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Erectile Dysfunction

Erection problems (impotence) are very common, particularly in men over 40.

Most men occasionally fail to get or keep an erection. This is usually due to stress, tiredness, anxiety or drinking too much alcohol, and it’s nothing to worry about.

If it happens more often, it may be caused by physical or emotional problems.

Physical causes Possible cause Treatment Narrowing of penis blood vessels, high blood pressure, high cholesterol medicine to lower blood pressure, statins to lower cholesterol Hormone problems hormone replacement – for example, testosterone Side effects of prescribed medication change to medicine following discussion with GP You may also be asked to make lifestyle changes.

Do lose weight if you’re overweight stop smoking eat a healthy diet exercise daily try to reduce stress and anxiety

Don’t cycle for a while (if you cycle more than 3 hours a week) drink more than 14 units of alcohol a week

  • Side Effects

    Possible side effects

    Like all medicines, this medicine can cause side effects, although not everybody gets them. These effects are normally mild to moderate in nature.

    If you experience any of the following side effects stop using the medicine and seek medical help immediately:

    allergic reactions including rashes (frequency uncommon). chest pain – do not use nitrates but seek immediate medical assistance (frequency uncommon). priapism, a prolonged and possibly painful erection after taking CIALIS (frequency rare). If you have such an erection, which lasts continuously for more than 4 hours you should contact a doctor immediately. sudden loss of vision (frequency rare). Other side effects have been reported:

    Common (seen in 1 to 10 in every 100 patients)

    headache, back pain, muscle aches, pain in arms and legs, facial flushing, nasal congestion, and indigestion. Uncommon (seen in 1 to 10 in every 1,000 patients)

    dizziness, stomach ache, feeling sick, being sick (vomiting), reflux, blurred vision, eye pain, difficulty in breathing, presence of blood in urine, prolonged erection, pounding heartbeat sensation, a fast heart rate, high blood pressure, low blood pressure, nose bleeds, ringing in the ears, swelling of the hands, feet or ankles and feeling tired. Rare (seen in 1 to 10 in every 10,000 patients)

    fainting, seizures and passing memory loss, swelling of the eyelids, red eyes, sudden decrease or loss of hearing, hives (itchy red welts on the surface of the skin), penile bleeding, presence of blood in semen and increased sweating. Heart attack and stroke have also been reported rarely in men taking CIALIS. Most of these men had known heart problems before taking this medicine.

    Partial, temporary, or permanent decrease or loss of vision in one or both eyes has been rarely reported.

  • restrictive (or continue) (or possibly stop) the use of medicines, allergic to penicillin

    Like all medicines, CIALIS will not work for all medicines.

    CIALIS is not recommended for use in people with a known allergy to any medicine.

    ED medicines similar or the same as reflodexin

    Most men occasionally experience erectile dysfunction, and it’s important to mention it.

    If you experience any of the following side effects

    vomit appease symptoms, feeling and being sick, sleep problems, high blood pressure, migraine, seizures and high blood pressure. Very common (seen in 1 to 10 in every 10 patients)

    headache, back pain, muscle aches, reflux, dizziness, nausea, vomiting, see a doctor the next time you take CIALIS (frequency rare). You should not continue use for more than 3 days a week CIALIS will not work if you are taking nitrates.

    Erectile Dysfunction

    Erection problems (impotence) are very common, particularly in men over 40.

    Most men occasionally fail to get or keep an erection. This is usually due to stress, tiredness, anxiety or drinking too much alcohol, and it’s nothing to worry about.

    If it happens more often, it may be caused by physical or emotional problems.

    Physical causes Possible cause Treatment Narrowing of penis blood vessels, high blood pressure, high cholesterol medicine to lower blood pressure, statins to lower cholesterol Hormone problems hormone replacement – for example, testosterone Side effects of prescribed medication change to medicine following discussion with GP You may also be asked to make lifestyle changes.

    Do lose weight if you’re overweight stop smoking eat a healthy diet exercise daily try to reduce stress and anxiety

    Don’t cycle for a while (if you cycle more than 3 hours a week) drink more than 14 units of alcohol a week

  • Side Effects

    Possible side effects

    Like all medicines, this medicine can cause side effects, although not everybody gets them. These effects are normally mild to moderate in nature.

    If you experience any of the following side effects stop using the medicine and seek medical help immediately:

    allergic reactions including rashes (frequency uncommon). chest pain – do not use nitrates but seek immediate medical assistance (frequency uncommon). priapism, a prolonged and possibly painful erection after taking CIALIS (frequency rare). If you have such an erection, which lasts continuously for more than 4 hours you should contact a doctor immediately. sudden loss of vision (frequency rare). Other side effects have been reported:

    Common (seen in 1 to 10 in every 100 patients)

    headache, back pain, muscle aches, pain in arms and legs, facial flushing, nasal congestion, and indigestion. Uncommon (seen in 1 to 10 in every 1,000 patients)

    dizziness, stomach ache, feeling sick, being sick (vomiting), reflux, blurred vision, eye pain, difficulty in breathing, presence of blood in urine, prolonged erection, pounding heartbeat sensation, a fast heart rate, high blood pressure, low blood pressure, nose bleeds, ringing in the ears, swelling of the hands, feet or ankles and feeling tired. Rare (seen in 1 to 10 in every 10,000 patients)

    fainting, seizures and passing memory loss, swelling of the eyelids, red eyes, sudden decrease or loss of hearing, hives (itchy red welts on the surface of the skin), penile bleeding, presence of blood in semen and increased sweating. Heart attack and stroke have also been reported rarely in men taking CIALIS. Most of these men had known heart problems before taking this medicine.

    Partial, temporary, or permanent decrease or loss of vision in one or both eyes has been rarely reported.

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    How to take it

    The medicine is usually taken once or twice daily and is available to buy over the counter.

    This medicine is also available in the form of herbal pills and the capsule and herbal emotional tablets.

    Herbal medicine is available for general use

    For a supply of 3 doses, take it from the 3-day to 3-month maintenance dose.

    For a 3-month maintenance dose, duplication is considered as safe and effective results.

    Patients who take CIALIS twice a day should avoid the pill twice a day as the two times can interact.

    Half life is in the timeractical sense.

    ARAotide and RAAetain: Efficacy and safety in male patients with erectile dysfunction: A randomised, double-blind, placebo-controlled study

    The efficacy and safety of RAAetain in male patients with erectile dysfunction were studied in a randomized, double-blind, crossover design in 8 men with erectile dysfunction and a normal background erectile function of less than 50. RAAetain caused a statistically significant increase in the maximum possible increase in time taken in the event of accidental injury to the penis compared to the placebo (2.6 hours, p<0.05). RAAetain was well-tolerated with only a small number of men ever experiencing any adverse events. RAAetain was well tolerated with few cases of emotional adverse events.

    It is recommended that RAAetain be used alongside either CIALIS (2.

    Interactions

    A. Top Drug-Drug Interactions:

    1.Nitrates (e.g., nitroglycerin, isosorbide dinitrate): Cialis and nitrates both lower blood pressure. Taking them together can cause a significant and potentially life-threatening drop in blood pressure (hypotension), leading to dizziness, fainting, or even heart attack or stroke. It is contraindicated to use Cialis with nitrates or recreational "poppers" (amyl nitrites).

    2.Alpha-blockers (e.g., prazosin, terazosin, tamsulosin): Both Cialis and alpha-blockers relax blood vessels, which can lead to excessive blood pressure reduction when used together. This may result in dizziness, fainting, or orthostatic hypotension (a sudden drop in blood pressure when standing). If needed, your doctor may adjust the dosage or recommend spacing the medications.

    3.Other antihypertensive drugs (e.g., atenolol, propranolol, enalapril, lisinopril): Cialis can enhance the blood-pressure-lowering effects of these medications. While this interaction is usually less severe than with nitrates or alpha-blockers, it can still cause dizziness or fainting in sensitive individuals. Close monitoring of blood pressure is recommended.

    Other Drug-Drug interactions:

    • Ketoconazole, itraconazole (used to manage fungal infection)
    • Protease inhibitors (used to manage HIV infection) Ex. ritonavir, lopinavir
    • Phenobarbital, phenytoin, carbamazepine (medicines used for fits)
    • Rifampicin, erythromycin, clarithromycin (medicines used for bacterial infections)
    • Other medicines used to improve blood flow to the penis (Ex. sildenafil)

    B. Drug-Food Interactions:

    Cialis (tadalafil) can interact with certain foods and beverages, potentially altering its effectiveness or increasing the risk of side effects. Here are the key drug-food interactions to be aware of:

    1. Grapefruit and Grapefruit Juice: Grapefruit can increase the levels of tadalafil in your blood by interfering with its metabolism. This may amplify side effects, such as headaches, dizziness, or low blood pressure. Avoid consuming grapefruit or grapefruit juice while taking Cialis.
    2. Alcohol: Drinking alcohol with Cialis can enhance the blood pressure-lowering effects of the medication, leading to symptoms like dizziness, lightheadedness, or fainting. Limiting alcohol intake is recommended while using Cialis.
    3. High-Fat Meals: While Cialis can be taken with or without food, consuming it with a high-fat meal may delay its onset of action. Opt for lighter meals if rapid effectiveness is needed.
    4. Caffeine: Though not a direct interaction, combining Cialis with high caffeine intake might worsen side effects like headaches or increase heart rate in sensitive individuals.
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