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When a man is sexually stimulated, his body's normal response is to increase blood flow to his penis to produce an erection. By controlling the enzyme, tadalafil helps to maintain an erection after the penis is stroked by increasing blood flow to the penis. Without physical action to the penis, such as that occurring during sexual intercourse, tadalafil will not work to cause an erection.

However, other combinations of drugs may be used for this purpose. Also, other single medications may be used off-label to treat both ED and symptoms of BPH together. It usually occurs between 12 and 24 hours after taking Cialis. Usually, back pain goes away within 2 days of taking your dose.

In addition, be sure to talk with your doctor or pharmacist about any other medications that you’re taking. They’ll be able to determine whether the drugs may interact with Cialis and whether that may lead to an increased risk of side effects. If you have any questions about the best way to avoid specific side effects from Cialis, talk with your doctor. Do not use this medicine if you are also using riociguat (Adempas®) or a nitrate medicine, often used to treat angina (chest pain). Nitrate medicines include nitroglycerin, isosorbide, Imdur®, Nitro-Bid®, Nitrostat®, Nitro-Dur®, Transderm Nitro®, Nitrol® Ointment, and Nitrolingual® Spray.

A selective inhibitor of CYP3A4, ketoconazole (200 mg daily), increased tadalafil (10 mg) exposure (AUC) 2-fold and Cmax by 15 %, relative to the AUC and Cmax values for tadalafil alone. Ketoconazole (400 mg daily) increased tadalafil (20 mg) exposure (AUC) 4-fold and Cmax by 22 %. Ritonavir, a protease inhibitor (200 mg twice daily), which is an inhibitor of CYP3A4, CYP2C9, CYP2C19, and CYP2D6, increased tadalafil (20 mg) exposure (AUC) 2-fold with no change in Cmax. Consequently, the incidence of the adverse reactions listed in section 4.8 might be increased. CIALIS must not be used in men with cardiac disease for whom sexual activity is inadvisable. Physicians should consider the potential cardiac risk of sexual activity in patients with pre-existing cardiovascular disease.

Tadalafil is in a class of medications called phosphodiesterase (PDE) inhibitors. It works to treat erectile dysfunction by increasing blood flow to the penis during sexual stimulation. Tadalafil treats PAH by relaxing the blood vessels in the lungs to allow blood to flow more easily.

This may be a good option for people who have trouble swallowing pills. Tadalafil encourages blood flow to the penis, by blocking the action of PDE5. In women, PDE5 does not prevent blood flow to the genitals, to the same extent as it does in men. This means that it is unlikely to have much of an effect on women. Pharmaceutical companies which produce generic copies of existing medicines do not incur the high initial research and development costs.

This can be due to lifestyle factors damaging the blood vessels, underlying health problems, or there could be psychological causes. If you're concerned about on going&nbsp