Cialis Extra Dosage represents a specialized formulation designed for men requiring a higher therapeutic threshold to achieve and sustain erections sufficient for sexual activity. This medication contains tadalafil as its active pharmaceutical ingredient, a potent phosphodiesterase type 5 (PDE5) inhibitor that enhances blood flow to the penile tissues. It is specifically indicated for patients who have demonstrated suboptimal response to standard-dose therapies, providing a robust option under appropriate medical supervision. Clinical use should always follow a comprehensive evaluation by a healthcare provider to ensure suitability and mitigate associated risks.

Features

• Active ingredient: Tadalafil 20mg or custom-compounded higher strengths as per prescription
• Pharmacological class: Selective phosphodiesterase type 5 (PDE5) inhibitor
• Onset of action: As early as 30 minutes post-administration
• Duration of efficacy: Up to 36 hours, allowing for spontaneous sexual activity
• Administration: Oral tablet, taken with or without food
• Available by prescription only, following diagnostic confirmation of erectile dysfunction

Benefits

• Provides a highly effective therapeutic option for patients non-responsive to standard PDE5 inhibitor dosing
• Facilitates spontaneous sexual activity due to an extended window of efficacy
• Improves erectile rigidity and sustainability through enhanced nitric oxide-mediated vasodilation
• Supports psychological confidence and relationship satisfaction by reliably addressing erectile dysfunction
• Allows dosing flexibility, reducing anxiety associated with timed medication intake
• May improve erectile function even in cases of moderate to severe vasculogenic etiology

Common use

Cialis Extra Dosage is primarily prescribed for the treatment of erectile dysfunction (ED) in adult males. It is specifically reserved for individuals who have not achieved satisfactory results with lower doses of tadalafil or equivalent PDE5 inhibitors. The medication is also occasionally used off-label under specialist supervision for managing pulmonary arterial hypertension, though this requires distinct dosing protocols. It is not indicated for use by women, adolescents, or men without a clinical diagnosis of erectile dysfunction.

Dosage and direction

The recommended starting dose for treatment-naïve patients is 10mg, taken prior to anticipated sexual activity. Cialis Extra Dosage (20mg or higher) is reserved for those who have tolerated lower doses without significant adverse effects but require enhanced efficacy. The tablet should be swallowed whole with a glass of water; consumption with a high-fat meal may delay absorption. Dosing should not exceed once in a 24-hour period. For daily low-dose regimens (2.5mg or 5mg), a separate product should be used—this high-dose formulation is not designed for chronic daily administration.

Precautions

Prior to initiation, a thorough cardiovascular assessment is mandatory due to the potential for cardiac risk during sexual activity. Patients with anatomical deformation of the penis (e.g., Peyronie’s disease) or conditions predisposing to priapism (e.g., sickle cell anemia, leukemia) should use this medication with extreme caution. Renal or hepatic impairment necessitates dose adjustment or avoidance. Concurrent use with other erectile dysfunction treatments is strictly contraindicated. Avoid grapefruit juice, as it may elevate tadalafil plasma concentrations.

Contraindications

Cialis Extra Dosage is contraindicated in patients using any form of organic nitrates (e.g., nitroglycerin, isosorbide mononitrate) or guanylate cyclase stimulators (e.g., riociguat). It must not be administered to individuals with a known hypersensitivity to tadalafil or any excipients in the formulation. Severe hepatic impairment (Child-Pugh Class C), severe cardiovascular instability (including recent myocardial infarction or unstable angina), or a history of non-arteritic anterior ischemic optic neuropathy (NAION) also represent absolute contraindications.

Possible side effects

Common adverse reactions (>10% incidence) include headache, dyspepsia, back pain, myalgia, nasal congestion, and flushing. Less frequently (1–10%), dizziness, visual disturbances, and gastroesophageal reflux may occur. Rare but serious side effects (<1%) include priapism, sudden hearing loss, significant hypotension, and cardiovascular events. Patients should seek immediate medical attention if an erection persists beyond 4 hours or if sudden vision loss occurs.

Drug interaction

Tadalafil is primarily metabolized by CYP3A4. Concomitant use with strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir) necessitates dose reduction. Alpha-blockers (e.g., doxazosin) may potentiate hypotensive effects—concurrent use should be avoided or carefully monitored. Antihypertensives, alcohol, and other vasodilators may amplify blood-pressure-lowering effects. Avoid use with other PDE5 inhibitors.

Missed dose

As Cialis Extra Dosage is taken on an as-needed basis, missed dose protocols are not applicable. Patients should not take an additional tablet to compensate for a missed dose. If a dose is inadvertently missed, the next dose may be taken when needed, respecting the minimum 24-hour interval between administrations.

Overdose

In cases of suspected overdose, standard supportive measures should be employed. Expected manifestations include severe hypotension, syncope, and prolonged erection. Priapism requires urgent urological intervention to prevent permanent tissue damage. Hemodialysis is unlikely to significantly eliminate tadalafil due to high protein binding and extensive tissue distribution.

Storage

Store at room temperature (15–30°C) in the original container, protected from light and moisture. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Discard any tablets that show signs of physical damage or discoloration.

Disclaimer

This information is intended for educational purposes and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before starting or altering any medication regimen. Do not disregard professional medical advice or delay seeking it based on content provided herein.

Reviews

Clinical studies and post-marketing surveillance indicate high patient satisfaction with Cialis Extra Dosage among appropriate candidates. In a 12-week randomized trial, 85% of men previously unresponsive to standard-dose therapy reported improved erections. Real-world evidence supports its efficacy, though individual responses may vary. Common feedback highlights the extended duration of action as a significant advantage over shorter-acting analogues.