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Before using this drug, tell your doctor your medical history, including any allergies (especially drug allergies), any penis conditions such as fibrosis/scarring, history of painful/prolonged erection (priapism), sickle cell anemia, blood system cancers (such as leukemia or myeloma), or Peyronie's disease, eye problems (retina diseases). kidney or liver disease, bleeding disorders or active stomach ulcers, heart diseases, stroke or severe high or low blood pressure. Limit alcohol intake, as it may aggravate side effects of this drug. To avoid dizziness and lightheadedness when rising from a seated or lying position, get up slowly. The elderly may be more sensitive to the side effects of this drug, therefore caution is advised in this group.

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Pharmacotherapeutic group: medicines used in erectile dysfunction.

cialas is a potent, selective, reversible inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5). When sexual stimulation causes the local release of nitric oxide, inhibition of PDE5 by cialas produces increased levels of cGMP in the corpus cavernosum. This results in smooth muscle relaxation and inflow of blood into the penile tissues, thereby producing an erection. cialas has no effect in the absence of sexual stimulation.
No special requirements.
In clinical studies, cialas (10 mg) was shown to augment the hypotensive effects of nitrates. This is thought to result from the combined effects of nitrates and cialas on the nitric oxide/cGMP pathway. Therefore, administration of cialas to patients who are using any form of organic nitrate is contraindicated. cialas should not be used in patients with a known hypersensitivity to cialas or to any of the excipients.
Treatment of erectile dysfunction. In order for cialas to be effective, sexual stimulation is required. Dosage and Administration cialas tablets are for oral use. Use in Adult Men The maximum recommended dose of cialas is 20 mg, taken prior to anticipated sexual activity. The maximum recommended dosing frequency is once per day. cialas may be taken between 30 minutes and 36 hours prior to anticipated sexual activity. Patients may initiate sexual activity at varying time points relative to dosing in order to determine their own optimal window of responsiveness. The dose may be lowered to 10 mg based on individual response and tolerability. cialas may be taken without regard to food. Use in Elderly Men Dosage adjustments are not required in elderly patients. Dosage recommendations described in "Use in Adult Men" apply to elderly men. Use in Men with Impaired Renal Function Dosage adjustments are not required in patients with renal impairment (see Warnings and Precautions). Use in Men with Impaired Hepatic Function Dosage adjustments are not required in patients with mild to moderate hepatic impairment (Child-Pugh Class A and B) (see Pharmacokinetics). Use in Men with Diabetes The presence of diabetes does not require a dose reduction.
cialas, when taken as needed up to once daily, is effective in improving erectile function in men with erectile dysfunction (ED). In clinical studies assessing patients' ability to engage in successful and satisfying sexual activity, cialas demonstrated highly statistically significant improvement compared to placebo. Additionally, partners of patients on cialas had statistically significantly greater satisfaction with sexual activity compared to partners of patients on placebo.

Patient Confidence and Sexual Satisfaction

The IIEF also measures patients' confidence that they can attain and keep an erection sufficient for sexual intercourse. cialas statistically significantly improved patient confidence. Analysis of the Intercourse Satisfaction and Overall Satisfaction domains of the IIEF showed that cialas treatment provided statistically significant enhancement of sexual satisfaction measured by both domains. Additionally, cialas improved the proportion of sexual encounters that were satisfying for both the patient and the partner.

Period of Responsiveness

cialas demonstrated statistically significant improvement in erectile function and the ability to have successful sexual intercourse up to 36 hours following dosing, as well as patients' ability to attain and maintain erections for successful intercourse compared to placebo as early as 16 minutes following dosing.
This drug is taken by mouth as needed 20 minutes before sexual activity. Take only as directed, usually once each 3 days as needed. cialas works along with sexual stimulation to help achieve an erection. The usual dose for most people is 10mg (half a pill).
Millions of men taking cialas are satisfactory in their sexual life. Every day thousands of men are buying cialas

cialas is rapidly absorbed after oral administration and the mean maximum observed plasma concentration (Cmax) is achieved at a median time of 2 hours after dosing. Absolute bioavailability of cialas following oral dosing has not been determined.

The rate and extent of absorption of cialas are not influenced by food, thus cialas may be taken with or without food. The time of dosing (morning versus evening) had no clinically relevant effects on the rate and extent of absorption.

Elderly

Healthy elderly subjects (65 years or over), had a lower oral clearance of cialas, resulting in 25% higher exposure (AUC) relative to healthy subjects aged 19 to 45 years. This effect of age is not clinically significant and does not warrant a dose adjustment.

Renal Impairment

In a clinical pharmacology study in subjects with mild (creatinine clearance 51 to 80 mL/min) or moderate (creatinine clearance 31 to 50 mL/min) renal impairment, cialas exposure (AUC) was higher than in healthy subjects after administration of a 10-mg dose. In another clinical pharmacology study in subjects with end-stage renal failure undergoing haemodialysis, the cialas exposure (AUC) after a 10-mg dose was comparable to the exposure in healthy subjects (see Warnings and Precautions).
cialas 10 mg tablets are blister packed and are presented in cartons containing 4 tablets.

cialas 20 mg tablets are blister packed and are presented in cartons containing 1, 4, or 8 tablets.
Headache, flushing, stomach upset, nasal stuffiness, diarrhea and dizziness might occur. If these effects persist or worsen, notify your doctor promptly.