Manufacturer: Axiolabs
Pharmaceutical name: Tadalafil
Pack: 4 tabs (20 mg/tab)

Cialis is used for treating erectile dysfunction.
Cialis is a phosphodiesterase inhibitor. It works by helping to increase blood flow into the penis during sexual stimulation. This helps you to achieve and maintain erection.

Therapeutic actions:
Penile erection during sexual stimulation is caused by increased penile blood flow resulting from the relaxation of penile arteries and corpus cavernosal smooth muscle. This response is mediated by the release of nitric oxide from nerve terminals and endothelial cells, which stimulates the synthesis of cGMP in smooth muscle cells. Cyclic GMP causes smooth muscle relaxation and increased blood flow into the corpus cavernosum. The inhibition of phosphodiesterase type 5 (PDE5) enhances erectile function by increasing the amount of cGMP. Tadalafil inhibits PDE5. Because sexual stimulation is required to initiate the local release of nitric oxide, the inhibition of PDE5 by tadalafil has no effect in the absence of sexual stimulation.

What is it used for?:
CIALIS is indicated for the treatment of erectile dysfunction.

Contraindications and cautions:
Cialis should not be used if:
• you are allergic to any ingredient in Cialis
• you have severe kidney problems and will be taking Cialis daily • you have severe liver problems or certain hereditary degenerative eye problems (eg, retinitis pigmentosa)
• you have certain heart problems (eg, unstable angina, angina during sexual intercourse, severe heart failure, uncontrolled irregular heartbeat), low blood pressure, or uncontrolled high blood pressure
• you have had a heart attack within the past 90 days or a stroke within the past 6 months
• you are taking nitrates (eg, isosorbide, nitroglycerin) in any form (eg, tablet, capsule, patch, ointment) or nitroprusside
• you have been advised by your doctor to avoid sexual activity because of heart problems
• you use certain recreational drugs called "poppers" (eg, amyl nitrate, butyl nitrate)

Side effects:
General: dizziness; flushing; headache; heartburn; mild back or muscle pain; stomach upset; stuffy or runny nose.
Serious allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; fainting; fast or irregular heartbeat; prolonged, painful erection; red, swollen, blistered, or peeling skin; ringing in the ears; severe or persistent back or muscle pain; severe or persistent dizziness; severe or persistent vision changes; sudden decrease or loss of vision in one or both eyes; sudden hearing loss.

Interactions:
• Alpha-blockers (eg, doxazosin), medicines for high blood pressure, nitrates (eg, isosorbide, nitroglycerin), or nitroprusside because severe low blood pressure with dizziness, lightheadedness, and fainting may occur
• Azole antifungals (eg, itraconazole), HIV protease inhibitors (eg, ritonavir), macrolide antibiotics (eg, erythromycin), or telithromycin because they may increase the risk of Cialis 's side effects
• Rifampin because it may decrease Cialis 's effectiveness