Ninety-three percent of patients reported ED of at least 1-year duration.In each of these trials, conducted without regard to the timing of dose and sexual intercourse, CIALIS demonstrated clinically meaningful and statistically significant improvement in erectile function, as measured by the EF domain of the IIEF questionnaire and Questions 2 and 3 of the SEP diary (see Table 16). When taken as directed, CIALIS was effective at improving erectile function.In the 6 month double blind study, the treatment effect of CIALIS did not diminish over time.Efficacy Results in ED Patients with Diabetes Mellitus — CIALIS for once daily use was shown to be effective in treating ED in patients with diabetes mellitus. Patients with diabetes were included in both studies in the general ED population (N=79). A third randomized, multicenter, double-blinded, placebo-controlled, parallel-arm design trial included only ED patients with type 1 or type 2 diabetes (N=298).

A vacuum constriction device is a non-pharmacological alternative for ED.
Penile implants and injection therapy are other second-line treatment options.
Lifestyle modifications like weight loss and exercise can improve ED.
Smoking cessation is highly recommended, as smoking impairs blood flow.
The 10 mg dose represents a specific point on the drug's dose-response curve.
Higher doses (20 mg) provide greater efficacy but also greater side effect risk.
Lower doses (5 mg) minimize side effects but may be less effective for some.
The choice of dose is a personalized decision between patient and doctor.
Patient satisfaction with treatment is high due to the long window of opportunity.
It has improved the quality of life and relationships for many men.

In this third trial, CIALIS demonstrated clinically meaningful and statistically significant improvement in erectile function, as measured by the EF domain of the IIEF questionnaire and Questions 2 and 3 of the SEP diary (see Table 17). The efficacy and safety of tadalafil in the treatment of erectile dysfunction has been evaluated in 22 clinical trials of up to 24-weeks duration, involving over 4000 patients. CIALIS, when taken as needed up to once per day, was shown to be effective in improving erectile function in men with erectile dysfunction (ED). CIALIS was studied in the general ED population in 7 randomized, multicenter, double-blinded, placebo-controlled, parallel-arm design, primary efficacy and safety studies of 12-weeks duration. Additional efficacy and safety studies were performed in ED cialis 5mg generique patients with diabetes mellitus and in patients who developed ED status post bilateral nerve-sparing radical prostatectomy. In these 7 trials, CIALIS was taken as needed, at doses ranging from 2.5 to 20 mg, up to once per day. Food and alcohol intake were not restricted.

Quick summary

Efficacy Results in ED Patients following Radical Prostatectomy — CIALIS was shown to be effective in treating patients who developed ED following bilateral nerve-sparing radical prostatectomy. In 1 randomized, placebo-controlled, double-blinded, parallel-arm design prospective trial in this population (N=303), CIALIS demonstrated clinically meaningful and statistically significant improvement in erectile function, as measured by the EF domain of the IIEF questionnaire and Questions 2 and 3 of the SEP diary (see Table 15). Results in Studies to Determine the Optimal Use of CIALIS — Several studies were conducted with the objective of determining the optimal use of CIALIS in the treatment of ED. At or prior to 30 minutes, 35% (26/74), 38% (28/74), and 52% (39/75) of patients in the placebo, 10-, and 20-mg groups, respectively, reported successful erections as defined above. Two studies were conducted to assess the efficacy of CIALIS at a given timepoint after dosing, specifically at 24 hours and at 36 hours after dosing.

Taking Cialis with food

In the first of these studies, 348 patients with ED were randomized to placebo or CIALIS 20 mg. At the 36-hour timepoint (more specifically, 33 to 39 hours), 49/133 (37%) of patients reported at least 1 successful intercourse in the placebo group versus 88/137 (64%) in the CIALIS 20-mg group. In the second of these studies, a total of 483 patients were evenly randomized to 1 of 6 groups: 3 different dosing groups (placebo, CIALIS 10, or 20 mg) that were instructed to attempt intercourse at 2 different times (24 and 36 hours post-dosing). At the 36-hour timepoint, the mean, per-patient percentage of attempts resulting in successful intercourse were 33, 56, and 62% for placebo, CIALIS 10-, and 20-mg groups, respectively. The efficacy and safety of CIALIS for once daily use in the treatment of erectile dysfunction has been evaluated in 2 clinical trials of 12-weeks duration and 1 clinical trial of 24-weeks duration, involving a total of 853 patients. Several assessment tools were used to evaluate the effect of CIALIS on erectile function.

Product	Dosage	Quantity + Bonus	Price
Cialis Professional	40mg	10 Pills	65.09€ 61.99€
Cialis Generic	20mg	20 Pills	54.72€ 52.11€
Cialis Generic	60mg	120 + 8 Pills	240.18€ 228.74€
Cialis Generic	60mg	270 + 10 Pills	443.96€ 422.82€
Cialis Professional	20mg	30 Pills	104.57€ 99.59€
Cialis Original	20mg	12 Pills	78.32€ 74.59€
Cialis Professional	20mg	90 + 2 Pills	241.49€ 229.99€
Cialis Generic	20mg	120 + 8 Pills	188.15€ 179.19€
Cialis Professional	20mg	360 + 6 Pills	807.03€ 768.60€
Cialis Generic	2.5mg	10 Pills	28.51€ 27.15€
Cialis Super Active	20mg	60 + 8 Pills	230.32€ 219.35€
Cialis Generic	40mg	360 + 10 Pills	477.87€ 455.11€
Cialis Generic	60mg	30 + 2 Pills	85.33€ 81.27€
Cialis Generic	5mg	90 + 6 Pills	115.91€ 110.39€
Cialis Original	20mg	92 + 4 Pills	377.99€ 359.99€
Cialis Generic	2.5mg	90 + 6 Pills	112.43€ 107.08€
Cialis Professional	20mg	180 + 4 Pills	423.11€ 402.96€

SEP Question 2 asks, “Were you able to insert your penis into the partner's vagina?” SEP Question 3 asks, “Did your erection last long enough for you to have successful intercourse?” The overall percentage of successful attempts to insert the penis into the vagina (SEP2) and to maintain the erection for successful intercourse (SEP3) is derived for each patient.

Is There A Difference Between Tadalafil and Cialis?

Food and alcohol intake were not restricted. Several assessment tools were used to evaluate the effect of CIALIS on erectile function. SEP Question 2 asks, “Were you able to insert your penis into the partner's vagina?” SEP Question 3 asks, “Did your erection last long enough for you to have successful intercourse?” The overall percentage of successful attempts to insert the penis into the vagina (SEP2) and to maintain the erection for successful intercourse (SEP3) is derived for each patient. Results in ED Population in US Trials — The 2 primary US efficacy and safety trials included a total of 402 men with erectile dysfunction, with a mean age of 59 years (range 27 to 87 years). The treatment effect of CIALIS did not diminish over time.

What are the most common side effects of tadalafil?

Results in General ED Population in Trials Outside the US — The 5 primary efficacy and safety studies conducted in the general ED population outside the US included 1112 patients, with a mean age of 59 years (range 21 to 82 years). In addition, there were improvements in EF domain scores, success rates based upon SEP Questions 2 and 3, and patient-reported improvement in erections across patients with ED of all degrees of disease severity while taking CIALIS, compared to patients on placebo. Therefore, in all 7 primary efficacy and safety studies, CIALIS showed statistically significant improvement in patients' ability to achieve an erection sufficient for vaginal penetration and to maintain the erection long enough for successful intercourse, as measured by the IIEF questionnaire and by SEP diaries. Efficacy Results in ED Patients with Diabetes Mellitus — CIALIS was shown to be effective in treating ED in patients with diabetes mellitus. In this randomized, placebo-controlled, double-blinded, parallel-arm design prospective trial, CIALIS demonstrated clinically meaningful and statistically significant improvement in erectile function, as measured by the EF domain of the IIEF questionnaire cialis 20 mg 8 tablets and Questions 2 and 3 of the SEP diary (see Table 14). Results in ED Population in US Trials — The 2 primary US efficacy and safety trials included a total of 402 men with erectile dysfunction, with a mean age of 59 years (range 27 to 87 years). The treatment effect of CIALIS did not diminish over time.

Drug Class	Interaction Effect	Notes
Nitrates	Severe hypotension	Contraindicated
Alpha-blockers	Increased risk of blood pressure drop	Use cautiously
CYP3A4 inhibitors	Increased tadalafil levels, risk of side effects	Dose adjustment needed
Other ED medications	Potential additive effect	Avoid combination
Antihypertensives	May enhance blood pressure lowering	Monitor closely

Cialis 10 mg is often chosen for its efficacy and safety.
It is considered a second-line treatment for ED.
Price varies depending on pharmacy and location.
Generic versions of tadalafil are available.
Cialis may help improve confidence and intimacy.
It is important to follow prescribed dosage instructions.
Some men may need a lower dose initially.
Cialis should not be used with certain health conditions.
Be aware of potential allergic reactions.
Combining Cialis with other ED drugs is not advised.
Always inform your doctor about other medications.

Efficacy Results in ED Patients with Diabetes Mellitus — CIALIS was shown to be effective in treating ED in patients with diabetes mellitus. In this randomized, placebo-controlled, double-blinded, parallel-arm design prospective trial, CIALIS demonstrated clinically meaningful and statistically significant improvement in erectile function, as measured by the EF domain of the IIEF questionnaire cialis 20 mg 8 tablets and Questions 2 and 3 of the SEP diary (see Table 14). Efficacy Results in ED Patients following Radical Prostatectomy — CIALIS was shown to be effective in treating patients who developed ED following bilateral nerve-sparing radical prostatectomy. In 1 randomized, placebo-controlled, double-blinded, parallel-arm design prospective trial in this population (N=303), CIALIS demonstrated clinically meaningful and statistically significant improvement in erectile function, as measured by the EF domain of the IIEF questionnaire and Questions 2 and 3 of the SEP diary (see Table 15). Results in Studies to Determine the Optimal Use of CIALIS — Several studies were conducted with the objective of determining the optimal use of CIALIS in the treatment of ED. At or prior to 30 minutes, 35% (26/74), 38% (28/74), and 52% (39/75) of patients in the placebo, 10-, and 20-mg groups, respectively, reported successful erections as defined above. Two studies were conducted to assess the efficacy of CIALIS at a given timepoint after dosing, specifically at 24 hours and at 36 hours after dosing.

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In the first of these studies, 348 patients with ED were randomized to placebo or CIALIS 20 mg.

6.1 Clinical Studies Experience

CIALIS, when taken once daily, was shown to be effective in improving erectile function in men with erectile dysfunction (ED). CIALIS was studied in the general ED population in 2 randomized, multicenter, double-blinded, placebo-controlled, parallel-arm design, primary efficacy and safety studies of 12- and 24-weeks duration, respectively. Timing of sexual cialis tadalafil 5 mg 28 tablets activity was not restricted relative to when patients took Cialis. 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). Most (>96%) patients reported ED of at least 1-year duration.

Off-label use for Cialis

The primary efficacy and safety study conducted outside the US included 268 patients, with a mean age of 56 years (range 21 to 78 years). Ninety-three percent of patients reported ED of at least 1-year duration. In each of these trials, conducted without regard to the timing of dose and sexual intercourse, CIALIS demonstrated clinically meaningful and statistically significant improvement in erectile function, as measured by the EF domain of the IIEF questionnaire and Questions 2 and 3 of the SEP diary (see Table 16). When taken as directed, CIALIS was effective at improving erectile function. In the 6 month double blind study, the treatment effect of CIALIS did not diminish over time. At the 36-hour timepoint (more specifically, 33 to 39 hours), 49/133 (37%) of patients reported at least 1 successful intercourse in the placebo group versus 88/137 (64%) in the CIALIS 20-mg group. In the second of these studies, a total of 483 patients were evenly randomized to 1 of 6 groups: 3 different dosing groups (placebo, CIALIS 10, or 20 mg) that were instructed to attempt intercourse at 2 different times (24 and 36 hours post-dosing). At the 36-hour timepoint, the mean, per-patient percentage of attempts resulting in successful intercourse were 33, 56, and 62% for placebo, CIALIS 10-, and 20-mg groups, respectively. The efficacy and safety of CIALIS for once daily use in the treatment of erectile dysfunction has been evaluated in 2 clinical trials of 12-weeks duration and 1 clinical trial of 24-weeks duration, involving a total of 853 patients. CIALIS, when taken once daily, was shown to be effective in improving erectile function in men with erectile dysfunction (ED). CIALIS was studied in the general ED population in 2 randomized, multicenter, double-blinded, placebo-controlled, parallel-arm design, primary efficacy and safety studies of 12- and 24-weeks duration, respectively. Timing of sexual cialis tadalafil 5 mg 28 tablets activity was not restricted relative to when patients took Cialis. 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). Most (>96%) patients reported ED of at least 1-year duration.

The mechanism for treating BPH is separate from its effect on blood vessels.
For BPH, it works by inhibiting PDE5 in the prostate, bladder, and urethra.
This leads to smooth muscle relaxation in the lower urinary tract.
Patients may experience improved urinary frequency, urgency, and flow.
It is not a treatment for prostate cancer, though symptoms can overlap.
A prostate-specific antigen (PSA) test is often done before and during treatment.
Tadalafil can cause a slight decrease in measured PSA levels.
Your doctor needs to be aware you are taking it when interpreting PSA results.
It represents a non-surgical option for managing moderate BPH symptoms.
Surgical options remain for cases where medication is not effective enough.

2.4 Concomitant Medications

Efficacy Results in ED Patients with Diabetes Mellitus — CIALIS for once daily use was shown to be effective in treating ED in patients with diabetes mellitus. 16 HOW SUPPLIED/STORAGE AND HANDLING 16.1 How SuppliedCialis 10mg tablets are available in bottles of 10 (NDC 21695-028-10)Cialis 20mg tablets are available in bottles of 10 (NDC 21695-029-10)Cialis 20mg tablets are available in bottles of 16 (NDC 21695-029-16)Cialis 20mg tablets are available in bottles of 30 (NDC 21695-029-30)REPACKAGED BY:REBEL DISTRIBUTORS CORP.THOUSAND OAKS, CA 91320 Cialis 10mg tablets are available in bottles of 10 (NDC 21695-028-10) Cialis 20mg tablets are available in bottles of 10 (NDC 21695-029-10) 17 PATIENT COUNSELING INFORMATION See FDA approved Patient Labeling17.1 NitratesPhysicians should discuss with patients the contraindication of CIALIS with regular and/or intermittent use of organic nitrates. Patients should be counseled that concomitant use of CIALIS with nitrates could cause blood pressure to suddenly drop to an unsafe level, resulting in dizziness, syncope, or even heart attack or stroke.Physicians should discuss with patients the appropriate action in the event that they experience anginal chest pain requiring nitroglycerin following intake of CIALIS. Therefore, patients who experience anginal chest pain after taking CIALIS should seek immediate medical attention [see Contraindications (4.1) and Warnings and Precautions (5.1)].17.2 Cardiovascular ConsiderationsPhysicians should consider the potential cardiac risk of sexual activity in patients with preexisting cardiovascular disease. Physicians should advise patients who experience symptoms upon initiation of sexual activity to refrain from further sexual activity and seek immediate medical attention [see Warnings and Precautions (5.1)].17.3 Concomitant Use with Drugs Which Lower Blood PressurePhysicians should discuss with patients the potential for CIALIS to augment the blood-pressure-lowering effect of alpha blockers and antihypertensive medications [see Warnings and Precautions (5.6), Drug Interactions (7.1), and Clinical Pharmacology (12.2)].17.4 Potential for Drug Interactions When Taking CIALIS for Once Daily UsePhysicians should discuss with patients the clinical implications of continuous exposure to tadalafil when prescribing CIALIS for once daily use, especially the potential for interactions with medications (e.g., nitrates, alpha blockers, antihypertensives and potent inhibitors of cytochrome P450 3A4) and with substantial consumption of alcohol.17.5 PriapismThere have been rare reports of prolonged erections greater than 4 hours and priapism (painful erections greater than 6 hours in duration) for this class of compounds.

Mild side effects

When taken as directed, CIALIS was effective at improving erectile function. In the 6 month double blind study, the treatment effect of CIALIS did not diminish over time. Efficacy Results in ED Patients with Diabetes Mellitus — CIALIS for once daily use was shown to be effective in treating ED in patients with diabetes mellitus. 16 HOW SUPPLIED/STORAGE AND HANDLING 16.1 How SuppliedCialis 10mg tablets are available in bottles of 10 (NDC 21695-028-10)Cialis 20mg tablets are available in bottles of 10 (NDC 21695-029-10)Cialis 20mg tablets are available in bottles of 16 (NDC 21695-029-16)Cialis 20mg tablets are available in bottles of 30 (NDC 21695-029-30)REPACKAGED BY:REBEL DISTRIBUTORS CORP.THOUSAND OAKS, CA 91320 Cialis 10mg tablets are available in bottles of 10 (NDC 21695-028-10) Cialis 20mg tablets are available in bottles of 10 (NDC 21695-029-10) 17 PATIENT COUNSELING INFORMATION See FDA approved Patient Labeling17.1 NitratesPhysicians should discuss with patients the contraindication of CIALIS with regular and/or intermittent use of organic nitrates.

Region	Typical Price per 10 mg Cialis	Over-the-Counter Availability	Prescription Required
North America	$20 - $40 per tablet	Prescription only	Yes
Europe	€15 - €35 per tablet	Prescription required	Yes
Asia	$10 - $20 per tablet	Varies by country	Often prescription
Australia	AUD 25 - AUD 45 per tablet	Prescription required	Yes

Patients should be counseled that concomitant use of CIALIS with nitrates could cause blood pressure to suddenly drop to an unsafe level, resulting in dizziness, syncope, or even heart attack or stroke.Physicians should discuss with patients the appropriate action in the event that they experience anginal chest pain requiring nitroglycerin following intake of CIALIS.

14.1 CIALIS for Use as Needed

Could I take an 80-mg dose of Cialis?

The efficacy and safety of tadalafil in the treatment of erectile dysfunction has been evaluated in 22 clinical trials of up to 24-weeks duration, involving over 4000 patients. CIALIS, when taken as needed up to once per day, was shown to be effective in improving erectile function in men with erectile dysfunction (ED). CIALIS was studied in the general ED population in 7 randomized, multicenter, double-blinded, placebo-controlled, parallel-arm design, primary efficacy and safety studies of 12-weeks duration. Additional efficacy and safety studies were performed in ED cialis 5mg generique patients with diabetes mellitus and in patients who developed ED status post bilateral nerve-sparing radical prostatectomy. In these 7 trials, CIALIS was taken as needed, at doses ranging from 2.5 to 20 mg, up to once per day. Therefore, patients who experience anginal chest pain after taking CIALIS should seek immediate medical attention [see Contraindications (4.1) and Warnings and Precautions (5.1)].17.2 Cardiovascular ConsiderationsPhysicians should consider the potential cardiac risk of sexual activity in patients with preexisting cardiovascular disease. Physicians should advise patients who experience symptoms upon initiation of sexual activity to refrain from further sexual activity and seek immediate medical attention [see Warnings and Precautions (5.1)].17.3 Concomitant Use with Drugs Which Lower Blood PressurePhysicians should discuss with patients the potential for CIALIS to augment the blood-pressure-lowering effect of alpha blockers and antihypertensive medications [see Warnings and Precautions (5.6), Drug Interactions (7.1), and Clinical Pharmacology (12.2)].17.4 Potential for Drug Interactions When Taking CIALIS for Once Daily UsePhysicians should discuss with patients the clinical implications of continuous exposure to tadalafil when prescribing CIALIS for once daily use, especially the potential for interactions with medications (e.g., nitrates, alpha blockers, antihypertensives and potent inhibitors of cytochrome P450 3A4) and with substantial consumption of alcohol.17.5 PriapismThere have been rare reports of prolonged erections greater than 4 hours and priapism (painful erections greater than 6 hours in duration) for this class of compounds.