Sialis

• Structure
• Release form
• Pharmacological action
• Pharmacodynamics and pharmacokinetics
• Indications to use
• Contraindications
• Side effects
• Application instruction of Sialis
• Overdose
• Interaction
• Terms of sale
• Storage conditions
• Period of validity
• Special instructions
• Analogs
• With alcohol
• At pregnancy and a lactation
• Responses
• The price where to buy

Structure

Tablets Sialis contain in structure 5 mg of a tadalafil, lactose (in the form of monohydrate) and the monohydrate which is dried up by lactose spraying, a hypro rod and an extra thin hypro rod, Na lauryl sulfate, MKTs, Na kroskarmelloza, vegetable Mg stearate.

Structure p / about: Opadry yellow (gipromelloza, triacetin, Ti dioxide, lactoses monohydrate, E172 dye (yellow)).

Release form

Tablets in p/o.5 mg. Packaging No. 14 and No. 28.

Tablets of an amygdaloid form, are covered with a light yellow film cover. On one of the parties it is engraved "With 5".

Pharmacological action

Improves erectile function.

Pharmacodynamics and pharmacokinetics

What is Sialis?

Sialis (tadalafit) - it is drug, reversibly and tsGMF (a cyclic guanozinmonofosfat) which is selectively suppressing specific FDE-5.

In Wikipedia it is said that drug is intended for treatment of frustration at which the man is not capable to reach and keep an erection, necessary for commission of the sexual intercourse.

Pharmacodynamics

At sexual excitement there is a local release of nitrogen oxide, and owing to suppression by the drug FDE-5 concentration of a cyclic guanozinmonofosfat in a cavernous body of a penis increases.

As result of they are unstriated muscles of arteries relax, inflow of blood to tissues of a penis amplifies and there is an erection. In lack of sexual excitement the similar effect is absent.

The increased concentration of tsGMF are observed also in smooth muscles of a bladder, prostate and the vessels supplying with their blood.

Relaxation of muscles of vessels promotes increase in perfusion (passing) in blood in these bodies and to reduction of expressiveness of symptoms of DGPZh, and relaxation of unstriated muscles of a bladder and prostate in addition strengthens vascular effects.

Improving an erection, tadalafit thus raises a possibility of carrying out PAS (sexual intercourse).

At the same time healthy men have it, in comparison with placebo, change DAD, the GARDEN and ChSS does not cause reliable change, does not influence the electroretinogram, visual acuity, VGD and the size of a pupil, (green/blue) does not break ability of recognition of flowers.

Pharmacokinetics

After reception of a tablet tadalafit well it is absorbed in an organism. Concentration of substance in a blood plasma reaches peak values in 2 hours after reception. The food and time of administration of drug do not exert clinically significant impact on the speed of absorption of a tadalafil and its bioavailability.

About 94% of substance are in the state connected with plasma proteins. It is metabolized in a liver with the participation of CYP3A4 isoenzyme. The main circulating metabolite in comparison with tadalafily shows at least in 13 thousand times smaller activity concerning FDE-5.

The average period of semi-elimination at healthy men — 17.5 hours. Drug is excreted generally in the form of pharmacological inactive metabolites. About 61% of the accepted dose are removed with excrements, about 36% — with urine.

Indications to use

Drug is used at ED (erectile dysfunction); at SNPM (symptoms of the lower uric ways) at patients with DGPZh; at ED at patients with SNMP against DGPZh.

Contraindications

Sialis do not appoint at:

• hypersensitivity to a tadalafil or auxiliary components of tablets;
• simultaneous use of any drug containing organic nitrates;
• simultaneous use of Doksazozin or drugs for treatment of ED;
• existence of contraindications to sexual activity at men with pathologies of heart and vessels (unstable stenocardia, the postponed within the last three months IT, the attacks of stenocardia, HSN II-IV of classes arising during PAS according to classification of NYHA, AG, uncontrollable arrhythmias, ischemic stroke which is had during the last half a year);
• connected or not connected using FDE-5 NAION inhibitors (front ischemic neuropathy of an optic nerve);
• lactose intolerances, lactose intolerance, malabsorption of a glucose/galactose.

Besides, drug is contraindicated to persons more young than eighteen-year age, and more than 2 rubles/week at men with damages of kidneys at which Clcr is lower than 30 ml/min. cannot be applied.

Relative contraindications

Due to the lack of data concerning persons with the liver failure corresponding on classification of Chayld-Pyyu to the S-class it is necessary to show care at use of a tadalafil in this group of patients.

With care Sialis appoint to persons who receive medical treatment for blockers α1-адренорецепторов. It is connected with what at simultaneous use of a tadalafil with the specified drugs has risk of development of the symptomatic arterial hypotension (SAH).

Clinical trials of pharmacological properties of a tadalafil in group of healthy men, showed that the single dose of a standard dose of Sialis does not give to SAGAS at simultaneous use α1А-адреноблокатора a tamsulozin. 18 people took part in research.

Other restrictions to use:

• predisposition to a priapism;
• anatomic deformation of a penis;
• concomitant use of hypotensive drugs, and also the drugs which are powerfully suppressing CYP3A4 isoenzyme (Erythromycin, Sakvinavir, Itrakonazol, Ritonavir, Ketokonazol).

Diagnosis of ED has to include identification of a basic reason of impotence, carrying out the corresponding inspection and definition of adequate therapy.

Side effects

At erection dysfunction Sialis's use most often is followed by muscle or spin pain, a headache, rushes of blood to the person, dyspepsia, a nose congestion.

At patients with ED/DGPZH extremity and/or muscles pains, a headache, a gastroesophageal reflux (GER), dyspepsia were most often fixed.

Other possible side reactions:

• often — dizziness;
• infrequently — hypersensitivity reactions, an illegibility of perception of visual objects, pain in an eyeglobe, tachycardia, a heart consciousness, increase or decrease in the ABP (the last is possible at the persons which were already accepting antihypertensives), an asthma, a congestion of a nose, GER, an abdominal pain, a hyperhidrosis, rash;
• seldom — a stroke (including an acute disorder of blood circulation of a brain with a rupture of a vessel and hemorrhage (ONMK on hemorrhagic type)), tranzitorny amnesia, an epileptic seizure, a swelling a century, disturbance of fields of vision, an injection (expansion) of vessels of a sclera of an eyeglobe, to THEM, bleeding from a nose, the small tortoiseshell, a long erection.

At patients with earlier being available risk factors of development of SSZ arose:

• infrequently — a stethalgia;
• in rare instances — faints, migraines, tranzitorny ischemic attacks, a sudden cardiac death.

However precisely to tell, these phenomena using a tadalafil, are connected by risk factors of development of SSZ, sexual excitement, other factors or a combination of factors, or not, it is impossible.

Also there are messages on separate cases of a sudden hearing loss against use of FDE-5 inhibitors (including tadalafit) during clinical and post-market researches.

Side effects which arose during post-market researches, but were not found when carrying out clinical placebos - controlled researches:

• face edema;
• migraine;
• NAION;
• occlusion of vessels of a retina;
• unstable stenocardia;
• ventricular arrhythmias;
• exfoliative dermatitis;
• priapism;
• Stephens-Johnson's syndrome;
• sudden cardiac death.

Application instruction of Sialis

How to accept Sialis at ED?

Patients with frequent sexual activity when the PAS occurs more than 2 rubles/week, are recommended to take a pill of 5 mg daily, on one, at the same time. Depending on individual portability it is possible to reduce a dosage of a tadalafil to 2.5 mg.

If PASES occur less than 2 rubles/week, it is recommended to take a pill just before a coitus in a dose of 20 mg.

Admissible upper limit of a daily dose of drug Sialis — 20 mg.

The application instruction of Sialis on indications of ED/DGPZH or DGPZh

At the specified pathologies to the patient appoint administration of drug of 1 ruble/day on one tablet, at the same time (any, irrespective of time of meal and time of sexual activity).

Duration of a course of treatment Sialis of 5 mg is established individually.

In addition

At damages of kidneys when the indicator of Clcr makes 31-80 ml/min., there is no need for dose adjustment. Daily use of drug is contraindicated to patients with severe damages of kidneys at which Clcr does not exceed 30 ml/min.

Overdose

The single dose to 0.5 g of a tadalafil the healthy person and repeated use to 100 mg/days of a tadalafil for patients with dysfunction of an erection is followed by the side effects similar to that arise at use of lower of drug.

In case of overdose carry out standard symptomatic therapy. Sialis is practically not brought at a hemodialysis.

Interaction

On tadalafit influence of other HP

Sialis's biotransformation is carried out with the participation of CYP3A isoenzyme in this connection the drugs inhibiting this isoenzyme increase size Smakh and AUC of a tadalafil.

In spite of the fact that specific researches were conducted only concerning interaction of a tadalafil with Ketokonazol and Ritonavir, it is possible to assume that such drugs as Itrakonazol and Erythromycin, are also capable to increase activity of a tadalafil.

Rifampicin which is the inductor CYP3A reduces exposure of a single dose of drug and size Smakh. Most likely, simultaneous use of other HP from group of the inductors CYP3A, has to promote decrease in plasma concentration of a tadalafil.

Sialis's use in a combination with antacids (Al/hydroxide Mg hydroxide) promotes reduction in the rate of absorption of active agent of drug without change of AUC for a tadalafil.

The drugs raising an indicator of acidity of a stomach (pH), and, in particular, H2 blocker nizatidin do not influence pharmacokinetic parameters of a tadalafil.

Research of safety and efficiency of use of Sialis in combination with other methods of treatment of dysfunction of an erection (including with other FDE-5 inhibitors) was not carried out to combinations in this connection it is recommended to avoid similar combinations.

Tadalafil does not promote increase in the bleeding time caused by reception of ASK.

Influence of a tadalafil on other HP

Tadalafil is capable to strengthen hypotensive effect of nitrates because of what these drugs are not appointed in a combination.

Substance has no significant effect on clearance of HP which are metabolized with the assistance of system of P450 cytochrome. During researches it was established that tadalafit:

• does not suppress and does not induce isoenzymes of CYP3A4, CYP1A2, CYP2C19, CYP2C9, CYP2T1 and CYP2D6;
• has no significant effect on pharmacokinetics of S-or R-warfarin, and also on effect of warfarin concerning PTV (prothrombin time);
• does not increase duration of the bleedings provoked by reception of ASK;
• causing system vasodilating effect, it is capable to strengthen hypotensive action of the ABP of means intended for decrease (at the patients accepting several hypotensive drugs at badly controlled AG, the ABP decreased it is more expressed; at the same time at most of patients this phenomenon was not connected with hypotensive symptoms);
• has no significant effect on a pharmacodynamics and a pharmacokinetic profile of Theophylline.

Results of two researches show that use of drug for healthy men in a combination with Tamsulozin (α1А-адреноблокатор) does not cause essential decrease in the ABP.

Use by healthy volunteers of drug with α1-адреноблокатором Doksazozin (provided that the last is accepted in the dose making from 4 to 8 mg/days) was followed by strengthening of hypotensive action of Doksazozin. Certain patients had symptoms connected with pressure decrease, including a syncope.

Terms of sale

According to the recipe.

Storage conditions

Three years.

Period of validity

Tablets have to be stored at a temperature below 30 °C.

Special instructions

Sexual activity can be dangerous at a number of pathologies of heart and vessels. In this regard to the men with diseases demanding restrictions of sexual activity, treatment of dysfunction of an erection, including tadalafily, contraindicated.

There are messages on cases of emergence of a priapism (the long, not connected with sexual excitement, involuntary erection) against treatment by FDE-5 inhibitors.

It is necessary to inform patients on need to see urgently a doctor if the erection remains during four (and more) hours. In the absence of the timely help similar states lead to irreversible impotence.

As well as other FDE-5 inhibitors, drug are caused by system vasodilatation that can provoke tranzitorny decrease in the ABP. Before purpose of a tadalafil the doctor has to be convinced that the patient with pathology of hearts/vessels will not undergo undesirable influence due to this effect.

Not arterial AION is one of the reasons of vision disorders (in some cases before its total loss). During post-marketing supervision messages on exceptional cases of development of this pathology were fixed (cases were connected on time using FDE-5 inhibitors).

To establish precisely whether is available between treatment tadalafily and NAION a feedforward, is impossible today.

In case of sudden loss of sight reception of a tadalafil it is necessary to stop and ask for medical care.

The patient also has to be warned that at the transferred NAION of people, the risk of repeated development of optical neuropathy is high.

If at the patient the diagnosis of DGPZh is supposed, it should pass additional inspection to exclude a prostate cancer.

In spite of the fact that dizzinesses at reception of a tadalafil arose with the same frequency, as at placebo reception, during treatment it is necessary to be careful when driving and mechanisms.

Sialis's analogs

Analogs with the close mechanism of action: AFALAZA, Viasan-LF, Viagra, Yohimbine hydrochloride, Verona, Dinamiko, Vizarsin, Tornetis, Zidena, Raylis, Maksigra, Silafil, Impaza, Sirbida, Sildenafil, Olmaks Strong.

Sialis's generics — what is it and what they differ from original drug in?

The most popular generics of Sialis (generic Cialis) — Sialis Soft, Sialis Forte, Sialis Kapsuly.

Sialis Forte is feature of generic the fact that he at the action duration, identical with Sialis, acts quicker and provides more resistant erection.

Generic Sialis Soft also works quicker, than usual tablets Sialis. The effect is reached thanks to the fact that drug is accepted sublingual, and thanks to it contained in it tadalafit gets to a system blood stream quicker.

In drug Sialis Kapsuly active agent contains in a type of the concentrated gel placed in an instant gelatinous cover. Such dosage form provides higher speed of influence of a tadalafil. Important feature of capsules is also that the tadalafila in them contains 4 times more, than in tablets.

Effect duration at use of capsules approximately same, as well as at use of the tableted drug form.

For people who for any reason cannot or do not want to take a pill, Sialis Gel is issued.

One more analog of drug is female Sialis — Female Cialis. Generic promotes increase in inflow of blood to generative organs of the woman and thus increases their sensitivity to stimulation.

Along with tablets Sialis Oranzh also tablets of high power and duration of action Sialis Black of 800 mg are issued.

Also there are generics with an extra-dosage of active agent:
Cialis Extra Dosage (40, 50, 60, 200, 100 mg; 30 tablet, 40 tablet, 60 tablet, 90 tablet, 120 tablet, 180 tablet, 10 or 20 tablet);
Cialis Professional (20 mg and 40 mg; 10, 20, 30, 40, 60, 90, 120, 180 tablet).

On many foreign websites and in Internet drugstores (pharmacy/apotheke/eczane) it is possible to buy the drug online without recipe (eng — without a prescription; es — sin receta; de — ohne rezept bestellen).

Before ordering means, it is very convenient to make comparison of the prices (price/preise/precio; price comparison/preiswert im internet bestellen) in different shops. Search can be done on requests of "discount cialis send thread", "buy cialis 5mg", "kaufen ohne rezept 20mg", "cialis rezeptfrei kaufen deutschland", "daily cialis forum".

It is also possible to compare the prices of generics (generics in uk/generika in deutschland/generico en espana) and to study their action, contraindications to use (contraindications/gegenanzeigen/ñontraindicaciones/êontrendikasyonlar) and side effects (side effects/nebenwirkungen/efectos secundarios/yan etkileri).

Information on drug Sialis can also be obtained on the website www.cialis.com.

Sialis or Sealeks?

Because of accord of names Sialis quite often confuse to drug of Sealeks. However these means have the mass of differences.

Sialis promotes emergence of a natural erection, without creating at the same time artificially sexual excitement. In need of it it is possible to accept one-time, just before sexual activity.

Sealeks's effects are caused by properties of the components of a plant origin which are contained in him which receive by method of special extraction.

Zhgun-koren Monnye whose active agent is ostol renders preventive effect at erection dysfunction, yohimbine stimulates synthesis of endogenous testosterone, the ginseng promotes relaxation of smooth muscles of blood vessels of a penis.

Indole-3-carbinol is a powerful natural antioxidant which prevents growth of tissues of prostate, facilitates an urination at problems with a prostate and an ejaculation.

Meletin regulates permeability of walls of vessels, has vasodilating and kroverazzhizhayushchy effect.

Vitamins B6 and B12 actively participate in metabolismamino acids , show properties of antioxidants and protect walls of vessels.

Irreplaceable L-arginine amino acid is necessary for synthesis of nitrous oxide (NO) with NO synthase participation. Nitrous oxide synthesis in turn is one of the key moments without which implementation of erectile function is impossible.

Folic acid provides protection of cavernous bodies of a penis at the erection dysfunction associated with a diabetes mellitus, reduces concentration of a gomotsistein and risk of defeat by atherosclerosis of vessels, significant for an erection.

Zinc participates in forming of dihydrocorticosterone and inhibition of FDE-5 enzyme that is reflected in a krovenapolneniya of cavernous bodies of a penis.

Sealeks's advantages are convenience of use (capsules accept on one in day, one-time or — in need of the general improvement of an organism — a course), complex recreational action, safety, availability, the expressed effect after the first use.

Sealeks has natural structure thanks to what side reactions against treatment by this drug arise exclusively seldom.

What it is better — Sialis, Levitra or Viagra?

Levitra and Viagra are the main analogs of tablets Sialis today.

Active agent of Levitra is vardenafit. The effect after use of this drug develops on average in 15 minutes and remains till 12 o'clock.

— sildenafit active agent of Viagra. Substance begins to work in half an hour-hour after reception of a tablet, the effect remains within 4 hours.

Distinctive feature and Sialis's advantage before analogs is its duration of action: the effect of usual tablets remains till 36 o'clock, effect of tablets with an extra dosage of a tadalafil — till 72 o'clock.

Sialis it is possible to accept just before sexual activity, to Levitr — in 20 minutes, Viagra — in 30-60 minutes.

One more important point is that meal (as well as quantity eaten) and the use of alcohol does not influence Sialis and Levitra's pharmacokinetics, Viagra is recommended to be accepted on an empty stomach.

Thus, trying to find the answer to the questions "Viagra or Sialis, Sialis or Levitra — What Is Better?", it is necessary to be guided by that, how fast it is necessary to gain effect as long gained effect has to remain whether alcohol intake before sexual activity is planned.

Sialis or Zidena — what is better?

Zidena is covered p / about tablets which part as actively active ingredient is udenafit (100 mg / tab.).

As well as tadalafit, udenafit selectively and reversibly suppresses FDE-5 — the enzyme promoting tsGMF metabolism.

Substance begins to work half an hour later after reception of a tablet, the effect remains till 24 o'clock, but expressiveness of action udenafit slightly less, than at a tadalafil.

At the same time Zidena acts very softly, stabilizing the major processes in the man's organism, increasing duration of an erection and promoting extension of time of sexual intercourse.

Positive sides of drug are also lack of influence on a blood pressure and sight, concentration and amount of sperm, morphology and mobility of spermatozoa.

from 980 rub for packaging No. 1, 20 of mg. The price Sialis of 5 mg No. 14 — from 3000 rub. The majority of Internet drugstores carries out sale of drug across all territory of Russia: to Yekaterinburg, to Krasnodar, to Novosibirsk, Ufa, etc.

It is possible to buy Sialis in Ukraine from 390 V Kiev, in Odessa, in Dnipropetrovsk, in Kharkiv and in other large cities the average price of tablets Sialis 20 mg No. 1 — 470 UAH, tablets of 20 mg No. 2 — 740

In Minsk the cost of tablets is 20 mg No. 1 — from 151.5 thousand rub, in Kazakhstan — of 2950

The price of generics is slightly lower. So, for example, price of tablets Sialis Soft (unitary enterprise. — from 200 to Buy No. 5) in Ukraine Sialis's generic in Russia (unitary enterprise. No. 5) it is possible for 450 rub.