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National Academy of Medicine:
Articles

How Does Cialis Work

When you cannot perform to the maximum during sex, there is that awful feeling that you are less of a man. Several factors can predispose to erectile dysfunction such as the use of certain medications and even increasing age. But you should not feel like you hit rock bottom when this occurs. It is always a good thing to put up a fight when something strange come your way. What I mean here is that there have been erectile dysfunction problems before, and you are not the first one to suffer the condition. In first place, this is what explains the presence of the several erectile dysfunction drugs in pharmaceutical stores all over the world. Among top on the list of ED drugs is Cialis. You might have heard about it in local commercials or from a friend. Let us now take a closer look at this medication that can surely help you regain your full performance in the bedroom.

What is Cialis?

Cialis is the trade name for tadalafil which is a PDE5 inhibitor, and it has other uses in addition to treating erectile dysfunction. Tadalafil is also marketed as Adcirca which is the drug used for pulmonary hypertension.

Cialis made it to the US market in 2003 when FDA approved it as an ED drug. The drug came into existence after Viagra and Levitra, but its late arrival seemed not to affect it that much because it still proved to be a real competitor to the earlier entries. Of the three, Viagra was the earliest in the market after it was approved by FDA in 1998. Levitra was launched just two months before Cialis.

Glaxo and Icos decided to partner in 1991 in a quest to develop new drugs. This is the partnership that yielded Cialis. Currently, the joint company is called GlaxoSmithKline. ICOS cooperation started researching on a compound called IC351 which was a PDE5 inhibitor. The compound underwent clinical trials in men with ED and then, later on, the final clinical trials were done which made the drug subject to approval by the FDA. Glaxo and ICOS somehow lost the bond they had somewhere along the way, and it seemed as if ICOS was the only seller of IC531. The Lily and ICOS joint venture to market IC351 in 1998 is what led to the trade name Cialis. Elli Lily went ahead to buy the ICOS biochemical company and ended the joint venture to sell Cialis becoming the sole manufacturer of the drug.

The Cialis story wasn’t ending soon and in 2011, the drug was approved as a treatment for benign prostate hyperplasia (BPH). The condition is marked by enlargement of the prostate which causes difficulty in passing urine and a weak urine stream. It’s important to point out here that BPH is not like prostate cancer because the latter is more aggressive. With proper treatment, one can reduce the unpleasant effects of BPH without requiring an operation.

Cialis comes in different dosages. There are 5mg, 10mg, and 20mg pills. One can choose to take the drugs when they are expecting sex or as a daily dosage drug. Lower doses are recommended for the daily use because Cialis has a long half-life compared to Viagra and Levitra. Cialis 2.5mg and 5mg are the common everyday use dosages whereas Cialis for use as needed encompasses the 5mg, 10mg and 20mg dosages. The doctor’s prescription will describe which dosage you have to start with.

How Does Cialis Work?

If you want to try Cialis, then you are apparently itching with curiosity. Sometimes, with this kind of drugs you don't really know what to expect because there are all sorts of stories about them in every corner. But don’t be worried. It is anticipated that knowing some details about Cialis can help you predict the events that will follow your ingestion of the drug. You don’t have to be a chemistry guru to understand the mode of working of Cialis because it has been simplified here.

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When talking about erection, it's nice to look at the underlying events that make the shaft of the penis rigid and hard. What actually happens is that blood flows to the corpus cavernosum (a spongy chamber inside the penis) and for some time, it is locked there thanks to the action of a ligament located at the base of the penis and the penile muscles. So the arteries bring in blood, and the veins do not let it out. When one suffers from erectile dysfunction, it means that the blood flowing into the penis upon stimulation is not enough to cause a hard erection. The chemical basis for the Cialis action is inhibition of the Phosphodiesterase 5 enzyme (PDE5). This enzyme is responsible for the breakdown of cyclic guanylyl monophosphate cGMP.

Cyclic GMP is what’s responsible for causing smooth muscle relaxation which leads to an increased blood flow to the penis. The tadalafil in Cialis is responsible for inhibiting the PDE5 enzyme. When PDE5 is inhibited, then the cyclic GMP will not be degraded for some time thereby leading to the relaxation of the smooth muscles of the penile vessels. When the smooth muscles relax, the blood vessels expand and there is increased blood flow to the penis which gives the man a hard erection that will last for long thanks to the prolonged inhibition of the PDE5 enzyme. PDE5 is also found in the smooth muscle cells of the prostate. The exact mechanism of how this drug relieves the symptoms of benign prostate hyperplasia (BPH) is not understood, but it could be due to the relaxation of the muscles which improves voiding of urine.

How Long Does It Take for Cialis to Work?

The time taken for the actions of a drug to be felt pharmacologically is referred to as the onset of action. This is dependent upon several factors, key among them being the time taken for the drug to reach sufficient concentrations in the body. Therefore, the onset of action will be affected by the speed and degree of absorption, and you know this can be subject to many other influencing factors. If you have defective absorption, then drugs going into the bloodstream via the digestive system will not work as expected.

Let us also introduce the concept of bioavailability here. In simple terms, bioavailability refers to the amount of the drug substance that is accessible by the cells. It is the amount that reaches the cells after all the filter effects in the way of the drug. Drugs given intravenously will have a higher bioavailability because they are delivered directly in blood. Drugs administered perorally, however, will have to overcome the filtering effects of the liver and the gut.

With the above in mind, we can now assess the expected onset of action of Cialis. The tadalafil in Cialis is quite a quick acting substance. The effects of Cialis can be felt as early as 15 minutes after ingestion of the drug. Cialis has a faster onset of action than Viagra and Levitra. The rapid onset of action can be attributed to the high bioavailability of tadalafil which has been recorded as 80% compared to Viagra’s 40%. Although 15 minutes can be the earliest time for the actions of tadalafil to be seen, some people have reported up to two hours before feeling the effects of Cialis. Whereas taking Viagra (or sildenafil) with fatty meals can lead to a failure of treatment due to decreased absorption, the case is not the same with tadalafil. The Cialis active ingredient is absorbed gradually from the intestinal system, thus delivering just enough of the drug to the cells at a time and keeping a reservoir for later use. Therefore, you can take Cialis with fatty foods and still its action will not be compromised. When one has malabsorption conditions, then the onset of action of Cialis can be delayed. Whether taken as a daily dose drug, Cialis is expected to work without any delays at all allowing patients to enjoy sex any time they want without bothering about time periods between the intake and onset of action.

How Long Does Cialis Last?

When assessing how long a drug lasts, it is essential to define its half-life, which is the time that the drug takes to reach half of its initial concentration and for its effect to start fading away. Just like it was unique in terms of onset of action, Cialis also has a striking duration of action. In a healthy man, the half-life of tadalafil is about 18 hours. The drug will be active for some part of the day, and if you took it in the evening, then the effects will spill over to the next day. For the elderly, however, the half-life is about 24 hours, and this is in relation to the lower metabolic rates in the latter. The half-lives for Viagra and Levitra, as opposed to Cialis, are much shorter, namely, about 4 hours for both meds. In many cases, people have experienced the Cialis effects for as long as 48 hours and others even experience Cialis effects for up to three days.

The long half-life of Cialis has both benefits and shortcomings. It is a more beneficial drug to use because you don’t have to be anticipating sex in the next hour as is the case with sildenafil. You can take the pill and have the freedom to do your chores because it is going to last in your system for long and therefore you won’t have to keep taking more pills.

However, for people on certain treatments such as those on nitrates for angina pectoris, the other medications have to be halted for as long as the tadalafil is still active in their systems. The lower dosages for the daily Cialis allows for the action to be readily available. It means that the man will always be active in bed no matter the time of the day. As the concentrations become lower, another pill is added and therefore some level of constancy is attained. This is why people who use Cialis daily are advised to take it about the same time every day. Cialis for use as needed will also have its effects felt for as long as its half-life. The good thing is that you can use the drug and have hard erections with high-grade orgasms for the next two days. However, there’s no need to worry if it was only sex for a single day because the erections always come after stimulation.

Cialis is a quality drug that has proven to be an outstanding performer against erectile dysfunction. What makes it a favorite is the notably long duration of action and its incredibly short onset of action. It can be such a good substitute to sildenafil. If you are looking to solve your ED issues and regain your lost bedroom glory, this is clearly the way to go.