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Tadalafil Cialis

Tadalafil is metabolized in the liver. Excretion is carried out through the intestine and in small quantities with urine.

How to take Tadalafil: instructions for use.
The medicine is taken once a day at any time, regardless of food intake. The tablet should be washed down with a small amount of water.

The recommended dose of tadalafil is 20 mg., Including those over 65 years of age. Depending on the tolerability of the drug, the dose may vary from 2.5 mg. up to 40 mg. It should be remembered that a day can only take one tablet. Therefore, you can adjust the dose only the next day.
With functional violations of the liver in a mild or moderate degree, the dose of tadalafil is 10 mg.
With moderate renal failure – the initial dose of 5 mg. per day or 10 mg. once in 48 hours. With serious liver and kidney disease from taking the drug should be discarded.

If the patient is treated with strong inhibitors of cytochrome P 3A4, such as: ketoconazole, erythromycin, itraconazole, ritonavir and others, the maximum dosage of tadalafil is 10 mg. once in 3 days.
For men, in whom the symptoms of ED are strongly pronounced, and if necessary, feel as confident as possible, the dose can be 40 mg. This dose is the highest possible for a single dose.
It is not desirable to combine with other PDE 5 inhibitors. In this case, there may be an increase in side effects, as well as the occurrence of priapism (a prolonged and painful erection).

Contraindications.
Tadalafil can not be used in diseases and indicators:
hypersensitivity to the active substance; simultaneous intake with organic nitrates; treatment with alpha-blockers; severe hepatic and renal insufficiency; diseases of the cardiovascular system (unstable angina, heart rhythm disturbances, myocardial infarction and stroke, transferred not later than 6 months); children under the age of 18; degenerative diseases of the retina; anatomical curvature of the penis; propensity to priapism.
The tablets Sialis 20 mg (USA) and Tadalafil tablets 20 mg (India) instructions for use are the same. But the price of the original product and generic varies considerably.

On the first remedy it is 800 – 1000 rubles per 1 piece, and for the second – 80 – 150 rubles, depending on the number of tablets in the package. Why such difference?

To develop, test and implement the Cialis market, Eli Lilly has spent a large amount of money. And generics are produced by pharmaceutical companies using ready-made technology. Therefore, at much lower costs, a drug with the same effect as the original agent is created.

But despite the fact that tadalafil is included in the composition of Cialis, and generic, there are differences. The composition of the auxiliary components is likely to be very different, and the active substance is not sufficiently purified and has different impurities. This explains the more side effects from Erectafil generics.