Buy Tadalafil (Cialis) online

Buy Cialis (Tadalafil) drug for erectile dysfunction and PAH
Cheap qualitative Tadalafil 2.5 mg - 800 mg tablets online



HOW AND WHERE TO BUY TADALAFIL (CIALIS) 2.5, 5, 10, 20, 40, 50, 60, 80, 100, 200, 800 MG TABLETS AND CAPSULES ONLINE:

CIALIS (TADALAFIL): WARNINGS

Evaluation of erectile dysfunction should include an appropriate medical assessment to identify potential underlying causes, as well as treatment options.

Before prescribing Tadalafil (Cialis), it is important to note the following:

Cardiovascular

Physicians should consider the cardiovascular status of their patients, since there is a degree of cardiac risk associated with sexual activity. Therefore, treatments for erectile dysfunction, including Cialis (Tadalafil), should not be used in men for whom sexual activity is inadvisable as a result of their underlying cardiovascular status. Patients who experience symptoms upon initiation of sexual activity should be advised to refrain from further sexual activity and seek immediate medical attention.

Physicians should discuss with patients the appropriate action in the event that they experience anginal chest pain requiring nitroglycerin following intake of Tadalafil (Cialis) tablets. In such a patient, who has taken Cialis, where nitrate administration is deemed medically necessary for a life-threatening situation, at least 48 hours should have elapsed after the last dose of Cialis tablets before nitrate administration is considered. In such circumstances, nitrates should still only be administered under close medical supervision with appropriate hemodynamic monitoring. Therefore, patients who experience anginal chest pain after taking Cialis (Tadalafil) tablets should seek immediate medical attention.

Patients with left ventricular outflow obstruction, (e.g., aortic stenosis and idiopathic hypertrophic subaortic stenosis) can be sensitive to the action of vasodilators, including PDE5 inhibitors.

The following groups of patients with cardiovascular disease were not included in clinical safety and efficacy trials for Tadalafil (Cialis), and therefore until further information is available, this drug is not recommended for the following groups of patients:

  • unstable angina or angina occurring during sexual intercourse
  • myocardial infarction within the last 90 days
  • New York Heart Association Class 2 or greater heart failure in the last 6 months
  • stroke within the last 6 months.
  • uncontrolled arrhythmias, hypotension ( < 90/50 mm Hg), or uncontrolled hypertension ( > 170/100 mm Hg)

    As with other PDE5 inhibitors, tadalafil has mild systemic vasodilatory properties that may result in transient decreases in blood pressure. In a clinical pharmacology study, tadalafil 20 mg resulted in a mean maximal decrease in supine blood pressure, relative to placebo, of 1.6/0.8 mm Hg in healthy subjects. While this effect should not be of consequence in most patients, prior to prescribing Cialis (Tadalafil), physicians should carefully consider whether their patients with underlying cardiovascular disease could be affected adversely by such vasodilatory effects. Patients with severely impaired autonomic control of blood pressure may be particularly sensitive to the actions of vasodilators, including PDE5 inhibitors.

    Potential for Drug Interactions When Taking Tadalafil (Cialis) tablets for Once Daily Use

    Physicians should be aware that Cialis for once daily use provides continuous plasma tadalafil levels and should consider this when evaluating the potential for interactions with medications (e.g., alpha-blockers, nitrates, anti-hypertensives and potent inhibitors of CYP3A4) and with substantial consumption of alcohol.

    Prolonged Erection

    There have been rare reports of prolonged erections greater than 4 hours and priapism (painful erections greater than 6 hours in duration) for this class of compounds. Priapism, if not treated promptly, can result in irreversible damage to the erectile tissue. Patients who have an erection lasting greater than 4 hours, whether painful or not, should seek emergency medical attention.

    Cialis tablets should be used with caution in patients who have conditions that might predispose them to priapism (such as sickle cell anemia, multiple myeloma, or leukemia), or in patients with anatomical deformation of the penis (such as cavernosal fibrosis, angulation, or Peyronie's disease).

    Eye

    Physicians should advise patients to stop use of all PDE5 inhibitors, including Cialis (Tadalafil) tablets, and seek medical attention in the event of a sudden loss of vision in one or both eyes. Such an event may be a sign of non-arteritic anterior ischemic optic neuropathy (NAION), a cause of decreased vision, including permanent loss of vision that has been reported rarely postmarketing in temporal association with the use of all PDE5 inhibitors. It is not possible to determine whether these events are related directly to the use of PDE5 inhibitors or other factors. Physicians should also discuss with patients the increased risk of NAION in individuals who have already experienced NAION in one eye, including whether such individuals could be adversely affected by use of vasodilators such as PDE5 inhibitors.

    Patients with known hereditary degenerative retinal disorders, including retinitis pigmentosa, were not included in the clinical trials, and use in these patients is not recommended.

    Sudden Hearing Loss

    Doctors should advise patients to stop taking PDE5 inhibitors, including Tadalafil (Cialis), and seek prompt medical attention in the event of sudden decrease or loss of hearing. These events, which may be accompanied by tinnitus and dizziness, have been reported in temporal association to the intake of PDE5 inhibitors, including Cialis (Tadalafil). It is not possible to determine whether these events are related directly to the use of PDE5 inhibitors or to other factors.

    Alpha blockers and Antihypertensives

    Healthcare providers should discuss with patients the potential for Tadalafil (Cialis) tablets to augment the blood-pressure-lowering effect of alpha blockers and antihypertensive medications.

    Caution is advised when PDE5 inhibitors are coadministered with alpha blockers. PDE5 inhibitors, including Cialis, and alpha-adrenergic blocking agents are both vasodilators with blood-pressure-lowering effects. When vasodilators are used in combination, an additive effect on blood pressure may be anticipated. In some patients, concomitant use of these two drug classes can lower blood pressure significantly, which may lead to symptomatic hypotension (e.g., fainting). Consideration should be given to the following:

  • Patients should be stable on alpha-blocker therapy prior to initiating a PDE5 inhibitor. Patients who demonstrate hemodynamic instability on alpha-blocker therapy alone are at increased risk of symptomatic hypotension with concomitant use of PDE5 inhibitors.
  • In those patients who are stable on alpha-blocker therapy, PDE5 inhibitors should be initiated at the lowest recommended dose.
  • In those patients already taking an optimized dose of PDE5 inhibitor, alpha-blocker therapy should be initiated at the lowest dose. Stepwise increase in alpha-blocker dose may be associated with further lowering of blood pressure when taking a PDE5 inhibitor.
  • Safety of combined use of PDE5 inhibitors and alpha blockers may be affected by other variables, including intravascular volume depletion and other antihypertensive drugs.

    Recent posts:

  • Buy Cialis (Tadalafil) Online
  • Cialis prescribing information

    Copyright © Buy Tadalafil Online