Cialis

Cialis: A Comprehensive Guide to the Drug That Changes Your Sex Life and Health

Cialis is the trade name for a drug containing the active ingredient tadalafil. This drug has revolutionized the treatment of various medical conditions, especially in the field of men's health. It was first launched in 2002 by the pharmaceutical corporation Eli Lilly, and has since become one of the most popular drugs for improving the quality of life.

Important to remember: The information in this guide is not a substitute for medical advice or diagnosis. If you have any questions, please consult your doctor or pharmacist. For more detailed information, please refer to the consumer leaflet approved by the Ministry of Health.

What is Cialis for? Main treatment areas

Tadalafil, the active ingredient in Cialis, is used for a wide range of medical conditions, thanks to its unique mechanism of action:

1. Erectile dysfunction (impotence): This is the most well-known and common use of Cialis. Erectile dysfunction is a condition in which a man has difficulty achieving or maintaining an erection sufficient for sexual activity. Tadalafil improves blood flow to the penis, thus enabling an erection to be achieved in response to sexual stimulation. It is important to emphasize: without sexual stimulation, the drug will not cause an erection. Cialis is marketed for this treatment in 10 mg or 20 mg tablets (trade names: Cialis, Tadalafil, Tadalafil Teva, Tadalafil).
2. Benign Prostate Enlargement: Benign prostate enlargement is very common in older men and can cause symptoms such as difficulty urinating, frequent urination, or a weak urine stream. Tadalafil helps blood flow to the prostate, thereby reducing symptoms. For this treatment, Cialis is marketed in lower-dose tablets of 2.5 mg or 5 mg (same brand names). The drug is often given in combination with other drugs for this purpose. Before use, prostate cancer must be ruled out, as the symptoms may be similar.
3. Pulmonary hypertension: This is a less common condition, but tadalafil is also used to treat it in adults. It relaxes the blood vessels in the lungs, increasing blood flow to them, which improves the ability to engage in physical activity. For this purpose, tablets are available under the trade name Tadair. It should be clarified that this information focuses mainly on uses related to erectile dysfunction and benign prostatic hyperplasia.

How does Cialis work? The pharmacological mechanism

Cialis, like other medications for the treatment of erectile dysfunction such as Viagra (sildenafil) and Levitra (vardenafil), belongs to the group of drugs called PDE5 (phosphodiesterase type 5) enzyme inhibitors.

The action of tadalafil is based on a biochemical mechanism that occurs naturally in the body:

When sexual stimulation occurs, nitric oxide (NO) is released into the penis. NO binds to receptors on the enzyme guanylate cyclase, activating it. This enzyme produces a substance called cGMP (cyclic guanosine monophosphate), which causes the smooth muscles in the walls of the lysine blood vessels in the penis to relax. This relaxation leads to a dramatic increase in the amount of blood flowing through the arteries, resulting in an erection.

The enzyme PDE5 breaks down cGMP, thus stopping the erection. Tadalafil inhibits the activity of the enzyme PDE5, which causes high levels of cGMP to be maintained. These high levels allow for blood vessel relaxation and increased blood flow, thus maintaining an erection for a longer period of time. As mentioned, without sexual stimulation, that is, without the activation of the natural system by NO and cGMP, tadalafil should not cause an erection.

One of the most notable advantages of Cialis, compared to similar drugs, is its long half-life. Cialis's half-life is about 17.5 hours, which translates to a duration of effect that can reach up to 36 hours. This allows for more spontaneity in sexual activity, and the drug is sometimes called the "weekend pill." In contrast, sildenafil (Viagra) and vardenafil (Levitra) have shorter half-lives, about 4 to 5 hours.

Cialis dosage and instructions for use

Tadalafil is available in four main doses: 2.5 mg, 5 mg, 10 mg, and 20 mg. The dosage and method of treatment will always be determined by a doctor only, depending on the medical condition, the goal of treatment, and the patient's response.

There are two main strategies for taking Cialis to treat erectile dysfunction:

1. Cialis "On-demand":
   • Dosage: A common starting dose is 10 mg, or 20 mg depending on the doctor's decision.
   • How to take: One tablet, at least 30 minutes before sexual intercourse.
   • Frequency: Do not exceed the recommended dose. Do not take more than one tablet per day.
   • Duration of effect: The effect of Cialis can last up to 36 hours. Since its effect lasts for more than 24 hours, daily use of this product should be avoided when it is taken "as needed." It can be taken at any time of the day.
2. Cialis "Daily":
   • Dosage: 2.5 mg or 5 mg tadalafil once a day.
   • How to take: Take one Cialis tablet every day at approximately the same time (regardless of the timing of sexual activity).
   • Purpose: Daily use at low doses allows erections to occur as a result of sexual stimulation at any time, 24 hours a day, and may be useful for men who expect to have sexual activity two or more times a week, or those who are also being treated for benign prostatic hyperplasia.

For the treatment of benign prostatic hyperplasia (with or without erectile dysfunction): The usual dosage is one 5 mg Cialis tablet per day, every day.

For the treatment of pulmonary hypertension: The usual dosage is two 20 mg tablets taken once a day, one after the other.

Onset and duration of effect:

• For the treatment of erectile dysfunction: The onset of effect ranges from 30 minutes to 60 minutes, and the duration of effect is up to 36 hours.
• For the treatment of benign prostatic hyperplasia: The onset of effect varies depending on the severity of the symptoms and the treatment is taken daily for the long term, as long as needed.

Missed dose:

• For "as needed" or "daily" treatment of erectile dysfunction and enlarged prostate: Do not take a double dose. Continue taking the next dose on time.
• For the treatment of pulmonary hypertension: If no more than 8 hours have passed since taking the medication, take the dose as soon as you remember. Do not take a double dose to make up for it.

Discontinuation of the drug and overdose:

• Cialis can be stopped when the medication is no longer needed (on an "as needed" basis). For daily treatment or for pulmonary hypertension, follow your doctor's instructions.
• In case of overdose, or if you notice unusual symptoms, contact a doctor or emergency room immediately.

Warnings and side effects

Like any medication, Cialis has important warnings and possible side effects.

Who should not take Cialis?

Cialis is prohibited for use in the following cases:

• Sensitivity to tadalafil or any of the inactive ingredients of the drug (the drug contains lactose and may cause allergies in those who are sensitive).
• Taking certain medications from the nitrate family (such as isosorbide mononitrate, isosorbide dinitrate, and nitroglycerin) – this combination may cause a sharp and dangerous drop in blood pressure.
• Taking the drug Riociguat – used to treat pulmonary hypertension – increases the decrease in blood pressure caused by the use of tadalafil.
• Heart attack (myocardial infarction) within the last 90 days.
• A stroke that occurred within the last six months.
• Unstable angina, or uncontrolled arrhythmias.
• Uncontrolled hypertension or very low blood pressure (less than 90/50 mm Hg).
• A history of vision loss in one or both eyes due to a medical condition called NAION.
• Concurrent use of other medications to treat erectile dysfunction.
• The medicine is not intended for use by persons under the age of 18 or by women.

Additional warnings:

• Sexual activity and heart disease: Sexual activity poses a potential risk for heart disease due to the increased strain placed on the heart. Therefore, consult your doctor if you have an existing heart condition.
• Interactions with other medications: Be careful if you are taking other medications, including over-the-counter medications and dietary supplements. In particular, alpha-blockers (such as doxazosin), which are sometimes used to treat high blood pressure and/or benign prostatic hyperplasia, or other medications to treat high blood pressure. Concomitant use may increase the blood pressure-lowering effect of these medications.
• Alcohol: Cialis can be taken with or without food, but be careful not to drink too much alcohol, which may impair your ability to achieve an erection and increase the risk of dizziness when getting up from a lying position.
• Using Cialis does not protect against sexually transmitted diseases.

Possible side effects:

As with any medication, the use of Cialis may cause side effects in some users:

• Common side effects (occur frequently): Headache.
• Less common side effects (occur rarely): back pain and muscle pain (more common with Cialis than with Viagra, but usually transient), facial flushing, nasal congestion, indigestion (heartburn, abdominal pain, indigestion), and dizziness.
• Uncommon (rare) side effects: rashes, blurred vision, eye pain, increased sweating, feeling of a fast heartbeat, high or low blood pressure, and chest pain.
• Very rare and serious side effects: sudden decrease or loss of vision (in one or both eyes), sudden decrease or loss of hearing, fainting, seizure (epilepsy) and transient memory loss, pupil dilation, redness of the eyes, hives (urticaria), nosebleeds, and prolonged erection (priapism) requiring urgent medical attention. Cases of heart attack and stroke have been reported during the use of drugs in this group, but in most cases there was a heart problem before taking the drug, and a direct connection to taking it cannot be established.

In the event of serious or persistent side effects, seek medical advice immediately.

Frequently asked questions about Cialis:

Who should not take Cialis?

Cialis is contraindicated in people who are hypersensitive to tadalafil or any of the drug's ingredients, those taking nitrates or riociguat, those who have had a heart attack in the past 90 days, a stroke in the past 6 months, unstable angina, uncontrolled arrhythmia, uncontrolled hypertension, or very low blood pressure. It is also contraindicated in people with a history of NAION-type vision loss, or those using other medications to treat impotence. The drug is not intended for women or men under the age of 18.

How does Cialis work?

Cialis works by inhibiting the enzyme PDE5, which breaks down a substance called cGMP in the penis. When there is sexual stimulation, cGMP is produced which relaxes blood vessels and allows increased blood flow to the penis, thus causing an erection. Cialis' inhibition of PDE5 keeps cGMP levels high and allows an erection to be maintained for longer. It is important to note that the drug requires sexual stimulation to work.

When to take Cialis?

Cialis can be taken in two main ways, as directed by a doctor:

1. "As needed": One tablet (10 mg or 20 mg) at least 30 minutes before sexual intercourse. Its effect can last up to 36 hours.
2. "Daily": One tablet (2.5 mg or 5 mg) once a day, at about the same time, regardless of when sexual activity occurs. This option is suitable for men who expect more frequent sexual activity, and also for the treatment of benign prostatic hyperplasia.

Where to buy Cialis?

Cialis is a prescription drug in Israel. It can be purchased at pharmacies after receiving a prescription from a doctor. Avoid purchasing the drug from unauthorized sources or over the Internet without a prescription, as there is a risk of counterfeit or dangerous products.

Is Cialis kosher?

The issue of kashrut of medications is complex and depends on various rabbinical rulings and the ingredients of the medication. In many cases, as long as there are no direct and substantial animal ingredients, medications are considered kashrut "as needed" (especially when it comes to protecting life or health). It is recommended to consult with a rabbi or a pharmacy familiar with these laws regarding a specific preparation.

Does Cialis cause heartburn?

Yes, heartburn is a possible side effect of Cialis, although it is not as common as headache. It falls under the category of "indigestion" that can occur in some users. If you experience heartburn or other significant side effects, you should consult your doctor.

Storage of the medicine

Store Cialis in the original packaging that protects against moisture, at a temperature not exceeding 25 degrees Celsius. Keep out of the reach of children.