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Cialis is an effective, reversible, selective inhibitor of phosphodiesterase type 5 (PDE 5) specific to cyclic guanosine monophosphate (cGMP). When sexual stimulation causes local release of nitric oxide, inhibition of PDE 5 by Cialis leads to increase of cGMP levels in the cavernous body of penis.

It results in relaxation of arterial smooth muscles and blood flow to the tissues of the penis that causes erections. Cialis has no effect when sexual stimulation is absent. Cialis improves erection and lets achieve a successful sexual intercourse.

The drug acts during 36 hours. If sexual arousal is present the effect appears even after 16 minutes after the medication was taken. The recommended dose of Cialis is 20 mg it should be taken at least 16 minutes before the sexual activity.

The effect persists during 36 hours. Take Cialis once daily and do not exceed the recommended dose.It is preferable not to use Cialis with grapefruit juice, alcoholic beverages, tobacco. If you smoke tobacco and take Cialis concomitantly this may lead to a condition called NAION (sudden optic nerve-related vision loss).

Inform your doctor before to take Cialis if you have abnormal penis, including curved penis and birth defects of the penis, had coronary artery disease, arrhythmia, angina, heart attack or heart failure, hypo- or hypertension, bleeding, stomach ulcers, diabetes, hyperlipidemia (excess of lipids in the blood), sickle-cell anemia, liver or kidney failure in history.

Most usual side effects of Cialis are facial flushing (reddening), headaches, stomach upset, diarrhea, flu-like symptoms and nausea. In more rare cases low blood pressure, blurred vision and changes in color vision, and abnormal ejaculation may occur.

Prolonged erections or priapism (painful erections lasting more than 6 hours) are also possible. If your erection is longer than 4 hours, seek for immediate medical help as it may permanently damage your penis.

Aggravation of heart problems in patients with pre-existing heart disease using Cialis was reported.Co-administration with medications containing organic nitrates may cause severe hypotension which is dangerous in some cases. Avoid taking Calis with medications such as Erythrityl Tetranitrate, Isosorbide Dinitrate, Isosorbide Mononitrate, Nitroglycerin, Pentaerythritol Tetranitrate.

Levels and toxicity of Cialis are increased by erythromycin, ketoconazole (Nizoral), itraconazole (Sporanox), indinavir (Crixivan) and ritonavir (Norvir).

Inform your doctor if you are taking Atazanavir, Bunazosin, Clarithromycin, Doxazosin, Erythromycin, Indinavir, Itraconazole, Ketoconazole, Moxisylyte, Nefazodone, Nelfinavir, Phenoxybenzamine, Phentolamine, Prazosin, Saquinavir, Telithromycin, Terazosin, Trimazosin, Urapidil as your Cialis dose may require correction.

We also advise you to purchase these medications: BRAND VIAGRA and TENTEX FORTE

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