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what drug is cialis

what drug is cialis




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Tadalafil

Tadalafil is a PDE5 inhibitor marketed in pill form for treating erectile dysfunction (ED) under the name Cialis . and under the name Adcirca for the treatment of pulmonary arterial hypertension. In October 2011 the U.S. Food and Drug Administration (FDA) approved Cialis for treating the signs and symptoms of benign prostatic hyperplasia (BPH) as well as a combination of BPH and erectile dysfunction (ED) when the conditions coincide. It initially was developed by the biotechnology company ICOS. and then again developed and marketed world-wide by Lilly ICOS, LLC, the joint venture of ICOS Corporation and Eli Lilly and Company. Cialis tablets, in 2.5 mg, 5 mg, 10 mg, and 20 mg doses, are yellow, film-coated, and almond-shaped. The approved dose for pulmonary arterial hypertension is 40 mg (two 20-mg tablets) once daily.

Tadalafil is also manufactured and sold under the name of Tadacip by the Indian pharmaceutical company Cipla in doses of 10 mg and 20 mg.

On November 21, 2003 the FDA approved tadalafil (as Cialis) for sale in the United States as the third ED prescription drug pill (after sildenafil citrate (Viagra) and vardenafil Hydrochloride (Levitra)). Like sildenafil and vardenafil, tadalafil is recommended as an 'as needed' medication. Cialis is the only one of the three that is also offered as a once-daily medication.

Moreover, tadalafil was approved in May 2009 in the United States for the treatment of pulmonary arterial hypertension [1] and is under regulatory review in other regions for this condition. In late November 2008, Eli Lilly sold the exclusive rights to commercialize tadalafil for pulmonary arterial hypertension in the United States to United Therapeutics for an upfront payment of $150 million.

Contents

Tadalafil has been used in approximately 15,000 men participating in clinical trials, and over eight million men worldwide (primarily in the post-approval/post-marketing setting). The most common side effects when using tadalafil are headache, stomach discomfort or pain, indigestion, burping, acid reflux, back pain, muscle aches, flushing. and stuffy or runny nose. These side effects reflect the ability of PDE5 inhibition to cause vasodilation (cause blood vessels to widen), and usually go away after a few hours. Back pain and muscle aches can occur 12 to 24 hours after taking the drug, and the symptom usually disappears after 48 hours.

In May 2005, the U.S. Food and Drug Administration found that tadalafil (along with other PDE5 inhibitors) was associated with vision impairment related to NAION (nonarteritic anterior ischemic optic neuropathy ) in certain patients taking these drugs in the post-marketing (outside of clinical trials) setting. Most, but not all, of these patients had underlying anatomic or vascular risk factors for development of NAION unrelated to PDE5 use, including: low cup to disc ratio ("crowded disc"), age over 50, diabetes, hypertension, coronary artery disease, hyperlipidemia and smoking. Given the small number of NAION events with PDE5 use (fewer than one in one million), the large number of users of PDE5 inhibitors (millions) and the fact that this event occurs in a similar population to those who do not take these medicines, the FDA concluded that they were not able to draw a cause and effect relationship, given these patients underlying vascular risk factors or anatomical defects. However, the label of all three PDE5 inhibitors was changed to alert clinicians to a possible association.

In October 2007, the FDA announced that the labeling for all PDE5 inhibitors, including tadalafil, requires a more prominent warning of the potential risk of sudden hearing loss as the result of postmarketing reports of deafness associated with use of PDE5 inhibitors. [2]

Since PDE5 inhibitors such as tadalafil may cause transiently low blood pressure (hypotension ), organic nitrates (poppers) should not be taken for at least 48 hours after taking the last dose of tadalafil. Using organic nitrites (such as the sex drug amyl nitrite ) within this timeframe may increase the risk of life-threatening hypotension.

Since people who have taken tadalafil within the past 48 hours cannot take organic nitrates to relieve angina (such as glyceryl trinitrate spray), these patients should seek immediate medical attention if they experience anginal chest pain. [3] In the event of a medical emergency, paramedics and medical personnel should be notified of any recent doses of tadalafil.

Tadalafil is metabolized predominantly by the hepatic CYP3A4 enzyme system. The presence of other drugs which induce this system can shorten tadalafil half-life and reduce serum levels, and hence efficacy, of the drug.

Although sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) all work by inhibiting PDE5, tadalafil's pharmacologic distinction is its longer half-life (17.50 hours) [4] – compared to sildenafil and vardenafil (both 4.0–5.0 hours) [5] – resulting in longer duration of action, and so partly responsible for "The Weekend Pill" sobriquet. Furthermore, the longer half-life is the basis for current investigation of tadalafil's daily therapeutic use in relieving pulmonary arterial hypertension. Sildenafil is approved in several world regions as a thrice-daily therapy for pulmonary arterial hypertension.

Penile erection during sexual stimulation is caused by increased penile blood flow resulting from the relaxation of penile arteries and the smooth muscle of the corpus cavernosum. This response is mediated by the release of nitric oxide (NO) from nerve terminals and endothelial cells, which stimulates the synthesis of Cyclic guanosine monophosphate (more commonly known as Cyclic GMP or cGMP) in smooth muscle cells. cGMP relaxes smooth muscle and increases blood flow to the corpus cavernosum.

The inhibition of phosphodiesterase type 5 (PDE5) enhances erectile function by increasing the amount of cGMP. Tadalafil (and sildenafil and vardenafil) inhibits PDE5. However, because sexual stimulation is required to initiate the local penile release of nitric oxide, tadalafil's inhibition of PDE5 will have no effect without direct sexual stimulation of the penis. The recommended tadalafil starting dose for most men is 10 mg, taken as needed before sexual activity (but not more than once daily). The dose may be increased to 20 mg or decreased to 5 mg, per its efficacy and the man's personal tolerance of the drug. In June 2007, the European Commission approved low-dose (2.5 mg and 5 mg) Cialis to be used as single-daily ED therapy.

Although available since 2003 in 5, 10, 20 mg dosage, in late 2008/early 2009, the U.S. FDA approved the commercial sale of Cialis in 2.5 mg dosage as a one-a-day treatment for ED. The 2.5 mg dose avoids earlier dispensing restrictions on higher dosages. The price of the 5 mg and 2.5 mg are often similar, so some people score and split the pill. [6] Both physicians and the manufacturer warn against splitting the pill, especially since it is enterically coated and splitting might impact absorption.

Moreover, tadalafil (Adcirca) 40 mg was approved in 2009 in the United States and Europe (and 2010 in Canada and Japan) as a once-daily therapy to improve exercise ability in patients with pulmonary arterial hypertension. In patients with pulmonary arterial hypertension. the pulmonary vascular lumen is decreased as a result of vasoconstriction and vascular remodeling, resulting in increased pulmonary artery pressure and pulmonary vascular resistance. Tadalafil is believed to increase pulmonary artery vasodilation, and inhibit vascular remodeling, thus lowering pulmonary arterial pressure and pulmonary vascular resistance. Right heart failure is the principal consequence of pulmonary arterial hypertension.

On October 6, 2011, the U.S. FDA approved tadalafil to treat the signs and symptoms of benign prostatic hyperplasia (BPH). BPH is a condition in males in which the prostate gland becomes enlarged, obstructing the free flow of urine. Symptoms may include sudden urges to urinate (urgency), difficulty in starting urination (hesitancy), a weak urine stream, and more frequent urination - especially at night. The FDA has also approved tadalafil for treatment of both BPH and erectile dysfunction (ED) where the two conditions co-exist.

Selectivity compared with other PDE5 inhibitors Edit

Tadalafil, sildenafil, and vardenafil all act by inhibiting the PDE5 enzyme. These drugs also inhibit other PDE enzymes. Sildenafil and vardenafil inhibit PDE6, an enzyme found in the eye, more than tadalafil. [7] Some sildenafil users see a bluish tinge and have a heightened sensitivity to light because of PDE6 inhibition. [8] Sildenafil and vardenafil also inhibit PDE1 more than tadalafil. [7] PDE1 is found in the brain, heart, and vascular smooth muscle. [7] It is thought that the inhibition of PDE1 by sildenafil and vardenafil leads to vasodilation. flushing. and tachycardia. [7] Tadalafil inhibits PDE11 more than sildenafil or vardenafil. [7] PDE11 is expressed in skeletal muscle. the prostate. the liver. the kidney. the pituitary gland. and the testes. [7] The effects on the body of inhibiting PDE11 are not known. [7]

The FDA's approval of sildenafil on March 27, 1998 [10] was a ground-breaking commercial event for the treatment of ED, with sales exceeding US$ 1 billion. Subsequently, the FDA approved Levitra (vardenafil ) on August 19, 2003, [11] and Cialis (tadalafil) on November 21, 2003.

Cialis was discovered by Glaxo Wellcome (now GlaxoSmithKline ) under a partnership between Glaxo and ICOS to develop new drugs that began in August 1991. [12] [13] In 1993, the Bothell, Washington biotechnology company ICOS Corporation began studying compound IC351, a phosphodiesterase type 5 (PDE5) enzyme inhibitor. In 1994, Pfizer scientists discovered that sildenafil, which also inhibits the PDE5 enzyme, caused penile erection in men participating in a clinical study of a heart medicine. Although ICOS scientists were not testing compound IC351 for treating ED, they recognized its potential usefulness for treating that disorder. Soon, in 1994, ICOS received a patent for compound IC351 (structurally unlike sildenafil and vardenafil), and Phase 1 clinical trials began in 1995. In 1997, the Phase 2 clinical studies were initiated for men experiencing ED, then progressed to the Phase 3 trials that supported the drug's FDA approval. Although Glaxo had an agreement with ICOS to share profits 50/50 for drugs resulting from the partnership, Glaxo let the agreement lapse in 1996 as the drugs developed were not in the company's core markets. [8]

In 1998, ICOS Corporation and Eli Lilly and Company formed the Lilly ICOS, LLC, joint venture company to further develop and commercialize tadalafil as a treatment for ED. Two years later, Lilly ICOS, LLC, filed a new drug application with the FDA for compound IC351 (under the tadalafil generic name, and the Cialis brand name). In May 2002, Lilly ICOS reported to the American Urological Association that clinical trial testing demonstrated that tadalafil was effective for up to 36 hours, and one year later, the FDA approved tadalafil. One advantage Cialis has over Viagra and Levitra is its 17.5-hour half-life (thus Cialis is advertised to work for up to 36 hours, [14] after which time there remains approximately 25 percent of the absorbed dose in the body) when compared to the four-hour half–life of sildenafil (Viagra).

In 2007, Eli Lilly and Company bought the ICOS Corporation for $2.3 billion. As a result, Eli Lilly owned Cialis and then closed the ICOS operations, ending the joint venture and firing most of ICOS's approximately 500 employees, except for 127 employees of the ICOS biologics facility, which subsequently was bought by CMC Biopharmaceuticals A/S (CMC).

Persons surnamed "Cialis" objected to Eli Lilly and Company's so naming the drug, but the company has maintained that the drug's trade name is unrelated to the surname. [15]

On October 6, 2011, the U.S. FDA approved tadalafil [16] to treat the signs and symptoms of benign prostatic hyperplasia (BPH). BPH is a condition in males in which the prostate gland becomes enlarged, obstructing the free flow of urine. Symptoms may include sudden urges to urinate (urgency), difficulty in starting urination (hesitancy), a weak urine stream, and more frequent urination- especially at night. The FDA has also approved tadalafil for treatment of both BPH and erectile dysfunction (ED) where the two conditions co-exist.

Marketing Edit

20 mg Cialis tablet

In the United States, the FDA relaxed rules on prescription drug marketing in 1997, allowing advertisements targeted directly to consumers. [17] Lilly-ICOS hired the Grey Worldwide Agency in New York, part of the Grey Global Group. to run the Cialis advertising campaign. [18] Marketers for Cialis has taken advantage of its greater duration compared to its competitors in advertisements for the drug; Stuart Elliot of The New York Times opined: "The continuous presence of women in Cialis ads is a subtle signal that the drug makes it easier for them to set the pace with their men, in contrast to the primarily male-driven imagery for Levitra and Viagra." [18] Iconic themes in Cialis ads include couples in bathtubs and the slogan "When the moment is right, will you be ready?" [18] Cialis ads were unique among the ED drugs in mentioning specifics of the drug. [19] As a result, Cialis ads were also the first to describe the side effects in an advertisement, as the FDA requires advertisements with specifics to mention side effects. One of the first Cialis ads aired at the 2004 Super Bowl. [19] Just weeks before the Super Bowl, the FDA required more possible side effects to be listed in the advertisement, including priapism. [19] Although many parents objected to the Cialis ad being aired during the Super Bowl, Janet Jackson 's halftime "wardrobe malfunction " overshadowed Cialis. [19] In January 2006, the Cialis ads were tweaked, adding a doctor on screen to describe side effects and only running ads where more than 90 percent of the audience are adults, effectively ending Super Bowl ads. [17] In 2004, Lilly-ICOS, Pfizer, and GlaxoSmithKline spent a combined $373.1 million to advertise Cialis, Viagra, and Levitra respectively. [19] Cialis has sponsored many sporting events, including the America's Cup and the PGA Tour. once being title sponsor of the PGA Tour Western Open tournament. [20]

In the United States as of 2015 the cost is between 29.84 and 45.83 USD per 10mg pill. [21]

Cialis Prices, Coupons and Patient Assistance Programs

Cialis (tadalafil) is a member of the impotence agents drug class and is commonly used for Benign Prostatic Hyperplasia and Erectile Dysfunction.

Cialis Prices

This Cialis price guide is based on using the Drugs.com discount card which is accepted at most U.S. pharmacies. The cost for Cialis tablet 2.5 mg is around $288 for a supply of 30, depending on the pharmacy you visit. Prices are for cash paying customers only and are not valid with insurance plans.

Cialis is available as a brand name drug only, a generic version is not yet available. For more information, read about generic Cialis availability .

Tablet

2.5 mg Cialis tablet

from $287.65 for 30 each

Important. When there is a range of pricing, consumers should normally expect to pay the lower price. However, due to stock shortages and other unknown variables we cannot provide any guarantee.

5 mg Cialis tablet

from $287.65 for 30 tablet

Important. When there is a range of pricing, consumers should normally expect to pay the lower price. However, due to stock shortages and other unknown variables we cannot provide any guarantee.

10 mg Cialis tablet

from $601.90 for 10 tablet

$21.19 – $55.17

$635.68 – $1,655.21

Important. When there is a range of pricing, consumers should normally expect to pay the lower price. However, due to stock shortages and other unknown variables we cannot provide any guarantee.

20 mg Cialis tablet

from $87.07 for 3 tablet

$12.14 – $60.19

$121.43 – $601.90

$25.07 – $55.17

$752.25 – $1,655.21

Important. When there is a range of pricing, consumers should normally expect to pay the lower price. However, due to stock shortages and other unknown variables we cannot provide any guarantee.

Drugs.com Printable Discount Card

The free Drugs.com Discount Card can save you up to 80% or more off the cost of prescription medicines, over-the-counter drugs and pet prescriptions.

Please note: This is a drug discount program, not an insurance plan.

Manufacturer Coupons and Rebates

Cialis offers may be in the form of a printable coupon, rebate, savings card, trial offer, or free samples. Some offers may be printed right from a website, others require registration, completing a questionnaire, or obtaining a sample from the doctor's office.

Cialis Savings Card: Eligible patients receive $200 off their 30-day supply prescriptions; for additional information contact the program at 800-545-5979.

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Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Data sources include Micromedex® (updated Sep 2nd, 2016), Cerner Multum™ (updated Sep 5th, 2016), Wolters Kluwer™ (updated Aug 8th, 2016) and others. To view content sources and attributions, please refer to our editorial policy .

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CIALIS is approved to treat erectile dysfunction and the signs and symptoms of benign prostatic hyperplasia.

CIALIS – The Only Drug Approved to Treat Both ED and BPH

Erectile dysfunction (ED) is a common problem for many men. It describes a difficulty in achieving or maintaining an erection and can disrupt normal sexual activity. BPH, or benign prostatic hyperplasia, affects roughly 50 percent of all men who suffer from ED. In BPH, the prostate becomes swollen, partially blocking the urethra and affecting urinary frequency. CIALIS is the only drug currently approved to treat both conditions concurrently.

CIALIS is the brand name for tadalafil, a drug that is also used in ADCIRCA, used to relieve pulmonary arterial hypertension. There is currently no generic form of CIALIS, so be wary of imitators when buying CIALIS online.

How Does CIALIS Work?

Erectile dysfunction is caused by poor blood circulation. Since the penis must have ample blood flow to become erect, problems with circulation will result in difficulty achieving or sustaining that erection. In many cases, this reduction in blood flow is caused by an enzyme called phosphodiesterase 5, or PDE5, which occurs in both smooth muscle tissue and blood vessels. The presence of too much PDE5 keeps blood vessels from relaxing, prohibiting them from filling up with enough blood.

CIALIS is a PDE5 inhibitor. This means that it halts the production of the PDE5 enzyme, which in turn will relax the affected blood vessels and encourage better circulation. This is also why the drug is effective against certain types of hypertension.

The effect of CIALIS on the prostate is still being investigated, but clinical studies show that patients have a reduction in BPH symptoms after taking CIALIS.

It’s important to remember that taking CIALIS by itself will not cause an erection. It will simply make it easier to achieve and maintain one. The patient will require sexual stimulation to achieve an erection after taking CIALIS. Once sexual activity has been stopped, the penis should return to a flaccid state as normal. In some situations, a prolonged erection can occur. If this happens for longer than four hours, it is imperative to seek medical attention.

What Makes CIALIS Different From Other ED Drugs?

The effects of all ED drugs are quite similar. All of them work by improving blood flow. Different drugs utilize different active ingredients and release into the body in different ways.

There are two primary benefits to using CIALIS instead of a different drug. First, CIALIS can be taken daily rather than on an as-needed basis. Second, the effects of the drug last in the system longer than with other ED drugs. While a dose of similar brands last approximately four hours, the effects of CIALIS can last up to 36 hours. Some users find these results preferable as they provide for more flexibility and spontaneity for timing periods of intimacy.

Two Types of CIALIS Dosage

Depending on the patient’s needs, CIALIS dosage is available in several levels. The drug can be taken on an as-needed basis, similar to Viagra, or it can be taken every day. The latter is the only way to take CIALIS as a treatment for BPH; the as-needed dose will not be effective for treating prostate swelling.

If taking CIALIS daily, the recommended dose is 2.5 to 5 mg. Patients will often be started at the lower dose, with a higher dose being administered if the drug lacks effectiveness. For best results, the drug should be taken at roughly the same time each day. Taking CIALIS every day, the patient should begin to see ED symptoms improve within four to five days. BPH symptoms should show signs of improvement within two to four weeks.

If CIALIS is taken on an as-needed basis, the dosage goes up to 5, 10 or 20 mg. The average starting dosage is 10 mg. The drug becomes effective within 30 minutes and can stay in the patient’s system and remain effective for up to 36 hours.

Regardless of which CIALIS dosage the patient takes, the pill can be taken with or without food. However, alcohol consumption should be moderated while taking CIALIS.

CIALIS Side Effects and Warnings

When researching CIALIS online, you will come across a number of warnings. Be advised that not every patient experiences side effects, and most CIALIS side effects are very mild and clear up within a few hours. These are the most commonly reported side effects:

  • Headache
  • Indigestion
  • Back pain
  • Muscle aches
  • Flush skin
  • Nasal congestion or discharge

Other side effects are uncommon but serious. If experiencing any of these CIALIS side effects, seek immediate medical care:

  • Persistent erection lasting more than four hours
  • Sudden decrease or loss of vision or hearing

Some patients may also experience an allergy to the active ingredient in CIALIS or to other ingredients in the drug. Discontinue use if you experience swelling of the lips or throat, break out into a rash or have difficulty swallowing as these may be signs of an allergic reaction. If you do experience these symptoms, seek prompt medical attention.

Additionally, before taking CIALIS, it’s important to tell your doctor about any other medications you are taking to prevent potential drug interactions. In particular, certain drugs should not be mixed with CIALIS:

  • ADCIRCA, a drug containing the same ingredients as CIALIS and used to treat pulmonary arterial hypertension
  • Heart medications including nitrates
  • Alpha blockers, such as those prescribed for prostate problems
  • Blood pressure medications
  • Certain anti-fungal medications and HIV treatments
  • Certain antibiotics
  • Any other medications for erectile dysfunction
  • Recreational drugs called “poppers,” such as amyl nitrite or butyl nitrite

Combining any of these drugs with CIALIS can result in potentially serious complications. Talk to your doctor about potential drug interactions with any of your current medications; there may be specific contraindications that you would not find from general research of CIALIS online.

Finally, it’s important to discuss your overall health and fitness with your doctor. You should be in good enough health for sexual activity before attempting to treat erectile dysfunction. Your doctor may advise against taking CIALIS if you have any of the following conditions:

  • Heart problems
  • Stroke
  • High or low blood pressure
  • Liver or kidney disease
  • Degenerative eye disease
  • Bleeding disorders
  • Stomach ulcers
  • Sickle cell anemia, leukemia, multiple myeloma and other blood disorders

During sexual intercourse, stop immediately if you begin to feel dizzy or nauseous or if you experience chest pain.

Buy CIALIS Online

CIALIS is only available by prescription. If you have been researching CIALIS online, make a point of bringing it up at your next doctor appointment. This can open discussion about treatment options for erectile dysfunction.

Before you talk to your doctor, it’s a good idea to search for information about CIALIS online so that you can make an informed decision. This will make it easier to discuss your needs with your doctor. To aid in the discussion, bring along this page or other information you’ve found about CIALIS online.

Once you have obtained a prescription, you have the option of buying CIALIS online or in person at the drugstore of your choice. If shopping for CIALIS online, be sure that the pharmacy you choose is reputable. You can check the reputation of a pharmacy by visiting LegitScript.com. In general, the websites of major chain pharmacies like Walgreens and CVS will be safe. Many other independent pharmacies offer CIALIS online and are totally legitimate. Ask your doctor for additional recommendations.

At this time, CIALIS is not covered by all forms of insurance, but many insurance companies do cover drugs for erectile dysfunction. Check with your insurance company to see whether you can save money by ordering CIALIS online or through your local pharmacy. Also be advised that Medicare does not currently pay for erectile dysfunction medication.

You can, however, save money by taking advantage of a CIALIS coupon. The CIALIS website offers coupons for a free trial of CIALIS online. This free trial allows you to receive a 30-day supply of daily 5 mg CIALIS or three tablets of the as-needed CIALIS dosage. You can only redeem this offer if you have a doctor’s prescription, but it’s a good way to try out the drug and see if you like it. If you are unsatisfied after using the CIALIS online offer, you can receive an additional coupon for any other CIALIS product or competitor ED drug.

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