This is the generic option for the known brand Cialis. All is the same, the effect and the ingredients. If you could point out one difference, that would be the price. Tadalafil comes in tablet and is quite easy to take and fast to act - within 30 minutes after you take it, lasting up to 36 hours.
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An online doctor consultation means filling out a medical questionnaire. A registered EU doctor assesses your medical questionnaire and analize whether generic Tadalafil is suitable and safe for you to buy. After approval, a prescription is issued and send to the registered EU pharmacy. You will receive your discretely shipped Tadalafil pills within 3 business days.
Erectile Dysfunction (ED) - The inability to achieve or maintain an erection that allows coition. More than 67% of men have a deterioration in the quality of their sexual lives due to erectile dysfunction. The prevalence of the disease correlates with age. ED is detected in 40% of men aged 40–50 years, in 57% of those aged 50–60 years, and in 70% of those older than 60 years. It is expected that by 2025 more than 300 million men will suffer from erectile dysfunction. When determining treatment tactics, it should be borne in mind that 31.5–44% of the male population remains sexually active until they are 80 years old.
Today, first-line drugs for the treatment of ED are type 5 phosphodiesterase inhibitors (PDE-5), which have been used to treat erectile dysfunction since 1998.
During sexual stimulation, the parasympathetic nervous system is first activated, after which the relaxing factor, nitric oxide, is released from the vascular endothelium, which leads to the accumulation of cyclic guanosine monophosphate in the cavernous tissue and relaxation of the walls of the arteries and cavernous bodies. The result of the active filling of the cavernous bodies of the penis with arterial blood is compression of the venules, which allows blocking the outflow of blood, thereby provoking the appearance of an erection. It is important to note that when the intracellular activity of PDE-5 is inhibited, even slight activation of guanylate cyclase can cause a sharp increase in the concentration of cyclic guanosine monophosphate inside the cell. As a result, the tonus of the smooth muscle frame of blood vessels decreases with a further drop in blood pressure.
Currently, four PDE-5 inhibitors are presented on the Russian market: sildenafil, tadalafil, vardenafil, and sildenafil. Speaking about the pharmacodynamic properties of these drugs, it is necessary to note the selectivity of their effect on PDE. So, sildenafil and vardenafil have similar selectivity with respect to PDE-5. In addition, they have a weak inhibitory effect on PDE-1 and 6. It is known that blocking PDE-6 can provoke color perception disorders. Exposure to PDE-1 leads to side effects from the cardiovascular system. Unlike other drugs of the group under discussion, the affinity of tadalafil to PDE-1 is significantly weaker. It is proved that this drug, highly selective for PDE-5, to a lesser extent inhibits PDE-6, which minimizes the likelihood of side effects, in particular, from the viewpoint. Moreover, the tadalafil molecule has a high affinity for PDE-11, which is found in muscle tissue. For this reason, patients taking tadalafil are more likely to have myalgia and back pain. However, daily intake of tadalafil in low doses (2.5–5 mg) can reduce the frequency and severity of headache, nausea, dizziness, myalgia, and redness of the face by three to five times compared to taking it on demand at a dose of 10–20 mg. The low level of development of side effects of tadalafil is due to the long half-life of the drug, which allows its use in low doses. A number of studies have revealed the absence of serious side effects during the daily intake of tadalafil. In addition, it was found
Tadalafil was approved for clinical use in Europe in February 2003 and has since become the drug of choice for most men with ED. Its effectiveness is confirmed by the results of a large number of randomized placebo-controlled studies. In the example of 2102 patients with ED, it was proved that the probability of a successful coitus attempt increased by 61 and 72% after taking 10 and 20 mg of tadalafil, respectively. More than 80% of men noted an improvement in the quality of an erection; in 54%, the indicators of the International Index of Erectile Function corresponded to the norm.
C. McMahon et al. analyzed the treatment results for men with ED. Of the 70 men taking tadalafil (20 mg) on-demand, 73% gave answers indicating a significant improvement in the quality of an erection. According to D. Hatzichristou et al., Patients with diabetes mellitus also noted an improvement in erectile function against the background of daily intake of tadalafil without marked changes in the level of glycated hemoglobin.
In addition to the advantages characteristic of the entire class of PDE-5 inhibitors, tadalafil has a number of unique properties. Its half-life is 17.5 hours, which provides more than 36-hour action of the drug. This duration is especially relevant for young patients with high sexual activity. Daily intake of tadalafil (5 mg) allows you to maintain a therapeutic level of the drug in the body of a man, sufficient to maintain the spontaneity of sexual activity and not requiring prior planning of sexual intercourse. It was found that 79.2% of women preferred their partner to take tadalafil rather than sildenafil, citing a more comfortable approach to sexual contact and intimacy. In this way, the spontaneity of sexual life against the background of daily tadalafil therapy is an important and attractive factor for the majority of male partners suffering from erectile dysfunction. In another study, it was shown that the constant intake of tadalafil 5 mg/day as an effective treatment for ED satisfied both men and their sexual partners.
B. Brock et al. performed a comprehensive analysis of five randomized, double-blind, placebo-controlled trials conducted at 74 medical centers and included 1112 men aged 22 to 82 years with different forms and severities of ED. Patients received tadalafil in a daily dose of 2.5, 5, 10, 20 mg or placebo for 12 weeks. To assess the effectiveness of treatment, specialized questionnaires were used: the International Index of Erectile Function, the Sexual Encounter Profile, and the Global Assessment Question "Have your erections improved during the past four weeks?" Among patients taking tadalafil at a dose of 20 mg/day, normal erectile function was achieved in 59% of cases compared with 11% in the control group (score according to the International Index of Erectile Function). The proportion of successful sexual intercourse attempts was 75% compared with 32% in the placebo group (according to the Sexual Relationship Profile). From 73 to 80% of coitus that was committed by patients between 30 minutes and 36 hours after taking tadalafil were successful. After 12 weeks, 81% of men from the main group and only 35% of the placebo group reported improved erection (Global Assessment Questionnaire). It should be noted that neither the age of patients nor the etiology of ED had a significant effect on the effectiveness of tadalafil. From 73 to 80% of coitus that was committed by patients between 30 minutes and 36 hours after taking tadalafil were successful. After 12 weeks, 81% of men from the main group and only 35% of the placebo group reported improved erection (Global Assessment Questionnaire). It should be noted that neither the age of patients nor the etiology of ED had a significant effect on the effectiveness of tadalafil. From 73 to 80% of coitus that was committed by patients between 30 minutes and 36 hours after taking tadalafil were successful. After 12 weeks, 81% of men from the main group and only 35% of the placebo group reported improved erection (Global Assessment Questionnaire). It should be noted that neither the age of patients nor the etiology of ED had a significant effect on the effectiveness of tadalafil.
In the treatment of erectile dysfunction with tadalafil 20 mg, a significant improvement in orgasmic and ejaculatory functions was noted relative to the initial level in most men. The data were obtained by evaluating the results of 17 placebo-controlled studies in which 3581 patients with ED participated. It was found that 66% of men taking tadalafil (5, 10, and 20 mg) for 12 weeks showed a significant improvement in ejaculatory function compared with 36% in the placebo group (p <0.001). In 66% of patients with ED of men, the quality of orgasm also changed positively (in the placebo group - 35%, p <0.001).
The main advantage of tadalafil, due to which most patients prefer it, is the duration of action. So, in 45% of cases, the reason for choosing tadalafil was the duration of its action, and in 37% - the effectiveness. According to JR Tolra et al., 50% of men explained the choice of tadalafil as the possibility of having an active sex life the day after taking the medicine. Another advantage of tadalafil in contrast to sildenafil is the fact that fatty foods and alcohol do not affect its pharmacokinetics .
An important indicator of the effectiveness of a drug is the patient's commitment to treatment. In the largest European observational semi-annual study (EDOS), patients who were prescribed a PDE-5 inhibitor could change one drug for another. 89% of patients receiving tadalafil took it until the end of the study. The same indicator for sildenafil and vardenafil was 64%. Discontinuing tadalafil therapy, about 25% later resumed taking it .
In 2018, the first tadalafil generic under the trade name Dynamic Long (Teva company) appeared on the domestic market. The drug is bioequivalent to the original drug (Cialis)  and in March of this year, it became available in a dosage of 20 mg. Dynamically Long is made from the Israeli substance in the home of the Teva company - in Israel, in compliance with the most modern requirements and quality standards.
Thus, tadalafil in comparison with other representatives of the group of PDE-5 inhibitors has a number of undeniable advantages. This is primarily due to the duration of its action, due to the long half-life of the drug. A constant concentration of the drug in the blood allows you to maintain the spontaneity of sexual intercourse, which, of course, has a positive effect on the quality of life of both patients and their partners. In addition, tadalafil is presented in various dosages, which provides the possibility of daily use of the drug, increases adherence to treatment with a reduced likelihood of side effects.