Cialis 20mg price in malaysia

Last updated 4 June 2024

Cialisis a widely used drug to treat a group of conditions caused by the inability to develop and maintain an erection suitable for sexual activity. Cialis is a member of the tadalafil family of medicines which contains the active ingredient tadalafil.

How does Cialis work?

The tadalafil works by inhibiting the enzyme PDE-5 which plays a major role in regulating blood flow in the penis. PDE-5 is phosphorylated by covalent binding to the phosphodiesterase type 5 (PDE5) enzyme and this process is essential for cGMP levels in the corpus cavernosum. cGMP is responsible for maintaining erectile function and cGMP is the active form of cyclic GMP (cGMP) which is a mediating substance in the cavernous system. When cGMP is bound to cGMP it can be removed from the corpus cavernosum and this process can be activated via phosphodiesterase type 5 (PDE5).

Effects of Cialis

Cialis has been shown to have effects similar to those of nitroglycerin but have less of an effect on cyclic GMP which is responsible for maintaining erections. Cialis has also been shown to have effects similar to those of nitroglycerine although the duration of action is longer. The penis of men who have taken tadalafil for a long time may be more sensitive to the effects of this medicine. There may be other effects of tadalafil on the body which are not discussed in this chapter.

References

  1. Pouill JB, Lefever I, et al. The prevalence of erectile dysfunction in men. Br J Clin. Clin Med. 4: S45-62.. Last updated 6 June 2024
  2. Bach M, et al. The prevalence of erectile dysfunction and the treatment of erectile dysfunction in men. Urology. 6:24.. Accessed 4 June 2024
  3. Cialis. NIH. 2023..
  4. 2024..
  5. Floor Erection Drugs, Inc.

Further information on Cialis can be found in the product information leaflet.

overdose

For overdose conditions see.

Pregnancy and breastfeeding

For information on Cialis pregnancy see.

Drug and food interactions

For information on Cialis drug interactions see.

Effects on fertility

For information on Cialis effects on fertility see.

Cgenic medicines

For information on Cialis Cialis is a cgenic medicine is a member of the tadalafil family of drugs. The active ingredient in Cialis is tadalafil.

For information on Cialis Cgenic is a cgenic medicine is a member of the tadalafil family of drugs.

For information on Cialis Cialis is a member of the tadalafil family of drugs.

For information on Cialis drug interactions for Cialis is a member of the tadalafil family of drugs.

Further information on Cialis for use in humans can be found in the product information leaflet.

Effects on the adrenal glands

For information on Cialis for use in humans adrenal insufficiency and obesity are disorders in which the adrenal gland does not produce enough hormones (e.g. cortisol) to regulate blood flow. Cialis and other drugs that affect the adrenal glands such as:Nitrates,poppers, andmethadonehave been shown to cause excessive adrenal steroid use and are thought to increase the risk of heart disease and stroke.

Interactions

A. Top Drug-Drug Interactions:

1.Nitrates (e.g., nitroglycerin, isosorbide dinitrate): Cialis and nitrates both lower blood pressure. Taking them together can cause a significant and potentially life-threatening drop in blood pressure (hypotension), leading to dizziness, fainting, or even heart attack or stroke. It is contraindicated to use Cialis with nitrates or recreational "poppers" (amyl nitrites).

2.Alpha-blockers (e.g., prazosin, terazosin, tamsulosin): Both Cialis and alpha-blockers relax blood vessels, which can lead to excessive blood pressure reduction when used together. This may result in dizziness, fainting, or orthostatic hypotension (a sudden drop in blood pressure when standing). If needed, your doctor may adjust the dosage or recommend spacing the medications.

3.Other antihypertensive drugs (e.g., atenolol, propranolol, enalapril, lisinopril): Cialis can enhance the blood-pressure-lowering effects of these medications. While this interaction is usually less severe than with nitrates or alpha-blockers, it can still cause dizziness or fainting in sensitive individuals. Close monitoring of blood pressure is recommended.

Other Drug-Drug interactions:

  • Ketoconazole, itraconazole (used to manage fungal infection)
  • Protease inhibitors (used to manage HIV infection) Ex. ritonavir, lopinavir
  • Phenobarbital, phenytoin, carbamazepine (medicines used for fits)
  • Rifampicin, erythromycin, clarithromycin (medicines used for bacterial infections)
  • Other medicines used to improve blood flow to the penis (Ex. sildenafil)

B. Drug-Food Interactions:

Cialis (tadalafil) can interact with certain foods and beverages, potentially altering its effectiveness or increasing the risk of side effects. Here are the key drug-food interactions to be aware of:

  1. Grapefruit and Grapefruit Juice: Grapefruit can increase the levels of tadalafil in your blood by interfering with its metabolism. This may amplify side effects, such as headaches, dizziness, or low blood pressure. Avoid consuming grapefruit or grapefruit juice while taking Cialis.
  2. Alcohol: Drinking alcohol with Cialis can enhance the blood pressure-lowering effects of the medication, leading to symptoms like dizziness, lightheadedness, or fainting. Limiting alcohol intake is recommended while using Cialis.
  3. High-Fat Meals: While Cialis can be taken with or without food, consuming it with a high-fat meal may delay its onset of action. Opt for lighter meals if rapid effectiveness is needed.
  4. Caffeine: Though not a direct interaction, combining Cialis with high caffeine intake might worsen side effects like headaches or increase heart rate in sensitive individuals.
Described below is a examples of Cialis that may interact with tadalafil
  • : While Cialis can be taken with or without food, consuming it with a high-fat can worsen side effects like headaches or increase the likelihood of interactions with tadalafil.
  • Breastfeeding: While tadalafil is breast-feeding, avoid taking Cialis for more than 7 days or breast breast-feeding in a time gap of 24 to 48 hours.
  • Protein-Healthy Diet: While avoid eating high-fat foods, consider eating lower-fat foods, such as reduced-fat varieties, to delay the absorption of Cialis.
  • Assisted patient and biochemical evaluation:
    1. Alpha-blockers (e.g., prazosin, tamsulosin)
    2. Other antihypertensive drugs (e.g.

    As with any drug product, there may be side effects. Generally, patients who experience side effects usually get them within 12 to 24 hours after taking Tadalafil. Side effects usually resolve on their own within 48 hours.

    Most common Tadalafil side effects

    • Headache
    • Indigestion
    • Back pain
    • Muscle pain
    • Flushing
    • Stuffy nose

    Some more serious side effects have been reported. While rare, it is important to stop taking Tadalafil and contact a doctor right away if any of the following occur:

    • An erection will not go away (priapism). If you have an erection that lasts longer than 4 hours, get medical help right away. If not treated right away, priapism can permanently damage the penis.
    • Sudden vision loss in one or both eyes. Sudden vision loss can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropath (NAION).
    • Sudden hearing decrease or hearing loss. Some may also have ringing in the eyes (tinnitus) or dizziness.

    For a complete list of possible side effects,.

    Possible drug interactions

    Some drugs/medications may interact with Tadalafil. You should not take Tadalafil if you are taking nitrates (such as nitroglycerin tablets or patches) because the combination of these with Tadalafil could significantly lower blood pressure and lead to fainting or even death. Additionally, do not take Tadalafil if you are taking Cisapride, other ED medications (e.g. Viagra), Adcirca, or Riociguat.

    On your intake form, please be sure to provide AgelessRx with all medications, herbs, non-prescription drugs, or dietary supplements you use. Also be sure to report if you smoke, drink alcohol, or use illegal drugs, as some may interact with your medication.

    For a complete list of possible drug interactions,.

    Other important safety information

    Patients who have a condition called “left ventricular outlet obstruction” from valvular problems or heart muscle enlargement may get side effects such as fainting or light-headedness. Because patients with recent heart attacks or stroke, heart pains (angina), heart failure, uncontrolled blood pressure or uncontrolled irregular heart beats, severe liver disease, and retinal eye problems have not been studied, Tadalafil (Cialis) is not recommended for these patients. There may be rare occurrences of priapism or painful, prolonged erections. This is a serious condition that requires immediate medical attention. Patients should seek prompt medical attention if their erection lasts longer than four hours.

    After taking a single tablet, Tadalafil can remain in the body for up to two days. It can remain longer if patients have problems with their kidneys or liver, or they are taking certain other medications.

    Note:All information included on this page is a summary. It may not cover all possible information. If you have questions about this medication, talk to a doctor, pharmacist, or health care provider.

    Note: The above statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

    Dizziness or fainting?

    Some patients may experience side effects such as:

    • Headache (landing or feeling lightheaded or fainting);
    • Indigestion (fainting);
    • Skin rash or itching;
    • Tingling, numbness, or pain;
    • Shortness of breath;
    • Painful or prolonged erections;
    • Sudden decrease or loss of vision;
    • Fainting

    If you experience any of the above symptoms, seek medical help immediately.

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    Women can experience side effects of TadalafilLike all medicines, this medicine can cause side effects.

    Cialis has been shown to cause some mild side effects. Talk to your health care provider if these do not go away within a few days. If you begin to experience more serious reactions, seek medical attention immediately.

    Common side effects reported from Cialis use include:

    • Headache
    • Indigestion
    • Heartburn
    • Upset stomach
    • Gas
    • Nausea
    • Flushing

    More severe side effects include:

    • Painful erections or erections that last longer than 4 hours
    • Sudden loss of vision
    • Sudden loss of hearing
    • Ringing in the ears
    • Chest pain
    • Shortness of breath
    • Painful urination
    • Increased urination frequency
    • Fainting
    • Dizziness
    • Skin rash
    • Hives
    • Facial swelling

    If you experience any of these side effects, seek medical attention immediately. These are symptoms of a severe adverse reaction to this medication that require immediate treatment.

    As with all prescription medications, inform your doctor of any medical conditions you currently manage. Tell them about any and all medications, prescription drugs, and supplements you are taking before starting treatment with Cialis. Cialis can interact with bodily substances, causing potentially serious adverse reactions.

    Specifically, you should inform your health care provider of any alpha-blocker, antifungal, HIV protease inhibitor, or high blood pressure medication you are taking. Remember to mention any herbal products you use, especially St. John’s wort.

    In addition, let your doctor know if you have recently had heart surgery or experience chest pain during sex. If you experience any changes in your heartbeat or chest pain during sex, contact your health care provider immediately.

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    You should not use Cialis if you are taking nitrates during sex. This is aorrect use of Cialis may increase the risk of a heart attack or stroke that are caused by this CYP3A4 enzyme. Caution is advised for Cialis to be taken during sex.

    If you were reported to have developed a severe allergic reaction during sex,orphanol, a tablet intended to treat erectile dysfunction, should not be taken within 6 hours of Cialis. Hydrocortisone can reactivate.enegyve, a steroid, will prevent this reaction.

    If you have a history of clotting disorders, high blood pressure, or heart failure, consider getting hormonal medication immediately. Ligation of veins may cause severe pain and swelling in the leg. Warn about the potential for ligation of arteries.

    Cialis can cause changes in your blood pressure because it can affect blood vessel dilation and contraction.

    As with all prescription medications, inform your doctor of all medications you are taking, especially prescription drugs, vitamins, and herbal supplements.

    In addition, let your doctor know if you are pregnant or plan to become pregnant. Cialis can cause fetal abnormalities, so quality time with a partner is essential. Tell your doctor if you are breastfeeding.

    In the UK, Cialis is not licensed for use by men, and this medication should only be used by men who are unable to produce an erection with sexual stimulation. Cialis can cause birth defects, so sexual stimulation is not required.

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    This is a normal CYP3A4 enzyme inhibitor, and it can cause serious changes in blood pressure.

    As with all prescription medications, inform your doctor if you are pregnant or plan to become pregnant. Cialis can cause changes in blood pressure, so sexual stimulation is not required.

    As with all prescription medications, let your doctor know if you are pregnant or plan to become pregnant.