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- Use in men with diabetes :
No dosage adjustment is necessary in patients with diabetes.
- Use in children and adolescents :
cialis is not indicated for patients aged under 18 years.
cialis: its appearance and shape
The coated tablets are yellow almond-shaped, with the inscription "C 10" on one side.

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cialis: How it works
- cialis (Tadalafil) is a selective and reversible inhibitor of phosphodiesterase type 5 (PDE5), specific guanosine monophosphate (cGMP). When sexual stimulation causes local release of nitric oxide, inhibition of PDE5 by tadalafil causes increased levels of cGMP in the corpora cavernosa. The result is a smooth muscle relaxation and inflow of blood into the penile tissues, thereby producing an erection. Tadalafil has no effect in the absence of sexual stimulation.
- Studies in vitro have shown that tadalafil is a selective inhibitor of PDE5. PDE5 is an enzyme found in corpus cavernosum smooth muscle, vascular smooth muscle and visceral, skeletal muscle, platelets, kidneys, lungs and cerebellum. The effect of tadalafil is more potent on PDE5 than on other phosphodiesterases. The effect of tadalafil is> 10,000 times more potent for PDE5 than for PDE1, PDE2 and PDE4, enzymes present in heart, brain, blood vessels, liver and other organs. The effect of tadalafil is> 10,000 times more potent for PDE5 than for PDE3, an enzyme found in the heart and blood vessels. This selectivity for PDE5 over PDE3 is important because PDE3 is involved in cardiac contractility. In addition, tadalafil is about 700 times more potent for PDE5 than for PDE6, an enzyme present in the retina that is responsible for phototransduction. Tadalafil is> 10,000 times more potent for PDE5 than for PDE7 through PDE10.
- Three clinical studies were conducted in ambulatory patients in 1054 the period of responsiveness to cialis. Tadalafil improves a statistically significant erectile function and the ability to have successful intercourse up to 36 hours after dosing, and the opportunity for patients to achieve and maintain erections sufficient for successful intercourse , from the 16th minute after taking the dose compared to placebo.
- Tadalafil administered to healthy subjects resulted in no significant difference compared to placebo, the systolic and diastolic supine position (mean maximal decrease of 1.6 / 0.8 mmHg, respectively), systolic and diastolic standing (mean maximal decrease of 0.2 / 4.6 mmHg, respectively), no significant change in heart rate.

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- In a study to assess the effects of tadalafil on vision, no impairment of color discrimination (blue / green) was detected by the test of 100 colors Farnsworth-Munsell. This result is consistent with the low affinity of tadalafil for PDE6 compared to PDE5. During all clinical studies, changes in color vision were rare (<0.1%).
- Three studies were conducted in men to assess the potential effect of cialis 10 mg (study 6 months) and 20 mg (study of 6 months and 9 months) administered daily on spermatogenesis. In two of these studies it was observed a decrease in sperm count and decreased sperm concentration, in connection with tadalafil treatment of unlikely clinical significance. These effects were not associated with changes in other parameters, such as mobility and morphology of spermatozoa, and the FSH (follicle stimulating hormone).
- This medicine has been evaluated in 16 clinical trials at doses ranging from 2-100 mg in 3250 patients with erectile dysfunction severity mild, moderate or severe and aetiologies, ages (range 21-86 years) and different ethnic origins. Most patients reported erectile dysfunction for at least a year. In studies of general populations of effectiveness was the primary endpoint, 81% of patients reported that cialis improved their erections compared to 35% on placebo. Similarly, patients with erectile dysfunction, whatever the severity categories reported improved erections cialis (86%, 83% and 72% for mild, moderate and severe, respectively, compared to 45% , 42% and 19% for placebo). In studies where the effectiveness was the primary endpoint, 75% of intercourse attempts were successful in cialis-treated patients, compared to 32% on placebo.
- In a 12-week study performed in 186 patients (142 tadalafil, 44 placebo) with erectile dysfunction secondary to spinal cord, tadalafil significantly improved erectile function, leading to an average percentage of reports by successful sexual topic with tadalafil 10 or 20 mg (flexible dose, on-demand) by 48% in patients taking tadalafil compared with 17% in patients treated with placebo.

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