Buy Generic Cialis 20 Mg in Tulsa, Oklahoma | No Prescription Needed



Buy Generic Cialis 20 Mg in Tulsa, Oklahoma without doctor’s prescription. Free shipping. next day delivery.

Tadalafil 20 Mg is the active ingredient in Generic Cialis 20 Mg. It is used to treat erectile dysfunction in males.

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Buy Generic Cialis 20 Mg

What is Cialis 20 Mg

Cialis 20 Mg is the trade name for a drug called Tadalafil. Cialis is one of a class of drugs known as PDE-5 (Phosphodiesterase type 5) inhibitors. Cialis and the other PDE-5 inhibitors can help men with erectile dysfunction (male impotence) by enhancing the erectile response when a man is sexually stimulated. Aside from Cialis, the other drugs in this class are Viagra (Sildenafil) and Levitra (Vardenafil).

Cialis does not cause a man to be sexually aroused. Cialis will only be effective if a man is mentally sexually aroused. To understand how Cialis works you need to understand the mechanics of how a man gets an erection. When a man is sexually stimulated, the nervous system in the erectile tissue of your penis releases nitric oxide (NO). The nitric oxide stimulates an enzyme that produces a ‘messenger’ called cyclic guanosine monophosphate (cGMP). The cGMP relaxes the smooth muscle cells.

One result of this is that the arteries in the penis dilate and the blood can flow into the penis more easily. Another result is that the erectile tissue itself fills with blood. Both of these processes result in an erection. Cialis works by maintaining the level of cGMP in the smooth muscle cells. If you are not mentally sexually aroused, your brain will not stimulate the release of any nitric oxide and you will not produce increased levels of cGMP.

If using Cialis 10mg or Cialis 20mg, take your tablet at least half an hour before engaging in sexual intercourse. The medicine will usually remain effective for up to 36 hours.

Cialis Daily doesn’t necessarily need to be taken before sex, but it needs to be taken at the same time every day. This provides erectile potency 24 hours per day, and can be used by men who anticipate engaging in intercourse two or more times per week.

Cialis Dosage

Common Side Effects of Cialis

  • Headache
  • Back pain
  • Muscle aches
  • Stomach pain or discomfort
  • Indigestion
  • Burping
  • Acid reflux
  • Flushing
  • Stuffy or runny nose

Serious Side Effects of Cialis

  • Vision impairment
  • Irregular heartbeat or chest pain
  • Shortness of breath
  • Lightheadedness
  • Sudden hearing loss.

Patients are urged to contact physicians for erections lasting more than four hours.

Cialis Dosage

Cialis tablets are yellow, film-coated, almond-shaped tablets, available in doses of 5, 10, and 20 milligrams (mg).

Cialis for daily use comes in 2.5 mg and 5 mg.

  • Recommended dosage of Cialis for ED is 10 mg, taken at least 30 minutes before sexual activity. Dosage may be increased to 20 mg or decreased to 5 mg, based of efficacy and tolerability.
  • Recommended dosage for Cialis once daily for ED is 2.5 mg, taken at the same time every day. Dosage may be increased to 5 mg based on efficacy and tolerability.
  • Recommended dosage for Cialis once daily for BPH is 5 mg, taken at the same time every day.
  • For pulmonary arterial hypertension patients, doses of 20, 40, and 60 mg may be prescribed. Typically, after 16 weeks of treatment, a 40 mg daily dose proved effective.

For patients experiencing both ED and BPA, the recommended dose of Cialis is 5 mg, taken at the same time every day.

Cialis Overdose

Contact your physician if you experience numbness or pain during sexual activity.

Get emergency help if you experience sudden vision loss because Cialis can decrease blood flow to the optic nerve in the eye.

Missed Dose of Cialis

Patients using Cialis may not be on a dose schedule, so simply take it as needed.

Do not take extra medicine to make up for a missed dose.

CIALIS For Use As Needed For Erectile Dysfunction

  • The recommended starting dose of CIALIS for use as needed in most patients is 10 mg, taken prior to anticipated sexual activity.
  • The dose may be increased to 20 mg or decreased to 5 mg, based on individual efficacy and tolerability. The maximum recommended dosing frequency is once per day in most patients.
  • CIALIS for use as needed was shown to improve erectile function compared to placebo up to 36 hours following dosing. Therefore, when advising patients on optimal use of CIALIS, this should be taken into consideration.

CIALIS For Once Daily Use For Erectile Dysfunction

  • The recommended starting dose of CIALIS for once daily use is 2.5 mg, taken at approximately the same time every day, without regard to timing of sexual activity.
  • The CIALIS dose for once daily use may be increased to 5 mg, based on individual efficacy and tolerability.

CIALIS For Once Daily Use For Benign Prostatic Hyperplasia

  • The recommended dose of CIALIS for once daily use is 5 mg, taken at approximately the same time every day.
  • When therapy for BPH is initiated with CIALIS and finasteride, the recommended dose of CIALIS for once daily use is 5 mg, taken at approximately the same time every day for up to 26 weeks.
  •  

DESCRIPTION

CIALIS (tadalafil) is a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5). Tadalafil has the empirical formula C22H19N3O4 representing a molecular weight.

The chemical designation is pyrazino[1′;,2′;:1,6]pyrido[3,4-b]indole-1,4-dione, 6-(1,3-benzodioxol-5-yl)2,3,6,7,12,12a-hexahydro-2-methyl-, (6R,12aR)-. It is a crystalline solid that is practically insoluble in water and very slightly soluble in ethanol.

CIALIS is available as almond-shaped tablets for oral administration. Each tablet contains 2.5, 5, 10, or 20 mg of tadalafil and the following inactive ingredients: croscarmellose sodium, hydroxypropyl cellulose, hypromellose, iron oxide, lactose monohydrate, magnesium stearate, microcrystalline cellulose, sodium lauryl sulfate, talc, titanium dioxide, and triacetin.

INDICATIONS

Erectile Dysfunction

CIALIS® is indicated for the treatment of erectile dysfunction (ED).

Benign Prostatic Hyperplasia

CIALIS is indicated for the treatment of the signs and symptoms of benign prostatic hyperplasia (BPH).

Erectile Dysfunction And Benign Prostatic Hyperplasia

CIALIS is indicated for the treatment of ED and the signs and symptoms of BPH (ED/BPH).

Limitation Of Use

If CIALIS is used with finasteride to initiate BPH treatment, such use is recommended for up to 26 weeks because the incremental benefit of CIALIS decreases from 4 weeks until 26 weeks, and the incremental benefit of CIALIS beyond 26 weeks is unknown.

Do not split CIALIS tablets; entire dose should be taken.

CIALIS For Use As Needed For Erectile Dysfunction

  • The recommended starting dose of CIALIS for use as needed in most patients is 10 mg, taken prior to anticipated sexual activity.
  • The dose may be increased to 20 mg or decreased to 5 mg, based on individual efficacy and tolerability. The maximum recommended dosing frequency is once per day in most patients.
  • CIALIS for use as needed was shown to improve erectile function compared to placebo up to 36 hours following dosing. Therefore, when advising patients on optimal use of CIALIS, this should be taken into consideration.

CIALIS For Once Daily Use For Erectile Dysfunction

  • The recommended starting dose of CIALIS for once daily use is 2.5 mg, taken at approximately the same time every day, without regard to timing of sexual activity.
  • The CIALIS dose for once daily use may be increased to 5 mg, based on individual efficacy and tolerability.

CIALIS For Once Daily Use For Benign Prostatic Hyperplasia

  • The recommended dose of CIALIS for once daily use is 5 mg, taken at approximately the same time every day.
  • When therapy for BPH is initiated with CIALIS and finasteride, the recommended dose of CIALIS for once daily use is 5 mg, taken at approximately the same time every day for up to 26 weeks.

CIALIS For Once Daily Use For Erectile Dysfunction And Benign Prostatic Hyperplasia

The recommended dose of CIALIS for once daily use is 5 mg, taken at approximately the same time every day, without regard to timing of sexual activity.

Use With Food

CIALIS may be taken without regard to food.

Use In Specific Populations

Renal Impairment

CIALIS For Use As Needed

  • Creatinine clearance 30 to 50 mL/min: A starting dose of 5 mg not more than once per day is recommended, and the maximum dose is 10 mg not more than once in every 48 hours.
  • Creatinine clearance less than 30 mL/min or on hemodialysis: The maximum dose is 5 mg not more than once in every 72 hours.

CIALIS For Once Daily Use

Erectile Dysfunction
  • Creatinine clearance less than 30 mL/min or on hemodialysis: CIALIS for once daily use is not recommended.
Benign Prostatic Hyperplasia And Erectile Dysfunction/Benign Prostatic Hyperplasia
  • Creatinine clearance 30 to 50 mL/min: A starting dose of 2.5 mg is recommended. An increase to 5 mg may be considered based on individual response.
  • Creatinine clearance less than 30 mL/min or on hemodialysis: CIALIS for once daily use is not recommended.
Hepatic Impairment

CIALIS For Use As Needed

  • Mild or moderate (Child Pugh Class A or B): The dose should not exceed 10 mg once per day. The use of CIALIS once per day has not been extensively evaluated in patients with hepatic impairment and therefore, caution is advised.
  • Severe (Child Pugh Class C): The use of CIALIS is not recommended.

CIALIS For Once Daily Use

  • Mild or moderate (Child Pugh Class A or B): CIALIS for once daily use has not been extensively evaluated in patients with hepatic impairment. Therefore, caution is advised if CIALIS for once daily use is prescribed to these patients.
  • Severe (Child Pugh Class C): The use of CIALIS is not recommended.



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