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Table of Contents
- What is Cialis Professional?
- Tadalafil Mechanism of Action
- Active Substance and Auxiliary Components
- Pharmacokinetics
- Instruction for Use
- Contraindications
- Cialis Professional Side Effects
- Interactions with Other Drugs
- Special Instructions
- Cialis Professional and Alcohol?
- Reviews
What is Cialis Professional?
Cialis Professional is a unique product, which has a more powerful effect than regular Cialis (that is the main difference between Cialis and Cialis Professional). Its formula is referred to most advanced developments among similar drugs that affect potency. Each pill contains 20 mg of tadalafil – active substance, which is used for treating erectile disorders such as:
- complete lack of erection;
- weak and short-lasting erection;
- premature ejaculation.
Cialis Professional sold by Canadian Health&Care Mall has improved formula that makes it easier to achieve positive result in erectile dysfunction treatment.
Advantages of the product:
- long-lasting effect – only tadalafil, out of all PDE-5 inhibitors, has the longest positive action, reaching up to 36 hours and in some cases up to 48 hours.;
- reduced time for rest and recovery between sexual intercourses;
- due to increased blood flow to penis, there is a strong filling of it with blood, which allows it to significantly increase in volume.
- increased sexual desire;
- the drug eliminates psychological barriers and lack of confidence.
Cialis Professional is produced by Indian company «Combitic Global», which has an impeccable reputation in the world market. The company manufactures certified products and delivers it in 175 countries around the world. You can be confident in quality of Cialis Professional produced by «Combitic Global». Today ou can buy Cialis Professional in Canadian HealthCare Mall at the most attractive price.
The drug is effective for any degree of erectile dysfunction. Excessive filling of penis with blood leads to its increase in size, which allows to experience new sensations during sexual intercourse. Cialis Professional will help to overcome erectile dysfunction, gain energy and stamina during sexual intercourse, get rid of psychological problems.
Tadalafil Mechanism of Action
Active component of the drug – tadalafil, activates nitric oxide in the body. Tone of blood vessels reduces, they relax, and at sexual excitement fill with blood, resulting in quality and prolonged erection. Tadalafil delays the production by the body of enzymes that inhibit action of nitric oxide, it acts maximally softly and naturally.
At that, adverse effects on other organs are excluded, the drug has no effect on blood pressure, ability to perceive colors and operate vehicles. Cialis Professional equally effectively solves problems of patients with different causes of erectile dysfunction.
Medical consultation is required before using Cialis Professional Canadian Pharmacy. Despite good clinical performance and compatibility with other therapeutic agents, Canadian HealthCare Mall recommends to consult a doctor to get qualified advice. For this purpose, you can consult your doctor, therapist, cardiologist, endocrinologist and other specialists. They will help you to find optimal dosage for reception and to determine possible limitations for use of the drug.
Active Substance and Auxiliary Components
Tadalafil is one of PDE-5 enzyme inhibitors, the main advantage of these enzymes is in their high selective effect on male reproductive system. This important discovery has allowed to effectively deal with a range of men’s problems without adverse effects on health and other organs and body systems. In general, tadalafil allows to block PDE-5, it directly increases cGMP, synthesized under the influence of nitric oxide in response to sexual excitement. That’s how standard process of sexual excitation and erection appears.
Tadalafil is able to increase cGMP by several times, acting softly and naturally, which leads to appearance of high-quality and long-lasting erection. During this period, with presence of sexual stimulation, successful sexual intercourses can be performed. Clinical studies did not reveal any negative effect of tadalafil on spermatogenesis.
Tadalafil as other PDE5 inhibitors has symptomatic effect directly on male genitals. The drug is effective only in case of male sexual excitement, does not affect libido and, if sexual stimulation is insufficient, is useless. Why is this happening?
- in response to sexual stimulation nitric oxide affects guanylate cyclase enzyme, which affects cyclic guanidinemomophosphate (cGMP);
- the thing needed for erection, namely, relaxation of smooth muscles and increased blood flow to penis, directly depends on accumulation of cGMP;
- inhibition of PDE-5 prevents phosphodiesterase from suppressing cGMP synthesis, thereby ensuring strong and lasting erection.
The following substances are used as auxiliary components:
- lactose monohydrate;
- hyprolose;
- sodium lauryl sulfate;
- microcrystalline cellulose;
- croscarmellose sodium;
- magnesium stearate.
Composition of the shell – opadry yellow (Y-30-12863-A).
Pharmacokinetics
Absorption
After oral administration tadalafil is rapidly absorbed. Average maximal concentration (Cmax) in blood plasma is reached in about 2 hours after ingestion.
Speed and degree of tadalafil absorption are not dependent on food intake and Cialis Professional drug can be taken regardless of meals. Time of reception (morning or evening) has no clinically significant effect on speed and degree of absorption.
Tadalafil pharmacokinetics in healthy individuals is linear concerning time and dosage. In dosage range from 2,5 to 20 mg, area under «concentration-time» (AUC) curve increases proportionally to dosage. Equal concentration in blood plasma are reached within 5 days, in case of taking the drug one time a day.
Pharmacokinetics of tadalafil in patients with erectile dysfunction is similar to pharmacokinetics in patients without erectile dysfunction.
Distribution
According to Canadian Health and Care Mall data, average volume of distribution is about 63 liters shows that tadalafil is distributed in body tissues. In therapeutic concentrations, 94% of tadalafil in blood plasma binds with proteins. Binding with proteins does not change at impaired renal function.
In healthy patients less than 0,0005% of administered dosage was found in semen.
Metabolism
Tadalafil is mainly metabolized with participation of CYP3A4 isoenzyme of cytochrome P450. Major circulating metabolite is methylcatecholglucuronide. This metabolite is at least 13,000 times less active against PDE-5 than tadalafil. Consequently, concentration of this metabolite is not clinically significant.
Clearance
In healthy individuals average clearance of tadalafil at ingestion is 2,5 l/h and average half-life period – 17,5 hours. Tadalafil is excreted mainly in the form of inactive metabolites, mainly in feces (about 61% of dosages) and to a lesser extent in urine (about 36% of dosage).
Instruction for Use
Frequency of reception depends on different factors:
- planning of sexual intercourse (occasional intake);
- treatment course (daily intake);
- accompanying illnesses;
- intake of other drugs.
Consequences of Cialis Professional Reception
For the body medication poses no threat, if you follow instructions for use. In presence of diseases or in case of other drugs intake, it is necessary to consult a specialist to avoid negative effects of Cialis Professional.
- Positive. With the help of active substance – tadalafil, men, suffering from ED, can perform full sexual intercourse. The drug generally has positive effect on male sexual organs and treats erectile dysfunction. In case of course of taking Cialis Professional, patients observe recovery of morning erection, improved psychological state, improved general state.
- Negative. Psychological dependence on the drug may develop. After reception a number of patients experience side effects of varying severity. In case of concomitant use with nitrates, PDE-5 inhibitors can significantly reduce arterial blood pressure, including death.
Cialis Professional Dosage
Cialis Professional should be taken orally, with plenty of water; tadalafil onset of action is 30 – 40 minutes after ingestion. Specific feature of this product is considered to be opportunity to perform sexual intercourse within 36 hours, which is very convenient to use, for example, on the weekend, one pill will solve all problems in intimate sphere for two days.
The drug is taken not more than once a day. Maximum dosage of Cialis Professional is not more than 1 pill a day (20 mg). Canadian Healthcare Mall experts underline that this tadalafil dosage does not change for patients of different ages and can be used for 18-year-olds and after 65 years old. More frequent reception of Cialis Professional can cause headaches, pressure drops, joint and back pain. Erection occurs within half an hour after taking Cialis Professional, and only in presence of sexual stimulation. The drug does not lose its effectiveness in combination with food and small doses of alcohol and also does not depend on time of meals. It allows you to fully enjoy great food and a few glasses of wine before intimacy.
Depending on severity of erectile dysfunction, accompanying diseases and drug tolerability, dosage may be reduced to 10, 5 or 2,5 mg.
- For men with impaired liver function of mild to moderate degrees, maximal dosage of Cialis Professional should not exceed 10 mg.
- Dosage recommended for patients with impaired kidney function is 5 mg or 10 mg single dose, but not more than once every 2 days. On doctor’s advice in presence of these diseases tadalafil dosage can be reduced to 2,5 mg.
- If a patient undergoes treatment with potent P 3A4 cytochrome inhibitors, such as ketoconazole, erythromycin, itraconazole, ritonavir and others, maximal dosage of tadalafil is 10 mg once in 3 days.
Overdose
In case of overdose Cialis Professional acts on healthy and sick people in different ways. As a result of tests on healthy men in dosage active substance of 500 mg, it turned out that side effects are the same as at recommended dose. People with functional disorders of the body, described in instructions, side effects may worsen. In the event of overdose of Cialis Professional standard symptomatic treatment is carried out. During hemodialysis tadalafil is almost nor cleared.
Contraindications
All PDE-5 inhibitors in Canadian Health and Care Mall catalogue have approximately similar contraindications and side effects. Unlike counterparts, Cialis Professional side effects are less pronounced concerning rush of blood to head and changes in color perception, but more pronounced concerning digestive tract in the form of dyspepsia.
Contraindications for receiving Cialis Professional:
- hypersensitivity to active ingredient;
- concomitant reception with organic nitrates;
- concomitant reception with alpha-blockers;
- severe liver and renal insufficiency;
- diseases of cardiovascular system;
- degenerative retinal diseases;
- anatomical penis deformities;
- predisposition to priapism;
- persons under 18 years of age.
Cialis Professional Side Effects
Studies have shown that side effects while taking Cialis Professional are not observed. However, sometimes there are exceptions. The following side effects can be distinguished among them:
- nausea, diarrhea, bloating;
- back pains, rarer – in chest muscles and limbs;
- headaches and dizziness;
- nasal congestion;
- redness of conjunctiva and eye pain;
- blood rushes to head, nasal hemorrhages;
- sudden spontaneous erection;
- dryness of mucous membranes;
- itching and skin rashes;
- heart palpitations;
- decreased or increased blood pressure.
In case of adverse effects dosage of Cialis Professional should be reduced.
Interactions with Other Drugs
Influence of other drugs on tadalafil
Tadalafil is mainly metabolized by CYP3A4 enzyme. CYP3A4 selective inhibitor, ketoconazole (400 mg a day), increases effect of single dosage of tadalafil (AUC) by 312% and Cmax by 22% and ketoconazole (200 mg a day) increases effect of single dosage of tadalafil (AUC) by 107% and Cmax by 15% relative to AUC and Cmax for tadalafil only.
Ritonavir (200 mg twice a day), CYP3A4, 2C9, and 2S1E 2D6 inhibitor increases effect of single dosage of tadalafil (AUC) by 24% with unchanged Cmax. Despite the fact that specific interactions has not been studied, it is possible to assume that other HIV-protease inhibitors, such as saquinavir, and SURZA4 inhibitors, such as itraconazole and erythromycin, increase activity of tadalafil.
CYP3A4 selective inducer, rifampin (rifampicin 600 mg a day) reduces effect of single dosage of tadalafil (AUC) by 88% and Cmax by 46%, relative to AUC and Cmax tadalafil only. It is possible to assume that simultaneous administration of other CYP3A4 inducers should also reduce concentration of tadalafil in blood plasma.
Simultaneous administration of antacid (hydroxide / magnesium aluminum hydroxide) and tadalafil reduces speed of tadalafil absorption without altering area under concentration-time curve for tadalafil.
Increased pH level in the stomach as a result of receiving H2-antagonist – nizatidine, has no effect on tadalafil pharmacokinetics.
Influence of tadalafil on other drugs
It is known that tadalafil amplifies hypotensive effect of nitrates. This happens due to additive effect of nitrates and tadalafil on metabolism of nitric oxide and cGMP. Therefore, use of tadalafil during treatment with nitrates is contraindicated.
Tadalafil has no clinically significant effect on drug clearance, metabolism of which proceeds with participation of P450 cytochrome isoenzyme. Studies have confirmed that tadalafil does not inhibit or induce CYP1A2, CYP3A4, CYP2C9, CYP2C19, CYP2D6, CYP2E1 isozymes.
Tadalafil has no clinically significant effect on pharmacokinetics of 5-warfarin or R-warfarin. Tadalafil has no affect on warfarin action concerning prothrombin time.
Tadalafil does not increase duration of hemorrhages caused by acetylsalicylic acid.
Cialis Professional has systemic vasodilating properties and may exacerbate effects of antihypertensive drugs aimed at lowering blood pressure. Additionally, patients taking multiple antihypertensive agents, that have poorly controlled hypertension, observed several large decreases in blood pressure. In vast majority of these patients reduction was not associated with hypotensive symptoms. Patients receiving antihypertensive drugs and tadalafil should be given appropriate clinical advice.
There was no significant reduction in blood pressure in case of using Cialis Professional with selective alpha[1A]-blocker- tamsulosin.
During taking tadalafil by healthy volunteers who were using doxazosin (8 mg a day), alpha[1]-blacker, there were observed increased hypotensive action of doxazosin. Some patients experienced dizziness. Cases of syncope were not observed. Lower doses of doxazosin have not been studied.
Tadalafil did not affect concentration of alcohol, as well as alcohol did not affect concentration of tadalafil. At high doses of alcohol (0,7g/kg), reception of tadalafil did not cause statistically significant reduction in average blood pressure level. Some patients experienced postural dizziness and orthostatic hypotension. Tadalafil when administered in combination with lower doses of alcohol (0,6 g/kg) did not cause hypotension, and dizziness occurred with same frequency as in case of receiving alcohol only.
Tadalafil has no clinically meaningful effect on pharmacokinetics or pharmacodynamics of theophylline.
Special Instructions
Sexual activity is a potential risk for patients with cardiovascular disease. Therefore, treatment of erectile dysfunction, including with Cialis Professional, should not be carried out in men with heart diseases, at which sexual activity is not recommended. It is necessary to take into account potential risk of complications in case of sexual activity in patients with cardiovascular diseases:
- myocardial infarction during the past 90 days;
- unstable cardiac angina or cardiac angina occurring during sexual intercourse;
- cardiac insufficiency of the 2 class and higher according to NYHA, appeared during the past 6 months;
- uncontrolled cardiac arrhythmias, hypotension (with BP<90/50 mm Hg) or uncontrolled hypertension;
- blood stroke during the past 6 months.
Cialis Professional should be used with caution in patients with predisposition to priapism (e. g., sickle cell anemia, multiple myeloma or leukemia) or in patients with anatomical penis deformities (for example, angular distortion, cavernous fibrosis or Peyronie’s disease). There are reports of occurrence of priapism during using PDE-5 inhibitors, including tadalafil. Patients should be informed of necessity for immediate medical assistance in the event of erection, which lasts for 4 hours or more. Canadian Health&Care Mall reminds that untimely treatment of priapism leads to penile tissue damage, resulting in long-term potency loss.
Safety and efficacy of combination of Cialis Professional with other drugs for erectile dysfunction was not studied. Therefore, such combinations are not recommended.
As other PDE-5 inhibitors, tadalafil has systemic vasodilator properties, which may lead to transient decrease in blood pressure. Before prescribing Cialis Professional, physicians should carefully consider question – whether patients with existing cardiovascular diseases will suffer from undesirable impact due to these vasodilator properties.
Effect on operating vehicles and mechanisms
No special requirements.
Cialis Professional and Alcohol?
Alcohol is often a companion at parties and feasts, so people are very interested in question: whether it is possible to take during treatment. For some drugs it is acceptable, but for others – not.
Many participants of forums claimed that Cialis Professional and alcohol are compatible, considering it undoubtful benefit of the drug. This is true. Cialis Professional is compatible with food and with any beverages. A small amount of alcohol during romantic dinner will not hurt. However, excessive use of alcohol together with Cialis Professional is not recommended (you can not drink more than five glasses of wine or more than five shots of whiskey). Drinking alcohol is not prohibited, but keep in mind that excess content of alcohol in blood increases risk of tadalafil side effects such as headache, heart palpitations, low blood pressure and dizziness.
During treatment of erectile dysfunction and other male diseases, Canadian HealthCare Mall specialists and doctors strongly recommend patients to abstain from alcohol. It not only interferes with treatment, but may itself be the cause of impotence.
Cialis Professional Reviews
Mark
This is really a working thing, guys. Even despite the fact that I had already passed 40 years old, this drug is really effective for me. I had not had such erection when I was 18, with Cialis Professional there are quite different sensations during sex, what can I say, and duration erection and rest period, you can not pull out at all, more strength and energy, confidence. The main thing is that you have full freedom in sex, it’s not like with Viagra, I can not always plan sex, but I know that even in the evening I will not fail, if I took a pill in the morning!
Richard
To make sure of effectiveness I first took 1 pill of 20 mg, but in regular pharmacies it is really expensive.I found in the Internet this online pharmacy and ordered Cialis Professional, and I’m still satisfied. Quality is excellent! exactly the same effect as with Cialis from regular pharmacy, only for the same price you get 4 pills.
Guest
Compared to other generics of tadalafil, this one has the best and the longest effect!)
Rachel
Thank you very much, we ordered Dapoxetine first in your pharmacy, and the drug did not disappoint, excellent result without any side effects. We are waiting for Cialis Professional now, I think the result will be the same. I would like to thank you for adequate consultation, there was no question to which I would not get an answer!) Very good service, nice bonus in the form of free delivery, we are now one of your regular customers)))