What is Tadalista 10mg

Tadalafil works longer

Erectile dysfunction

by Conny Becker, Frankfurt am Main

The first prescriptions have been written, the Viagra® competition is here: On February 3rd, Cialis ™, the second phosphodiesterase 5 inhibitor, came onto the German pharmaceutical market and is intended to convince patients with its longer duration of action and a better side effect profile.

According to the reviews of patients who buy Cialis online and use Cialis for several months - most of them have solved the problem of prostate and erectile dysfunction.

The active ingredient of the new "weekend pill" is called Tadalafil, but does not bring any new mechanism of action for the treatment of erectile dysfunction. Like sildenafil, it inhibits phosphodiesterase type 5 (PDE-5), which is mainly localized in the testes, and thus prevents the breakdown of the second messenger cGMP (cyclic guanosine monophosphate). The vascular muscles in the erectile tissue relax and allow blood to flow in, so that an erection occurs.

However, the drug does not increase libido. Even when taking a PDE-5 inhibitor, sexual stimulation and the associated release of NO (nitrogen monoxide) must precede it. This messenger substance ensures the synthesis of cGMP.

Differences are small

In terms of effectiveness, there are no relevant differences to study results with Sildenafil. In five randomized, placebo-controlled, double-blind phase III studies, tadalafil 20 mg improved erections in 81 percent of a total of 1,112 men (placebo: 35 percent). 75 percent stated that they could have ended sexual intercourse as desired. When a dose of 10 mg was taken, the percentage decreased by about 15 percent in each case. The success of treatment decreases in men with diabetes, which, along with high blood pressure and coronary heart disease, is one of the risk factors for the development of erectile dysfunction.

In contrast to the vardenafil, which is expected to follow in March, tadalafil differs significantly in its structure from the precursor substance sildenafil. This results in the different pharmacokinetics, explained Professor Dr. med. Hartmut Porst at a press conference of the manufacturer Lilly ICOS in Frankfurt. The Hamburg urologist described the long half-life of 17.5 hours with tadalafil as a decisive advantage over the competition (half-life: just under 4 hours). This results in a clinical effectiveness of at least one to two days. In a study he supervised with 348 men, 60 percent were able to successfully end coitus after 36 hours. So those affected would have to plan the sex less, the psychological pressure gives way to extensive spontaneity.

Tadalafil reaches its maximum concentration (cmax) in the blood about two hours after oral intake (sildenafil: 70 minutes), but an erection was observed after 16 minutes. The short-acting vardenafil will close the need here (cmax: about 40 minutes).

In contrast to Sildenafil, absorption is not delayed when Tadalafil is taken while eating. Even moderate alcohol consumption leaves the bioavailability unaffected, so that nothing stands in the way of a romantic dinner.

Hardly any visual disturbances

The most common side effect of tadalafil was headache in 14 percent of men, but the incidence decreased as treatment progressed. 10 percent of the verum group complained of dyspepsia, especially heartburn. Since the PDE-5 inhibitor also relaxes the gastric entry porter, reflux occurs significantly more frequently. Rhinitis and flushing of the face, as well as back pain and muscle pain, were observed in about 5 percent.

The visual disturbances occurring with sildenafil, especially color vision, only affected 0.1 percent of men in the studies with tadalafil. This is explained by the lower affinity of the new PDE-5 inhibitor for the isoenzyme phosphodiesterase 6, which is localized in the retina. Tadalafil acts 700 times more strongly on PDE-5 than on PDE-6, with sildenafil the affinity only differs by a factor of 10.

However, PDE-11, the physiological function of which has not yet been clarified, inhibits tadalafil significantly more than its competitors. The isoenzyme occurs in the testes, prostate, pituitary gland and possibly in the heart. Studies on spermatogenesis showed no changes in fertility, and the mean concentrations of testosterone, luteinizing hormone or follicle-stimulating hormone were also unaffected.

Heart stories

Tadalafil has a significantly lower effect on other isoenzymes - for example PDE-3, which influences the force of contraction of the heart. Systolic and diastolic blood pressures are not reduced significantly. Cardiovascular patients still have to be checked for their cardiovascular risk, explained Professor Dr. med. Eckhard Peter Kromer from Hanau. Hypertensive patients can take tadalafil with continued medication. Heart failure in stages III and IV, a heart attack less than two weeks ago or unstable angina pectoris are, in the opinion of the cardiologist, exclusion criteria. Erectile dysfunction can only be treated after the cardiac situation has stabilized. After all, sexual activity is an oxygen-consuming physical strain. However, this can be trained with 20 minutes of slow running and then climbing stairs, according to the speaker.

Treatment with organic nitrates is also a strict contraindication for tadalafil. In combination with an NO donor, the systolic blood pressure can drop to below 85 mm Hg when standing.

Yellow instead of blue?

In principle, tadalafil hardly differs from its predecessor, but it works longer and causes visual disturbances much less frequently. However, the inhibition of PDE 11 should continue to be monitored. The fact that the pharmacokinetics are not disturbed by a dinner for two is sure to resonate with the couples.

Presumably, those affected will test both, starting in spring, all three preparations. For non-responders there is now new hope with Cialis ™. Whether blue diamond or yellow almond, the decision is probably made by men, especially since the price is, as expected, in the same range (four tablets of Cialis ™ 10 or 20 mg cost 47.99 euros).

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