce serum levels, and hence efficacy, of the drug. Pharmacodynamics tadalafil or cialis edit Although sildenafil (Viagra vardenafil (Levitra and tadalafil (Cialis) all work by inhibiting PDE5, tadalafil's pharmacologic distinction is its longer half-life (17.5 hours) 6 compared to sildenafil and vardenafil (both 45 hours) 7 resulting in longer duration of action, and so partly responsible for.

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