Cialis Strips
Cialis Strips - medicines to treat erectile dysfunction (Erectile Dysfunction). This is the relaxation of penile arteries and increases blood flow to the penile tissues, and resulting in an erection.
Latin name:
Cialis Strips / Cialis.
The composition and manner of publication:
Cialis Strips coated tablets, 1, 2, 4 or 8 pieces. in the package.
1 tablet contains 20 mg tadalafil Cialis Strips.
Active-active agent:
Tadalafil / Tadalafil.
Properties / Action:
Cialis Strips (tadalafil) is an effective, reversible, selective inhibitor of certain fosfodiesterazy type 5 (FDE5) guanozin cyclic monophosphate (tsGMF). When sexual excitation causes local release of nitric oxide, inhibition FDE5 tadalafilom leads to higher levels tsGMF in the corpus cavernosum of the penis. The result is relaxation of smooth muscles of arteries and blood flow to the tissues of the penis causing an erection. Tadalafil has no effect in the absence of sexual stimulation.
In vitro studies have shown that tadalafil is a selective inhibitor FDE5. FDE5 an enzyme that is found in smooth muscles of cavernous bodies in vascular smooth muscles of internal organs, skeletal muscle, platelets, kidney, lung, and cerebellum. Step FDE5 to tadalafil is more active than the other fosfodiesterazy. Tadalafil is 10 000 times more potent against FDE5 that FDE1, FDE2 and FDE4, which located in the heart, brain, blood vessels, liver and other organs. Tadalafil 10 000 times more blocks FDE5 that FDE3 - enzyme which is located in the heart and blood vessels. This selectivity in comparison with FDE5 against Fdez Fdez is important because an enzyme involved in the reduction of the heart muscle. In addition, tadalafil approximately 700 times more active against FDE5 that FDE6 found in the retina and is responsible for fotoperedachu. Tadalafil is 10 000 times more potent against FDE5 compared with its impact on FDE7 - FDE10.
Tadalafil improves erection and the possibility of a satisfying sexual relationship. The drug is valid for 36 hours. The effect is manifested after 16 minutes after taking the drug in the presence of sexual arousal.
Tadalafil in healthy individuals is a reliable change systolic and diastolic pressures compared with placebo in the prone position (mean maximum decrease of 1, 6 / 0, 8 mm Hg. Art, respectively) and standing (maximum mean decrease of 0 , 2 / 4, 6 mm Hg. art., respectively). Tadalafil does not cause a reliable change in heart rate.
Tadalafil does not cause changes in the recognition of colors (blue / green), due to its low affinity FDEb. In addition, tadalafil no influence on visual acuity, elektroretinogrammu, intraocular pressure and pupil size.
Tadalafil study in men in a daily dose of 10 mg showed no clinically significant effect on the quantity of drugs and sperm concentration, motility and morphology of spermatozoa.
Pharmacokinetics:
After receiving tadalafil Cialis Stripsa interior absorbs quickly. The average maximum concentration (smax) in plasma is reached after an average of 2 hours after ingestion.
The rate and extent of tadalafil absorption is not dependent on food intake, so Cialis Strips drug can be taken irrespective of food intake. Hours (morning or afternoon) had no clinically significant effect on the rate and extent of absorption.
Tadalafil pharmacokinetics in healthy people is linear with respect to time and dose. In the dose range of 2, 5 and 20 mg of the area under the concentration-time curve (AUC) increases proportionally to dose. Equilibrium plasma concentrations are reached within 5 days, while taking the medicine once a day.
Tadalafil pharmacokinetics in patients with dysfunction of erection is similar to the pharmacokinetics of the drug in patients without violating the duties of an erection.
The mean volume of distribution is around 63 liters, as indicated by the fact that Tadalafil is distributed in body tissues. At therapeutic concentrations of 94% tadalafil in plasma is associated with protein-mi. Protein binding is unchanged in renal failure.
In healthy people under the age of 0, 0005% imposed dose found in the sperm.
Tadalafil is primarily metabolized by the isoenzyme (CYP) 3A4 of cytochrome P450. The main circulating metabolite metilkateholglyukuronid. This metabolite of at least 13,000 times less active against FDE5 of Tadalafil. Therefore, one can hardly assume that the metabolite concentrations was observed, with clinically significant.
In healthy individuals the average clearance tadalafil with ingestion of 2, 5 l / h and the average half-life - 17, 5 hours. Tadalafil appears mostly as inactive metabolites mainly in the faeces (approximately 61% of the dose) and to a lesser extent, with urine (about 36% of the dose).
Healthy elderly (65 years) had a lower clearance with tadalafil ingestion, resulting in increased area under the concentration-time curve by 25% compared to healthy individuals aged 19 to 45 years. This distinction is not clinically significant and does not require the selection of doses.
People with mild (creatinine clearance 51 - 80 ml / min) or intermediate (kreatinina31-clearance 50 ml / min), renal failure, the area under the concentration-time curve was higher than in healthy individuals. People with severe renal impairment (creatinine clearance 30 ml / min) Tadalafil did not study (see "Special warnings and precautions in the application").
Tadalafil pharmacokinetics in patients with little or liver failure compared with healthy individuals. In these patients the selection of the dose is not necessary.
In patients with a history of diabetes tadalafil in an application area under concentration-time curve was 19% lower than that in healthy individuals. This distinction does not require the selection of doses.
Directions:
Cialis Strips shown with erectile dysfunction.
Dosage and Administration:
Cialis Strips inside.
Application Cialis Stripsa middle-aged men
Cialis Stripsa recommended dose is 20 mg. Cialis Strips take before the alleged sexual activity, regardless of the meal. Cialis Strips must be at least 16 minutes before sexual activity.
Patients can attempt sexual activity at any time within 36 hours after admission to establish the optimal Cialis Stripsa response time to receive the drug.
The maximum recommended intake frequency - once a day.
Application Cialis Stripsa in elderly
In elderly patients a special selection of the dose is not necessary. Recommendations for the reception, which is described in the section "Use of middle-aged men" apply to elderly patients.
Cialis Stripsa application in men with renal and hepatic
For patients with renal insufficiency (creatinine clearance 30 mL / min) and liver of a special selection of the dose is not necessary (see "Special warnings and precautions in the application").
Cialis Stripsa application in children
Cialis Strips not apply to persons under 18 years.
Overdose:
With the appointment of a single person to a healthy dose of tadalafil 500 mg and patients with erectile dysfunction - often up to 100 mg / day., Unwanted effects were the same as in the use of lower doses. In case of overdose should be the standard symptomatic treatment.
Contraindications:
# Set tadalafilu or hypersensitivity to any substance, the members of the Cialis Stripsa;
# In the case of products containing any organic nitrates;
# Use of persons under 18 years.
Use during pregnancy and lactation:
Cialis Strips is not intended for use in women.
Side effects:
The most frequently observed side effects were headache and dyspepsia (11 and 7% of cases, respectively). Adverse events associated with tadalafil accommodation often small or medium level of expressiveness, transient and declined with continued use of drugs.
Other common side effects are pain in the back, mialgiya established by the nose and the "bosses" of the blood-to-face.
Rarely - swelling of eyelids, eye pain, conjunctivitis, congestion and dizziness.
Instructions and precautions:
Since there is no evidence of controlled clinical studies on safety and efficacy Cialis Stripsa in the following groups:
# Patients with severe renal impairment (creatinine clearance 30 ml / min)
# Patients with severe hepatic insufficiency, such patients should appoint a drug with caution.
Sexual activity is a potential risk for patients with cardiovascular disease. Therefore, treatment of erectile dysfunction, including the use of Cialis Stripsa, not men with heart disease, in which sexual activity is not recommended.
It should take into account the potential risk of complications of sexual activity in patients with cardiovascular disease:
# Myocardial infarction in the last 90 days;
# Unstable angina, or angina that occurred during sexual intercourse;
# Heart Failure NYHA Class 2 and above, developed over the past 6 months;
# Violations uncontrolled heart rate, hypotension (blood pressure <90/50 mm Hg. St.), or uncontrolled hypertension;
Race # tabled in the last 6 months.
Cialis Strips be used with caution in patients with a predisposition to priapizmu (eg, sickle cell anemia, multiple myeloma or leukemia) or in patients with anatomical deformation of the penis (eg, when the distortion angle, cavernous fibrosis or disease Peyronie).
There are reports of it occurring priapizma using another inhibitor FDE5 - sildenafil, although at a reception Cialis Stripsa any priapizma. Patients should be informed of the need for immediate treatment for medical assistance if an erection continuing 4 hours or more. Late priapizma treatment leads to damage to the penile tissues, which can lead to long-term loss of potency.
Cialis Stripsa safety and efficacy of combination therapy with other types of damage to the functions of erection is not studied. The use of such combinations is not recommended.
Against the backdrop of Cialis Stripsom patients with renal failure secondary to gravity (creatinine clearance 31 -50 mL / min) is more common is an undesirable phenomenon, such as back pain, compared with patients with poorly pronounced renal insufficiency (creatinine clearance 51-80 ml / min) or healthy individuals. In patients with severe renal impairment (creatinine clearance 30 ml / min) Tadalafil has not been studied. Cialis Strips be named with caution to patients with creatinine clearance 50 ml / min.
Drug Interactions:
Effect of other drugs on Cialis Strips (tadalafil):
Tadalafil is metabolized primarily to the involvement of CYP3A4. A selective inhibitor of CYP3A4, ketokonazol increases the area under the concentration-time curve "at 107%, and rifampicin reduced by 88%.
Although the specific interactions are not studied, it can be assumed that like the protease inhibitors ritonavir and saquinavir, as well as inhibitors of CYP3A4 such as erythromycin and itrakonazol increase the activity of tadalafil.
Simultaneous reception of an antacid (aluminum and magnesium hydroxide) and tadalafil reduced the rate of absorption tadalafil without changing the area under the curve tadalafil pharmacokinetics.
The increase in gastric pH as a result of receiving H2-antagonist nizatidina not affect the pharmacokinetics tadalafil.
Influence Cialis Stripsa (tadalafil) on other drugs:
We know that Tadalafil increases the hypotensive effect of nitrates (nitroglycerin, isosorbide dinitrate, isosorbide mononitrate). This is due to the additive action of nitrates and tadalafil on the metabolism of nitric oxide and tsGMF. Therefore, the use of Cialis Stripsa in the context of the use of nitrates contraindicated.
Cialis Strips no clinically significant effect on clearance of the drug metabolism of which proceeds with the participation of the cytochrome P450 isoenzyme. Studies have confirmed that Tadalafil is not inhibited and is not induced isoenzyme CYP3A4, CYP1A2, CYP2D6, CYP2E1 and CYP2C9.
Tadalafil has no clinically significant effect on the pharmacokinetics of S-warfarin or R-warfarin. Tadalafil does not affect the effect of warfarin on prothrombin time.
Tadalafil does not increase the duration of bleeding caused by aspirin.
Tadalafil has no clinically significant interactions with major classes of antihypertensive means, including blocking calcium channels (amlodipine), inhibitors of angiotensin converting enzyme (enalapril), beta-adrenergic receptor blockers (metoprolol), alpha-blockers , diuretics tiazidnye (bendoflyuazid) receptor blockers and angiotensin II that were used in different doses as monotherapy or in combination. There were no significant differences in the undesirable events in patients receiving tadalafil in combination with antihypertensive drugs or not.
No influence of acute tadalafil administration on the concentration of alcohol in the blood, the influence of alcohol on cognitive function and blood pressure. Furthermore, no changes in tadalafil concentrations in the blood 3 hours after his admission, in combination with alcohol.
Tadalafil has no clinically significant effect on the pharmacokinetics or pharmacodynamics teofillina.
The impact on the ability to drive and work with the tools:
No special requirements.
Storage conditions:
Store at temperatures below 30 ° C in the original packaging.
Stored in places inaccessible to children.
Shelf life 2 years. Do not use after the date indicated on the packaging.
Terms of the licensing of pharmacies - with a doctor's prescription.
Cialis Strips - information for patients:
What is Cialis Strips?
Cialis Strips - medicines to treat erectile dysfunction. Cialis Strips is a class of enzyme inhibitors fosfodiesterazy-5. Its operation is based on a selective and effective blockade fosfodiesterazy-5, which helps to relax smooth muscle cells and increase blood flow to the penis. Cialis Strips treats erectile dysfunction by increasing blood flow to the penis, with sexual initiation.
Cialis Strips is intended for the treatment of erectile dysfunction of any degree of seriousness. It is recommended for use in internal dose of 20 mg before the alleged sexual activity, regardless of the concomitant ingestion of food or alcohol.
Cialis Strips now - the only fosfodiesterazy-5 inhibitor, the effect that persists longer than a day - up to 36 hours. Importantly, the erection occurs only when sexual initiation. This will help couples do not plan their sexual relationships and not to abandon the normal rhythm of life. Having taken the drug in the morning, take advantage of its effect may be at night.
Cialis Strips is already well established in Europe, Australia and New Zealand. The first countries where the drug has become the United Kingdom, Denmark, Finland, Sweden and Germany.
To date, over 4,000 men have participated in over 60 clinical studies have demonstrated the efficacy and safety of the drug. Cialis Strips improving erectile function in 81% of men and showed a good portability.
Cialis Strips positively influence the following symptoms and consequences of erectile dysfunction:
* Mount a whole;
* The ability to achieve erection sufficient for sexual intercourse;
* Ability to maintain an erection during intercourse;
Get the satisfaction of sexual relationships;
* Positive emotions;
* The satisfaction of a good erection;
* Confidence in the ability to achieve and maintain an erection;
* To meet a sex partner;
* Due to a prolonged effect is Cialis Strips, men now have the option of not constantly thinking about taking the medication.
Cialis Stripsa Why?
Cialis Strips is a high efficiency, which not only improves the erection but also helps the patient regain the naturalness of sexual relations. Cialis Strips is reliable, efficient, easy to use and safe, which restores a normal sexual life of patients suffering from erectile dysfunction, the release of the constant thoughts about treatment.
For a given number of patients clinical effect starts within 16 minutes. Cialis Stripsa after administration and lasts 36 hours.
Cialis Strips, which are in keeping with the need to once daily, improved erectile function in most men suffering from erectile dysfunction of any degree.
What are methods of treating erectile dysfunction are more common?
There are several methods. Oral medications, injections penialnye, erector vacuum implants can help with erectile dysfunction. Sexual or psychological counseling may be useful in the type of psychogenic erectile dysfunction.
If the patient severe erectile dysfunction, may help Cialis Strips?
Yes, clinical trials, 81% of patients receiving 20 mg tablets Cialis Strips showed improvement power. The study included patients with varying degrees of erectile dysfunction, low to severe.
Cialis Strips can help patients suffering from diabetes?
Yes, clinical trials 68% of men with diabetes who Cialis Strips tablets of 20 mg observed improvement in erection.
Andalusia take Cialis Strips?
Patients should take Cialis Strips as prescribed by a doctor or counselor. The drug takes effect within 30 minutes and remains effective up to 36 hours. Cialis Strips can take, regardless of the meal. The result of sexual arousal.
What side effects can be expected from Cialis Stripsa?
Patients receiving any form of organic nitrates should not take Cialis Strips or any other inhibitor FDE5. This combination can cause a dangerous drop in blood pressure. If a patient during the sexual act complained of chest pain or other symptoms related to heart, you should immediately consult a doctor. In clinical trials the most common side effects were headache, indigestion, back pain, muscle and flush-to-face. In general, side effects are weak or moderate, and are rapidly decreasing at a frequency of drug use. In clinical studies, most men do not suffer serious side effects that would lead them to stop Cialis Strips.
Cialis Strips can if you take nitrates?
The patients did not receive any kind of nitrates should not take Cialis Strips. If the patient takes any Cialis Strips taking nitrate drugs, blood pressure can drop to dangerous levels. Many drugs for treatment for pain in the sternum, caused by heart disease contain nitrates. These medicines include nitroglycerin (sprays, ointments, patches or pastes, and tablets under the tongue rassasyvaniya) or isosorbide mononitrate and dinitrate (pills to swallow, chew, or maintained under the tongue). Certain drugs such as amyl nitrate lungs also contain nitrates. This list is not complete, so it is important to know that you are taking nitrates or preparations containing them.
If you have any restriction in the treatment of Cialis Stripsom eat?
No. Cialis Strips may take in connection with or without food.
The best way to take Cialis Strips?
Some men Cialis Strips starts after 16 minutes. For most patients this time is 30 minutes. But remember, without the effect of sexual initiation does not occur. Most patients are Cialis Strips order to be prepared for intimacy with a partner at any convenient time within 36 hours. The recommended maximum duration of one tablet of 20 mg per day.
Can I use Cialis Strips daily for a long time?
Daily use of medication is not recommended.
Patients who suffer an erection when you do not want?
No, Cialis Stripsa necessary for effective sexual arousal.
Cialis Strips act if it is only half a pill?
Cialis Strips is designed for use in doses of 20 mg in divided doses can not be.
Can women take Cialis Strips?
No. Cialis Strips is only for men.
