Uses of TadalExtra 20

TadalExtra 20 drug used in men with erectile dysfunction with the main active ingredient is Tadalafil. TadalExtra is usually taken about 30 minutes before sex and the effect of the drug can last for 24 hours. The following article provides about the uses and dosage of TadalExtra 20mg.

TadalExtra 20 belongs to the group of vasodilators used to treat erectile dysfunction. TadalExtra has the main active ingredient, Tadalafil, in the form of tablets with a strength of 20mg. Tadalafil is a selective, reversible inhibitor of cyclic guanosine monophosphate (cGMP) – specifically of phosphodiesterase type 5 (PDE5). In the presence of sexual stimulation, nitric oxide is locally released, the PDE5 inhibitory effect of Tadalafil increases cGMP concentrations in the corpus cavernosum. This leads to smooth muscle relaxation and increased blood flow into the penile tissue causing penile erection. Tadalafil has no effect in the absence of sexual stimulation.

Indications TadalExtra 20 is indicated in case of erectile dysfunction. TadalExtra is effective only in the presence of aphrodisiac activity.
Contraindications In clinical studies, Tadalafil may potentiate the hypotensive effects of nitrates, due to the synergistic effect of Tadalafil and nitrates on the nitric oxide/cGMP cycle. Contraindications to the use of TadalExtra 20 in patients with cardiovascular disease:
New myocardial infarction within 90 days. Patients who have unstable angina or whose angina occurs during sexual intercourse. The patient was in group 2 according to the New York Heart Association classification of heart failure worsening within 6 months. Uncontrolled arrhythmia, low blood pressure (<90/50 mmHg), uncontrolled hypertension. Cerebrovascular accident within 6 months. TadalExtra 20mg should not be used in patients who are allergic or hypersensitive to Tadalafil or any of its ingredients.

3.1 Drug Dosage TadalExtra is taken orally. TadalExtra is used at the following dosage:
Adult Men Recommended daily dose: 20mg as needed. Use 30 minutes before sex. The time to take TadalExtra is not related to the meal.
The effect of TadalExtra can be maintained for up to 24 hours after taking the drug. The maximum number of doses is once per day and daily use is not recommended, as the safety of Tadalafil in long-term use is not available.
Elderly (>65 years old) No dose adjustment of TadalExtra is required in elderly patients.
Patients with renal failure It is recommended that patients use TadalExtra tablets with a strength of 10mg. There are currently no data on the use of Tadalafil in doses higher than 10 mg in patients with renal impairment.
Patients with liver failure It is recommended that patients use TadalExtra tablets with a strength of 10mg. There are currently no data on the use of Tadalafil in doses higher than 10 mg in patients with hepatic impairment.
Children and adolescents TadalExtra should not be used in children under 18 years of age.
3.2 Overdose and Management TadalExtra Symptoms of Overdose: a single dose trial of up to 500 mg Tadalafil in healthy subjects and 100 mg multiple times daily has shown that adverse events occurred similar to those observed in used at lower doses.
Management: Standard supportive measures should be taken according to the clinical setting of the patient. Hemodialysis has a negligible effect on the elimination of Tadalafil. Monitor the patient closely for timely treatment.

Undesirable effects when taking TadalExtra are usually transient, of mild or moderate severity. Some side effects may be encountered such as:
Common: headache, indigestion. Uncommon: dizziness, flushing, back pain, myalgia, nasal congestion. Rare: pain in the eye, conjunctival congestion, eyelid swelling. Inform the doctor about the unwanted effects encountered when using TadalExtra and go to the medical facility for timely treatment.

Before using TadalExtra, a clinical examination is necessary to diagnose erectile dysfunction and identify underlying comorbidities. Physicians should consider a patient's cardiovascular disease, as there is a degree of cardiovascular risk associated with sexual activity, before initiating any treatment for erectile dysfunction.
Tadalafil has vasodilator properties, blood pressure may decrease but to a mild and transient extent. Tadalafil thus enhances the potential for the hypotensive effects of nitrate drugs.
Serious cardiovascular events, including myocardial infarction, unstable angina, transient myocardial ischemia, sudden cardiac death, cerebrovascular accident, transient ischemic attack, arrhythmia ventricular tachycardia and tachycardia have been reported in clinical trials of TadalExtra. In addition, hypertension and hypotension also occurred but infrequently in clinical trials. Most of these patients were reported to have pre-existing cardiovascular risk factors. However, it is difficult to determine with certainty whether these events are directly related to risk factors, TadalExtra use, sexual activity, or a combination of other factors.
Currently, there are not enough data on the safety of TadalExtra in the following patient groups. The benefits and risks need to be carefully weighed on a case-by-case basis before prescribing TadalExtra to patients with severe renal impairment (creatinine clearance ≤ 30 ml/min) and severe hepatic impairment Child-Pugh C.
Erection Penis was not observed in clinical trials using TadalExtra. However, this symptom has been reported with other PDE5 inhibitors. If the patient has an erection lasting 4 hours or more, it is necessary to go to a medical facility for timely emergency treatment. If priapism is left untreated, damage to penile tissue and the ability to get an erection can be lost forever.
TadalExtra 20mg should be used with caution in patients with pathological conditions that cause penile erection (eg, multiple myeloma, sickle cell anemia, leukemia), or in patients with anatomical deformities of the penis (eg. cavernous fibrosis, penile flexion or Peyronie's disease).
It is not known whether TadalExtra 20mg is effective in patients with spinal cord injury, pelvic surgery, prostate surgery.
TadalExtra contains lactose. TadalExtra should not be used in patients with hereditary problems of galactose intolerance or glucose-galactose malabsorption.
Safety and effectiveness when combining TadalExtra with other drugs for the treatment of erectile dysfunction has not been well studied. Therefore, TadalExtra should not be used in combination with these drugs.
Efficacy of daily use of TadalExtra for a long period of time has not been established, therefore it is not recommended to use TadalExtra every day.

Tadalafil is metabolised primarily by CYP3A4. Selective inhibitors of CYP3A4, such as Ketoconazole, increase Tadalafil's AUC by up to 107%. Some protease inhibitors (such as Ritonavir or Saquinavir) and other CYP3A4 inhibitors (such as Erythromycin, Itraconazole, Clarithromycin) and grape juice when used concomitantly with Tadalafil should be used with caution, as the drug may increase plasma concentrations. Tadalafil plasma levels. This may also lead to an increased incidence of undesirable effects.
Inducers of CYP3A4 (such as Rifampicin) reduce Tadalafil AUC by up to 88%. Concomitant administration of TadalExtra with other CYP3A4 inducers such as Phenytoin, Phenobarbital and Carbamazepine reduces plasma concentrations of Tadalafil.
Nitrates: Tadalafil may increase the antihypertensive effect of this drug. Concomitant use of these two drugs is contraindicated.
Warfarin: Tadalafil had no clinically significant AUC-related effect when co-administered with Warfarin, in addition, Tadalafil had no effect on altering prothrombin time when co-administered with this drug. Medications to lower blood pressure, including calcium channel blockers (amlodipine), ACE inhibitors (enalapril), beta-adrenergic receptor blockers (metoprolol), thiazide diuretics (bendrofluazide), and blockers Angiotensin II bodies, have been studied experimentally in pharmacodynamics, showing the potential to potentiate the antihypertensive effect of these agents.
Caution should be exercised when TadalExtra is co-administered with PDE type 5 inhibitors, alpha receptor blockers and other vasodilators. Ethinylestradiol, Terbutaline: Tadalafil may increase the bioavailability of the drug when taken orally. However, the clinical impact is uncertain.
Theophylline (a non-selective phosphodiesterase inhibitor) when co-administered with Tadalafil showed no pharmacokinetic interaction, and the only pharmacodynamic effect was a slight increase in heart rate (3.5 beats/min). . Although this effect is insignificant and does not have a clinically significant effect, caution should be exercised when co-administering TadalExtra with this drug.
TadalExtra 20 is indicated in case of erectile dysfunction. TadalExtra is effective only in the presence of aphrodisiac activity. The drug is indicated for adult males over 18 years of age. Before using TadalExtra, a clinical examination is required to diagnose erectile dysfunction and identify underlying comorbidities. To use TadalExtra 20mg effectively and safely, you should consult your doctor before using the drug.