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Who Should Not Take Cialis?Vardenafil is metabolized predominantly by the hepatic enzyme CYP3A4, with contribution from the CYP3A5 and CYP2C isoforms. The major circulating metabolite, M1, results from desethylation at the piperazine moiety of vardenafil. M1 is subject to further metabolism. The plasma concentration of M1 is approximately 26% that of the parent compound. This metabolite shows a phosphodiesterase selectivity profile similar to that of vardenafil and an in vitro inhibitory potency for PDE5 28% of that of vardenafil. Therefore, M1 accounts for approximately 7% of total pharmacologic activity. information on viagra Results in General ED Population — The primary US efficacy and safety trial included a total of 287 patients, with a mean age of 59 years (range 25 to 82 years). The population was 86% White, 6% Black, 6% Hispanic, and 2% of other ethnicities, and included patients with ED of various severities, etiologies (organic, psychogenic, mixed), and with multiple co-morbid conditions, including diabetes mellitus, hypertension, and other cardiovascular disease. Most (>96%) patients reported ED of at least 1-year duration.Since Viagra enhances sexual arousal in men by increasing the blood flow to the penis, the Bermans theorized that the drug could have a similar effect on women, increasing the blood flow to the female genitals and thereby producing better arousal, sensation and lubrication in the genital area.

Three studies were conducted in men to assess the potential effect on spermatogenesis of CIALIS 10mg (one 6-month study) and 20mg (one 6-month and one 9-month study) administered daily. In two of these studies decreases were observed in sperm count and concentration related to tadalafil treatment of unlikely clinical relevance. These effects were not associated with changes in other parameters, such as motility, morphology, and FSH.a.) Typical Dosage Recommendations

For Healthcare Professionals viagra sale Erythromycin or clarithromycin.For Erectile Dysfunction "I'm 76. Been using Cialis for BPH and also ED. Tried Viagra last week. Wow. Never performed so well. Took about 2 hours before sex. Had a great erction and lasted as long as I wanted to. Decided to climax after about 1/2 hr. of continuas intercourse. My partnetr was amazed and said it was the best! I had received 50mg tablets, but I cut in half. Seemed to be more than enough. Maybe I'll try 50mg. for comparison."

When you must not take it In those patients already taking an optimized dose of PDE5 inhibitor, alpha-blocker therapy should be initiated at the lowest dose. Stepwise increase in alpha-blocker dose may be associated with further lowering of blood pressure in patients taking a PDE5 inhibitor. levitra commercial

Cytochrome P450 Inducers — Studies have shown that drugs that induce CYP3A4 can decrease tadalafil exposure. buy cialis professional (N=100) (N=100) (N=98) p-value Usual Adult Dose for Erectile Dysfunction: 2-phenyl substituted imidazotriazinones as phosphodiesterase inhibitorsThe classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Hypersensitivity reactionsCommon (1% to 10%): Dizziness, migraine, tremor, paresthesia, burning sensation