Tadalafil structure
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Cialis

Tadalafil is a drug used to treat male erectile dysfunction (impotence). It was developed by the biotechnology firm ICOS and marketed worldwide by Eli Lilly and Company under the brand name Cialis. It works by inhibiting an enzyme known as PDE5. Due to its 36-hour effect it is also known as the "Weekend Pill". In the United States, tadalafil has Food and Drug Administration approval and became available in December, 2003. more...

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Chemical information

The empirical formula for tadalafil is C22H19N3O4, and its official organic name is (6R,12aR)-6-(1,3-benzodioxol-5-yl)-2,3,6,7,12,12a- hexahydro-2-methyl-pyrazinopyridoindole-1,4-dione. The molecular weight is 389.41. The tablets are yellow, film-coated, and almond-shaped, and are produced in 5, 10, or 20mg doses. A 20mg dose of Tadalafil is comparable to a 100mg dose of sildenafil (Viagra). The MSDS for this compound can be found here:

Side effects

The most common side effects when using tadalafil are headache, indigestion, back pain, muscle aches, flushing, and stuffy or runny nose. These side effects usually go away after a few hours. Patients who get back pain and muscle aches usually get it 12 to 24 hours after taking the drug, and the symptom usually goes away after 48 hours.

In May 2005, the U.S. Food and Drug Administration found that tadalafil (along with other PDE5 inhibitors) could lead to vision impairment in certain patient groups, e.g. diabetics. An investigation is currently ongoing.

Drug interactions

Organic nitrates

Since PDE5 inhibitors such as tadalafil may cause transiently low blood pressure (hypotension), organic nitrates should not be taken for at least 48 hours after taking the last dose of tadalafil. Using organic nitrates within this timeframe may increase the risk of life-threatening hypotension. Since people who have taken tadalafil within the past 48 hours cannot take organic nitrates to relieve angina, these patients should seek immediate medical attention if they experience anginal chest pain . In the event of a medical emergency, paramedics and medical personnel should be notified of any recent doses of tadalafil.

Marketing

In the United States, Eli Lilly has a multiyear agreement to promote tadalafil (Cialis) with professional golf's PGA TOUR.

Trivia

  • The word "specialist" is frequently caught by primitive spam email blockers because it contains the word "cialis."

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Atazanavir : new recommendations if combined with tenofovir —and warning on Viagra, Cialis, and Levitra
From AIDS Treatment News, 3/26/04

On March 19, 2004 the FDA notified the public of new prescribing information and precautions for atazanavir (brand name Reyataz), if taken in combination with tenofovir (Viread)--and warned of risks with Viagra or similar drugs.

If atazanavir is taken with tenofovir, the blood level of atazanavir is decreased. Therefore it is now recommended that a small dose of ritonavir be taken in addition, to raise the blood level of atazanavir to compensate. All three drugs are taken together once per day, with food.

Also, Reyataz increases the blood level of Viread, which could increase its side effects. As a precaution, patients combining the drugs should be monitored for tenofovir side effects.

The new Patient Information flyer also warns that if atazanavir is combined with Viagra, Cialis, or Levitra, it could increase the risk of serious side effects of those drugs. Patients are advised not to combine atazanavir with any of these drugs unless their doctor tells them it is OK.

For more information see the new prescribing information for atazanavir, which will be posted at http://www.reyataz.com (we did not find it on the site on April 14). Also see the Patient Information flyer, which may be posted at the end of the prescribing information.

COPYRIGHT 2004 John S. James
COPYRIGHT 2004 Gale Group

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