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Also tell them if you smoke, drink alcohol, or use illegal drugs. Once aroused, a natural chemical is released, which the PDE5 inhibitors rely on to work with. Once this natural chemical is released, a chain reaction begins, relaxing the smooth muscle inside the penis. There is then an increase in blood flow into the penis allowing the penis to can become erect. It belongs to the group of drugs known as phosphodiesterase type 5 inhibitors, or PDE5 inhibitors.

Three studies were conducted in men to assess the potential effect on sperm characteristics of tadalafil 10 mg (one 6 month study) and 20 mg (one 6 month and one 9 month study) administered daily. There were no adverse effects on sperm morphology or sperm motility in any of the three studies. This effect was not seen in the study of 20 mg tadalafil taken for 6 months. In addition there was no adverse effect on mean concentrations of reproductive hormones, testosterone, luteinizing hormone or follicle stimulating hormone with either 10 or 20 mg of tadalafil compared to placebo. A study was conducted to assess the interaction of sustained-release metoprolol (25 to 200 mg daily) and tadalafil 10 mg. Following dosing, the mean reduction in supine systolic/diastolic blood pressure due to tadalafil 10 mg in subjects taking metoprolol was 5/3 mm Hg, compared to placebo.

Cialis tablets should be stored in a dry place at room temperature (68-77 F). Cialis was also investigated in combination with finasteride, another BPH medication, in another trial. The results showed the combination to be even more effective than either medication alone. Interestingly, Cialis has been more linked to improved self-esteem and other psychological factors than the other PDE5 medications. Tadalafil is sometimes prescribed off-label to treat ureteral stones (a type of kidney stone) and Raynaud’s syndrome. With ED, the penis cannot get or stay erect long enough for sex.

Some tadalafil brands are 'scored' with an indented line in the middle of the tablet to enable splitting. The usual advice for tadalafil tablets that are not scored, is that patients should use the minimum effective dose as a whole tablet. Tadalafil tablets are film-coated, however this is not an extended or delayed release coating (to achieve delayed absorption), so tablets should actually be safe to split. It has been suggested that tablet 'halves' may not contain equal doses but in reality any discrepancy is likely to be minimal. It can therefore be difficult to make an even break and sometimes the 'halves' may crumble. Erectile dysfunction can be caused by stress, psychosexual problems, and lifestyle choices such as smoking, heavy drinking, obesity, and lack of exercise.

Therefore, PDE5 inhibitors, including CIALIS, should be used with caution in these patients and only when the anticipated benefits outweigh the risks. PDE5inhibitors, including CIALIS, and alpha-adrenergic blocking agents are both vasodilators with blood-pressure-lowering effects. [see DOSAGE AND ADMINISTRATION, WARNINGS AND PRECAUTIONS, and CLINICAL PHARMACOLOGY] . Studies show that the drug begins to work 30 minutes to 6 hours after you take your first dose.

Normally, it is taken 1-2 hours before having sexual intercourse for it to be effective. In February 2007, it was announced that Boots, the UK pharmacy chain, would try over-the-counter sales of Viagra in stores in Manchester, England. Back pain