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In the case of the appointment of Brand Cialis 10 mg, the attending physician should proceed from a thorough individual assessment of the benefit-risk ratio.
Patients should be informed of the need for immediate medical attention in case of an erection lasting 4 hours or more. Untimely treatment of priapism can lead to damage to the tissues of the penis and persistent loss of potency;
Brand Cialis 10 mg should be used with caution in patients with anatomical deformity of the penis (for example, with angular curvature, cavernous fibrosis or Peyronie’s disease) or in patients with a predisposition to priapism (for example, with sickle cell anemia, multiple myeloma or leukemia);
Caution should be exercised when prescribing Brand Cialis 10 mg to patients taking potent CYP3A4 inhibitors (ritonavir, saquinavir, ketoconazole. itraconazole and erythromycin), since an increased concentration of tadalafil (Brand Cialis 10 mg) in blood plasma was observed while taking these drugs simultaneously;
Safety and efficacy of the combination of the drug Brand Cialis 10 mg Cytochrome P450 inhibitors, The metabolism of tadalafil occurs mainly under the action of the enzyme SUR3A4.
Taking ketoconazole, a selective CYP3A4 inhibitor, (at a dose of 200 mg per day) increases the plasma concentration (AUC) of tadalafil (Brand Cialis 10 mg) by 2 times. Although specific interactions have not been studied, other protease inhibitors such as saquinavir, as well as other CYP3A4 inhibitors such as erythromycin, clarithromycin, itraconazole and grapefruit juice should be taken with caution in conjunction with tadalafil, as an increase in plasma concentrations of tadalafil can be expected. As a consequence, cases of adverse reactions may increase.
The role of carriers (for example, p-glycoprotein) in the pharmacokinetics of tadalafil has not been studied. Therefore, there is a possibility of drug interaction mediated by vector inhibition.
Cytochrome P450 inducers The CYP3A4 inducer, rifampicin, reduces the plasma concentration of tadalafil by 88% compared to the plasma concentration of tadalafil (Brand Cialis 10 mg) when taken separately. A decrease in plasma concentration may lead to a decrease in the effectiveness of tadalafil, but the severity of such a decrease in effectiveness has not been studied. Other CYP3A4 inducers such as phenobarbital, phenytoin and carbamazepine may also reduce plasma concentrations of tadalafil.
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