Cialis Online UK

Cialis contains tadalafil, a phosphodiesterase type 5 (PDE5) inhibitor. It is licensed for erectile dysfunction (ED) and benign prostatic hyperplasia (BPH), an enlarged prostate.

Tadalafil relaxes the smooth muscle in the blood vessels of the penis. It does this by raising levels of a natural chemical called cyclic guanosine monophosphate (cGMP).

This improves blood flow when you are sexually aroused. Tadalafil works for longer than some other PDE5 inhibitors. Its half-life, the time the body takes to clear half a dose, is about 17.5 hours.

As a result, it can work for up to 36 hours. This longer window means you do not need to time your dose so closely around sex. You can take Cialis on demand, as a 10 mg or 20 mg tablet before sex.

You can also take a low daily dose of 5 mg, which keeps you ready at all times. The NICE Clinical Knowledge Summary lists tadalafil as a first-line medicine for ED.

It does not raise your sex drive, and you still need to be aroused to get an erection. More than 22,000 men have taken Cialis during its clinical trials.

On-demand dosing: Take one 10 mg tablet at least 30 minutes before you expect to have sex.

Your doctor may raise the dose to 20 mg or lower it to 5 mg, based on how well it works and how you tolerate it. Do not take more than one dose in 24 hours.

Daily dosing: Take one 5 mg tablet at the same time each day, whether or not you plan to have sex. This option suits men who expect to have sex more than twice a week.

It also helps men who have urinary symptoms from BPH.

Swallow the tablet whole with water. You can take Cialis with or without food. High-fat meals do not change how well it is absorbed. Avoid drinking too much alcohol (more than 5 units).

Heavy drinking can raise the risk of orthostatic hypotension, a drop in blood pressure when you stand up. It can also weaken your erection on its own.

Grapefruit juice can raise tadalafil levels in your blood by blocking an enzyme called CYP3A4. Avoid drinking it in large amounts.

The usual starting dose is 10 mg, taken before sex. Your doctor may change the dose to 20 mg or lower it to 5 mg, based on how you respond. For daily use, the dose is 5 mg once a day.

If you have reduced kidney function (creatinine clearance 30-50 mL/min), start with 5 mg on demand, and take it no more than once every 48 hours.

If your kidney function is severely reduced, on-demand use is not advised. You do not need a dose change for mild liver problems.

If you have moderate liver problems, do not take more than 10 mg on demand. If you also take strong CYP3A4 blockers, such as ketoconazole or ritonavir, you may need a lower dose.

The side effects seen in clinical trials are grouped by how often they happen, as set out in the Summary of Product Characteristics.

Very common (≥1/10): Headache (seen in up to 15% of men taking the 20 mg dose).

Common (≥1/100 to <1/10): Back pain, muscle pain (myalgia), a blocked nose, flushing, indigestion (dyspepsia), and acid reflux.

Uncommon (≥1/1,000 to <1/100): Dizziness, blurred vision, ringing in the ears (tinnitus), a fast heartbeat (tachycardia), low blood pressure (hypotension), nosebleeds (epistaxis), tummy pain, rash, and hives (urticaria).

Rare (≥1/10,000 to <1/1,000): A type of sudden sight loss called non-arteritic anterior ischaemic optic neuropathy (NAION), a long-lasting erection of more than 4 hours (priapism), and sudden hearing loss.

Back pain and muscle pain usually start 12-24 hours after a dose and clear up within 48 hours. They happen more often with the daily dose.

If you get priapism, get emergency medical help at once, because a long erection can cause lasting damage to the penis.

The MHRA advises that you report any sudden change in your sight or hearing while taking PDE5 inhibitors.

Do not take Cialis with nitrate medicines, such as glyceryl trinitrate or isosorbide mononitrate. Also avoid nitric oxide donors, such as amyl nitrite.

Together, these can cause a severe drop in blood pressure that may be fatal. Leave a gap of at least 48 hours between them. Take care if you have a heart problem that makes sex itself risky.

This includes unstable angina, a recent heart attack (less than 90 days ago), a recent stroke (less than 6 months ago), high blood pressure that is not under control, or NYHA Class II-IV heart failure.

If you take alpha-blockers, your dose of these should be steady before you start tadalafil. Begin with the lowest tadalafil dose. Your blood pressure may fall slightly for a short time.

Cialis has not been studied in men with inherited eye diseases that damage the retina, such as retinitis pigmentosa.

Do not take Cialis if you are allergic to tadalafil or any other ingredient in the tablet. Do not take it with nitrates or nitric oxide donors.

Avoid it if you have severe liver problems (Child-Pugh C), a recent stroke or heart attack, or very low blood pressure (below 90/50 mmHg). Do not use it if your heart cannot cope with sex.

Do not take Cialis if you have had NAION after using a PDE5 inhibitor before. You also must not take it with strong CYP3A4 blockers if you are already on the highest recommended dose.