Cialis Professional

1. What is Cialis Professional?
2. Indications for Use
3. Dosage
4. Overdose
5. How to Take Cialis Professional for Best Results
6. Contraindications
7. Side Effects
8. Interaction with Other Drugs
9. Cialis Professional and Alcohol
10. Cialis Generics vs Original
11. Reviews

What is Cialis Professional?

Cialis Professional is a version of generics of the last generation. Its pharmacological action is focused on treatment and stabilization of erectile function in men. This drug is characterized by high degree of effectiveness and no significant side effects (the latter mainly relate to possible individual intolerance of ingredients or serious health problems).

It is able to reliably relieve problems with erection, its improved formula gives the drug new properties. Erection becomes stronger and more lasting, orgasms are emotionally more saturated. In addition, maximum filling of the penis with blood can significantly increase its size, which will bring your sex life to a new level.

What is Cialis Professional made of?

In Canadian Health and Care Mall, Cialis Professional is available in the form of pills with active ingredient doses. As an active component, the drug includes a chemical substance – tadalafil. As auxiliary components it contains the following substances:

• lactose;
• giprolose;
• croscarmellose sodium;
• microcrystalline cellulose;
• magnesium stearate;
• sodium lauryl sulfate;
• titanium dioxide;
• triacetin.

These medication pills are almond shaped, and on top are covered with a film shell, painted in yellow or red. On one side of the pill, there are engraved numbers indicating dosage.

The active substance of the drug – tadalafil – is one of the inhibitors of the PDE-5 enzyme, the main advantage of these enzymes in their highly selective effect on the male reproductive system. This important discovery allowed to effectively solve a whole complex of male problems without harm to health and without harmful influence on other organs and systems of the body. Effect of tadalafil is aimed at activating nitric oxide in the body and inhibiting production of the PDE-5 enzyme. Nitric oxide reduces the tone of blood vessels. They relax and with sexual excitement are tightly filled with blood, causing a potent erection. All this happens precisely at the natural sexual excitement and is perfectly controlled. In addition, tadalafil inhibits production of fifth-type phosphodiesterase enzyme, which has opposite to nitric oxide effect – increases the tone of blood vessels, squeezing blood out of them and leading penis into a relaxed state. The result of this delay is a prolongation of erection time and, accordingly, sexual intercourse.

PDE enzymes exist not only in vessels of penis, but also in arteries of a retina, skeletal and cardiac muscles, lungs, etc. PDE in each organ is indicated by a certain number, for example, PDE-5 is an enzyme that works in vessels of the penis, PDE-6 is localized in the retina of the eye, and PDE-3 in heart muscle. Cialis Professional has a high specificity, and therefore acts selectively only on PDE-5. That is why the drug has no side effects such as influence on blood pressure, change in color perception, etc.

This ED drug is able to increase cGMP by several times, while it acts gently and naturally, which leads to the appearance of quality and long-lasting erection. A special feature of Cialis Professional from other PDE-5 inhibitors is record-breaking long-term beneficial effect lasting up to 36 hours. During this period, if there is sexual stimulation, you can have successful sex. Clinical studies have not revealed the negative effect on spermatogenesis.

For whom the drug is intended?

• if you have erection disorder for any reason, and you are not able to achieve it as much as necessary for full sexual intercourse;
• if you plan a date that requires a lot of emotional stress and will cause excitement;
• if you want to be always in perfect sexual form and always be in full combat readiness, regardless of circumstances.

Cialis Professional is the solution to your problems and the way to achieve your desires. It was created just for you. Please note that each of these cases requires individual dosage. Therefore, to define it, contact the doctor.

A professional version is an effective medicine of new generation, which allows to reliably relieve men from problems with potency. Despite the fact that causes of erectile dysfunction are very diverse, it can quickly cope with any of them without harming other organs and systems. Cialis Professional can be used regardless of age, if you are already 18 years old, older people should not adjust dosage. This drug can also be safely consumed by those representatives of the stronger sex who do not suffer from violation of erectile function. Its reception is able to open up unlimited possibilities, which will give unforgettable sensations.

Medical consultation is mandatory before using Cialis Professional, despite good clinical performance and compatibility with other medications, you need to see a doctor for qualified counseling. With this purpose, it is possible to address your attending physician, therapist, cardiologist, an endocrinologist and other experts. They will help you to choose optimal dosage and determine possible restrictions for use of the drug.

Advantages of the drug:

1. prolonged impact. Only Cialis Professional of all PDE-5 inhibitors has a record long positive effect, reaching up to 36 hours;
2. reduction of time needed for rest and recovery between sexual acts;
3. due to increased blood flow to the penis, there is the strong filling of it with blood, which makes it possible to significantly increase penis in volume.

Since this drug is an improved version of earlier released Cialis, it has some differences. Among them:

• more rapid action: the action of the drug is manifested after 15 – 30 minutes after intake;
• increased effectiveness: thanks to the improved formula of drug composition, the efficacy of components lasts for 36 hours, which allows a man to increase potency and maintain spontaneous sexual activity;
• high level of adaptation to external factors: in this case we are talking about high-calorie food and alcoholic beverages, which do not affect drug in any way.

The drug can also be taken as courses, which significantly increases therapeutic effect and fixes it for a longer period of time for those who suffer from acute problems with erectile dysfunction because the main purpose is the treatment of sexual disorders. And unlike Viagra when taking generic fewer side effects occur. But you need to bear in mind that Cialis Professional works similarly to Viagra, it also does not cause sexual excitement, this process depends solely on the mind of the man taking the drug, it only provides a stable erection.

Cialis Professional is quite compatible with various medications and has no contraindications for conceiving children, even opposite in this process the drug can be of great value. Generic effect on the body does not differ from original, but its more affordable price on Canadian Pharmacy Mall website makes this drug a much more interesting acquisition.

Indications for Use

• symptoms of the lower urinary tract in patients with benign prostatic hyperplasia;
• erectile dysfunction (ED);
• erectile dysfunction in patients with symptoms of the lower urinary tract on the background of benign prostatic hyperplasia.

To date, the main indication for use is the treatment of erectile dysfunction, that is, a condition in which penis does not become sufficiently firm and excited for full intimate contact. Cialis Professional is indicated for use at weak erection caused by the following factors:

• psychoemotional disorders;
• organic erectile dysfunction;
• diabetes;
• removed prostate gland;
• obesity;
• hypertension;
• spinal cord injury.

Dosage

How much Cialis Professional to take? It is taken 15 to 30 minutes before sexual intercourse. The action lasts from 36 to 48 hours. Average recommended a single dose of the drug is 20 mg. It is not recommended to take more than one tablet a day. Absorption in the body occurs regardless of fatty foods or alcoholic beverages. However, you should not abuse them, because, in large doses, fatty foods and alcohol slow action of the drug.

• Middle-aged men are recommended a dosage of 20 mg;
• For older men, a special dosage is not required. Recommendations for taking medication for middle-aged men are also applicable to elderly patients;
• For patients with impaired renal and hepatic function (CK>= 30 ml/min) special dosage is not required.

Cialis Professional is not intended for use by persons under 18 years of age and women.

To avoid overdose and side reactions, the optimal amount of substance should be selected by a doctor. If a smaller dosage is prescribed, the pill should simply be broken into parts.

Overdose

Overdose can occur either due to misdirected prescribing or due to an improper intake by the patient himself. All symptoms of overdose consist in the prolonged action of the drug; special treatment is not carried out.

With the single appointment of the drug to healthy volunteers at a dosage of 500 mg/day and to patients with erectile dysfunction – repeatedly up to 100 mg/day, undesirable effects were the same as at use of the drug in lower doses.

Treatment: ordinary symptomatic therapy. Symptomatic therapy for removal of side effects because of overdose consists in the use of local drugs and methods of treatment.

Canadian HealthCare Mall reminds: do not allow overdose with Cialis Professional, especially, several times. After all, this drug affects the condition of blood vessels.

How to Take Cialis Professional for Best Results

Cialis Professional pills should be taken orally, with a small amount of water. The pill can be taken regardless of food. A pill with the appropriate dosage should be taken no earlier than 16 minutes before planned sexual contact. After intake, you can make attempts to have sexual intercourse within 36 hours. In this case, it is possible to establish an optimal time during which effect of the drug develops. Then a man will be able to choose an individual for himself time for which he needs to take a pill to make successful sexual contact. Do not abuse frequent use of the drug. It is recommended to take Cialis Professional not more than once a day.

Contraindications

Cialis Professional has absolute and relative contraindications for use. In presence of absolute contraindications, the drug is prohibited for use under any circumstances. And in presence of relative contraindications, this Ed drug can be used with caution and careful monitoring of health state.

Absolute Contraindications

• sensitivity, allergy or intolerance of tadalafil and other components of the drug;
• age under 18 years.

Relative Contraindications

• sexual activity has a potential risk for patients with cardiovascular disease, therefore, treatment of erectile dysfunction should not be performed in men with heart diseases at which sexual activity is not recommended.
• cardiac insufficiency of II and above class that developed over a six-month period;
• unstable cardiac angina;
• cardiac angina developing during lovemaking;
• hypotension below 90/50 mm Hg;
• heart attack or blood stroke in the last six months;
• since there are no data from controlled clinical trials on safety and efficacy in patients with severe renal insufficiency (CK <= 30 ml/min) and severe hepatic insufficiency, the drug should be used with caution in this category of patients only in case of extreme necessity. On the background of treatment with Cialis Professional patients with moderate renal insufficiency (CK 31-50 ml/min) more often had back pain compared to patients with mild renal insufficiency (KK 51-80 ml/min) or healthy volunteers. Patients with CK <= 50 ml/min should administer the drug with caution;
• degenerative diseases of retina, for example, pigmented retinitis;
• caution should be taken in patients with a predisposition to priapism (e. g., sickle-cell anemia, multiple myeloma or leukemia) or in patients with anatomical penis deformities (e. g., angulation, cavernous fibrosis or Peyronie’s disease). The patient should be informed of the need to seek immediate medical attention in case of an erection lasting for 4 hours or more. Untimely treatment of priapism leads to damage to penile tissues, as a result of which a long-term loss of potency may occur;
• uncontrolled arrhythmias or hypertension;
• use of the drug for self-treatment should be excluded.

Influence on ability to drive vehicles and operate mechanisms
There are no specific recommendations.

Side effects

Cialis Professional has quite a wide range of side effects that develop with varying frequency. Side effects are associated primarily with incorrect dosage resulting from self-medication. So, the most frequent side effects of the drug (developing in 5 to 15% of men taking pills) are the following conditions:

• side effect can manifest as headaches. In some cases, these pains do not stop until the drug is canceled. Usually, they are successfully solved using means for a headache;
• a greater number of men noted that after taking medication they had various gastric disorders. Most noted pain in stomach, heaviness, swelling, that is, all symptoms of dyspepsia;
• also, some patients noted that after the appointment of Cialis Professional they had pains in a back area. Such patients are very few;
• some patients reported pain in muscles, but there were very few of such patients, as well as in case of back pain;

*** Back or muscle pain usually develops within 12 to 24 hours after taking the pill, and disappear within 2 days. These pains occur most often in the lower part of lower back, buttocks, hips, coccyx or sacrum. Especially pain in muscles and back is felt in lying position. Pain is slight or moderate. In some cases, these pains do not stop until the drug is canceled. But in most cases, they are successfully solved using painkillers.

• nasal congestion;
• hot flashes;
• pain in limbs;
• approximately 1% of patients had to swell of eyes or conjunctivitis, also these patients complained of pain in the eyes;
• several patients reported blurred vision after taking medication;
• dizziness;
• in some patients, various allergic reactions were noted, but all of them were of short and mild nature. Problem was solved either by using antihistamines or by canceling the main drug;
• several patients noted that after using the drug they were excessively sweating. Problem was solved by cancellation;
• patients who had previously suffered from cardiovascular diseases noted pain in the chest. But since symptoms were very weak and unclear, it is not clear whether this pain was caused by Cialis Professional or by cardiovascular disorder due to sexual activity.

Interaction with Other Drugs

If you need to take Cialis Professional with other medicines, you should know their effects on each other. If medications weaken its effect, it is necessary to increase the dosage of the latter. If the drug, on the contrary, enhances its effect, then dosage should be reduced, or even such combinations should be avoided. There are drugs that do not affect tadalafil action – in this case, there is no need to adjust its dosage.

Effect of Other Drugs

Cialis Professional is mainly metabolized with the participation of CYP3A4 isoenzyme. Selective inhibitor of CYP3A4 isoenzyme – ketoconazole (400 mg/day) – increases exposure to tadalafil single dose (AUC) by 312% and Cmax by 22%, and ketoconazole (200 mg/day) increases exposure to single dose (AUC) by 107% and Cmax by 15% relative to AUC and Cmax values for Cialis Professional only.

Ritonavir (200 mg twice a day) – an inhibitor of CYP3A4, 2C9, 2S19 and 2D6 isoenzymes, increases exposure to single dose of Cialis Professional (AUC) by 124% without changing Cmax. Although specific interactions have not been studied, it can be assumed that other HIV-protease inhibitors such as saquinavir, as well as inhibitors of CYP3A4 isoenzyme such as erythromycin and itraconazole, increase the professional version activity.

Selective inducer of CYP3A4 isoenzyme – rifampicin (600 mg/day) – reduces exposure of single dose (AUC) by 88% and Cmax by 46%, relative to AUC and Cmax values for Cialis Professional only. It can be assumed that simultaneous use of other inducers of CYP3A4 isoenzyme should also reduce its concentrations in blood plasma.

Simultaneous intake of antacid (magnesium hydroxide/aluminum hydroxide) and Cialis Professional reduces absorption rate of the latter without changing area under the pharmacokinetic curve.

Increase in pH of the stomach as a result of taking H2-histamine receptor blockers – nizatidine – did not affect the pharmacokinetics of Cialis Professional.

Safety and efficacy of the combination of tadalafil with other means for erectile dysfunction treatment have not been studied, so the use of such combinations is not recommended.

Effect of Cialis Professional on Other Drugs

It is known that Cialis Professional enhances hypotensive effect of nitrates. This occurs as a result of the additive action of nitrates and the mentioned previously drug on the metabolism of nitric oxide II (NO) and cGMP. Therefore, use of Cialis Professional on the background of taking nitrates is contraindicated.

This preparation does not have the clinically significant effect on clearance of drugs which metabolism occurs with the participation of P450 cytochrome. Studies have confirmed that tadalafil does not inhibit or induce CYP1A2, CYP3A4, CYP2C9, CYP2C19, CYP2D6, CYP2E1 isoenzymes.

Cialis Professional does not have a clinically significant effect on the pharmacokinetics of S-warfarin or R-warfarin. It also does not affect warfarin action on prothrombin time.

Cialis Professional does not potentiate increase in hemorrhages duration caused by intake of acetylsalicylic acid.

It has systemic vasodilatory properties and can enhance the effect of antihypertensive drugs aimed at lowering blood pressure.

In addition, in patients taking several antihypertensive drugs, with poorly controlled hypertension, a somewhat greater decrease in blood pressure was observed. In the vast majority of patients, this decrease was not associated with hypotensive symptoms. Patients receiving treatment with antihypertensive drugs and taking this ED drug should be given appropriate clinical recommendations.

There was no significant reduction in blood pressure by individuals who took selective alpha1-adrenoblocker – tamsulosin.

Simultaneous application of Cialis Professional with doxazosin is contraindicated. Healthy volunteers who took doxazosin (4 – 8 mg/day) – alpha1-adrenoblocker – observed an increased hypotensive effect of doxazosin. Some patients experienced dizziness. Fainting was not observed. Use of doxazosin at lower doses has not been studied.

Cialis Professional does not have a clinically significant effect on pharmacokinetics or pharmacodynamics of theophylline.

Cialis Professional and Alcohol Interaction

Cialis Professional did not affect the concentration of alcohol, nor did alcohol affect its concentration. According to Canadian Healthcare Mall data, at high doses of alcohol (0,7 g/kg), this drug did not cause a statistically significant decrease in average values of blood pressure. In some patients, postural dizziness and orthostatic hypotension were observed. When taking tadalafil in combination with alcohol in lower doses of (0,6 g/kg), blood pressure was not reduced, dizziness occurred with the same frequency as when taking alcohol only.

Generics vs Original

Tadalafil is a chemical substance, that is, it is synthesized in test tubes. In nature, it does not occur, so it is impossible to find this substance in any food or medicinal plant. Method of obtaining and chemical synthesis of tadalafil was developed by British pharmaceutical corporation «Elly Lilly» in 2003. Based on this substance, pharmacologists created original drug Cialis. All other medications on the basis of tadalafil are Cialis generics, including Cialis Professional, which are completely safe. Canadian Health&Care Mall decided to consider the main differences and characteristics of generics and original medicines.

Developing original medicinal product, pharmaceutical concern synthesizes and releases a certain chemical substance, which will be the active ingredient. Then, optimal dosages of the substance are detected experimentally, which has the best positive effect with minimal side effects. Optimum auxiliary components are also indicated. Then technology of synthesis of the substance and methods of its purification from various impurities, which often cause allergic reactions and side effects, are developed. After successful completion of all stages of development, a finished medicinal product is tested and released on the market under a specific name, invented specifically for it.

Thus, there are original pharmaceutical preparations that have international patents. However, a patent for the medicinal product is valid for a limited period of time, after which any pharmaceutical company can take the composition of original preparation (written in each instruction) and make its own medicine according to indicated dosages. It is this drug will be called a generic. In rare cases, a new name comes up with a generic drug. And most often, generics are called simply by the international name of the active substance. For example, in relation to the active substance of Cialis Professional, it looks like this: original preparation is called Cialis, and most generics – Tadalafil. That is, generic substance contains the same active substance as original preparation. Generics are usually much cheaper than original drugs.

Despite the same active ingredient in generics and original drugs, the composition of auxiliary components may vary significantly. Often, the only similarity of generic with the original drug is just the same active substance. In this case, as a rule, active substances to produce generics are obtained in chemical laboratories by industrial means, which are not subjected to serious and thorough purification from impurities. It is a large number of impurities that pharmacists mean when they say about the drug that it is quite «dirty».Thus, Cialis Professional has a large number of generics that belong to tadalafil group. Most of Cialis generics are produced by Indian pharmaceutical corporations, which specialize precisely in this direction of the drug market.

Reviews

Reviews about Cialis Professional preparation are mostly positive, and this applies to both original Cialis 20 mg, and various generics. Pills are used by both adult men and young boys, but both of them note the good effect of which manifests itself in the form of great erection, sufficient for sexual intercourse, lasting for several days – from 2 to 4.

In addition to good erection, men notice the extension of sexual intercourse, that is, it significantly prolongs it. Also, some men note changes in feelings during sex, which they regard simply as unusual. Such interesting sensations from a male point of view lead to bright and long orgasm.

On the background of undoubtedly positive action, most men developed minor side effects in the form of headaches and feeling of strong torsion of legs. However, men believe that these minor uncomfortable phenomena can be tolerated, because pleasure in sex, which Cialis Professional allows, is incommensurably higher. Therefore, these side effects men consider as a small payment for excellent sex, responding in general to drug positively.

There is also a small number of negative reviews about Cialis Professional, which are caused by the development of flashes, severe back pain, nasal congestion and headache instead of erection. That is, there are side effects, which completely eclipse the main action. In this situation, even with a persistent and good erection, it is impossible to perform sexual intercourse, which is very frustrating for men and makes them write negative feedback about the drug.

Some men note prolonged sexual intercourse because on the background of its use it is harder to achieve ejaculation. Some people like this because it allows enjoying sexual intercourse longer, while others, on the contrary, experience negative emotions. This phenomenon also influences opinion about the drug. Those men who like prolonged sex, consider this a plus of the drug and leave positive feedback. And those men who do not like long sexual intercourses consider the inability to relatively quickly achieve ejaculation as a minus and therefore leave negative feedback about the pill.

John, 45
Having experienced an unpleasant embarrassment in bed, I talked with my doctor, from which I received a standard dose of Cialis Professional for 36 hours. I took it at 15-00 and had rendezvous at 00.00. The reason is in the unique duration of action of the substance, which varies in the range of 24 – 36 hours. In patients on hemodialysis receiving 10 or 20 mg of tadalafil, no cases of back pain were reported. After the onset of Cialis therapy, a month later we switched from 1 attempt to have sex to 3 sexual intercourses a day, each of which could easily last for 1 – 2 hours.

Andrew, 38
I tried Cialis Professional and I am satisfied with the result. My potency is all right – I use stimulants to enhance my abilities, it’s nice when a girl says that you are the best. About side effects yet I do not know, did not feel them (took Cialis together with vodka and beer).

Leo, 29
I am not a master to write any feedback, about Cialis Professional I can say only one thing – this generic works. Although I’m still good in bed, an extra pill of Cialis to maintain my own confidence will not hurt. Let the girls use me while I’m young, and I’ll use it. I’ll order Viagra later to compare with Cialis.