Cialis Online UK

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

Tadalafil relaxes smooth muscle in the penile vasculature by increasing cyclic guanosine monophosphate (cGMP) concentrations, thereby improving blood flow in response to sexual stimulation.

Unlike shorter-acting PDE5 inhibitors, tadalafil has a pharmacological half-life of approximately 17.5 hours, giving it a clinically useful duration of action of up to 36 hours.

This longer window means patients do not need to time doses as precisely around sexual activity.

Cialis is available as an on-demand treatment (10 mg or 20 mg taken before intercourse) or as a once-daily low-dose regimen (5 mg) that provides continuous readiness.

NICE Clinical Knowledge Summary recognises tadalafil as a first-line pharmacological option for ED. It does not increase libido and requires sexual arousal to produce an erection.

Cialis has been extensively studied in over 22,000 men during its clinical development programme.

On-demand dosing: Take one 10 mg tablet at least 30 minutes before anticipated sexual activity. The dose may be increased to 20 mg or reduced to 5 mg based on efficacy and tolerability.

Do not take more than one dose in 24 hours.

Daily dosing: Take one 5 mg tablet at the same time each day, regardless of sexual activity.

This approach is preferred for men who anticipate sexual activity more than twice per week, and for those with concurrent lower urinary tract symptoms from BPH.

Swallow the tablet whole with water. Cialis can be taken with or without food; high-fat meals do not significantly affect absorption.

Avoid excessive alcohol consumption (more than 5 units) as this may increase the risk of orthostatic hypotension and reduce erectile function independently.

Grapefruit juice can raise tadalafil plasma levels through CYP3A4 inhibition and should be avoided in large quantities.

The recommended starting dose is 10 mg taken prior to sexual activity. Based on individual response, the dose may be adjusted to 20 mg or reduced to 5 mg.

For daily use, the dose is 5 mg once daily; in patients with renal impairment (creatinine clearance 30-50 mL/min), initiate at 5 mg on-demand with a maximum frequency of once every 48 hours.

In severe renal impairment, on-demand use is not recommended. No dose adjustment is needed for mild hepatic impairment; tadalafil should not exceed 10 mg on-demand in moderate hepatic impairment.

Concomitant use with potent CYP3A4 inhibitors (e.g. ketoconazole, ritonavir) may necessitate dose reduction.

Side effects reported in clinical trials are categorised by frequency per the Summary of Product Characteristics.

Very common (≥1/10): Headache (reported in up to 15% of patients at the 20 mg dose).

Common (≥1/100 to <1/10): Back pain, myalgia, nasal congestion, flushing, dyspepsia, gastro-oesophageal reflux.

Uncommon (≥1/1,000 to <1/100): Dizziness, blurred vision, tinnitus, tachycardia, hypotension, epistaxis, abdominal pain, rash, urticaria.

Rare (≥1/10,000 to <1/1,000): Non-arteritic anterior ischaemic optic neuropathy (NAION), priapism (erection lasting >4 hours), sudden sensorineural hearing loss.

Back pain and myalgia typically occur 12-24 hours after dosing and resolve within 48 hours; these are more frequent with the daily regimen.

If priapism occurs, seek emergency medical attention immediately as prolonged ischaemia can cause permanent penile damage.

The MHRA advises reporting any sudden visual or hearing disturbance while taking PDE5 inhibitors.

Cialis must not be taken with organic nitrates (e.g. glyceryl trinitrate, isosorbide mononitrate) or nitric oxide donors (e.g. amyl nitrite) owing to the risk of severe, potentially fatal hypotension.

Allow a minimum 48-hour washout period.

Caution is required in patients with cardiovascular conditions where sexual activity itself poses a risk, including unstable angina, recent myocardial infarction (<90 days), recent stroke (<6 months), uncontrolled hypertension, or NYHA Class II-IV heart failure.

Patients taking alpha-blockers should be stabilised on alpha-blocker therapy before starting tadalafil, and the lowest tadalafil dose should be used initially.

Mild, transient decreases in blood pressure may occur. Cialis has not been studied in patients with hereditary degenerative retinal disorders, including retinitis pigmentosa.

Cialis is contraindicated in patients with hypersensitivity to tadalafil or any excipient, concurrent use of nitrates or nitric oxide donors, severe hepatic impairment (Child-Pugh C), recent stroke or myocardial infarction, severe hypotension (blood pressure <90/50 mmHg), and conditions where sexual activity is inadvisable due to underlying cardiovascular status.

It should not be used in patients who have experienced NAION with previous PDE5 inhibitor use.

Co-administration with potent CYP3A4 inhibitors in patients already on the maximum recommended dose is contraindicated.