Tadalafil did not affect alcohol plasma concentrations and alcohol did not affect tadalafil plasma concentrations. [See Warnings and Precautions (5.9) and Clinical Pharmacology (12.2)].7.2 Potential for Other Drugs to Affect CIALIS[See Dosage and Administration (2.4) and Warnings and Precautions (5.10)].Antacids — Simultaneous administration of an antacid (magnesium hydroxide/aluminum hydroxide) and tadalafil reduced the apparent rate of absorption of tadalafil without altering exposure (AUC) to tadalafil.H2Antagonists (e.g.
| Ingredient | Quantity per Tablet | Function | Notes |
|---|---|---|---|
| Tadalafil | 10 mg | Active pharmaceutical ingredient | Main component for efficacy |
| Lactose | 50 mg | Filler | For tablet bulk |
| Microcrystalline Cellulose | 20 mg | Binder | Helps hold tablet together |
| Magnesium Stearate | 2 mg | Lubricant | Prevents sticking during compression |
| Croscarmellose Sodium | 5 mg | Disintegrant | Ensures tablet dissolves |
Nizatidine) — An increase in gastric pH resulting from administration of nizatidine had no significant effect on pharmacokinetics.Cytochrome P450 Inhibitors — CIALIS is a substrate of and predominantly metabolized by CYP3A4. Studies have shown that drugs that inhibit CYP3A4 can increase tadalafil exposure.CYP3A4 (e.g., Ketoconazole) — Ketoconazole (400 mg daily), a selective and potent inhibitor of CYP3A4, increased tadalafil 20 mg single-dose exposure (AUC) by 312% and Cmax by 22%, relative to the values for tadalafil 20 mg alone. Ketoconazole (200 mg daily) increased tadalafil 10-mg single-dose exposure (AUC) by 107% and Cmax by 15%, relative to the values for tadalafil 10 mg alone [see Dosage and Administration (2.4)].Although specific interactions have not been studied, other CYP3A4 inhibitors, such as erythromycin, itraconazole, and grapefruit juice, would likely increase tadalafil exposure.HIV Protease inhibitor — Ritonavir (500 mg or 600 mg twice daily at steady state), an inhibitor of CYP3A4, CYP2C9, CYP2C19, and CYP2D6, increased tadalafil 20-mg single-dose exposure (AUC) by 32% with a 30% reduction in Cmax, relative to the values for tadalafil 20 mg alone. Ritonavir (200 mg twice daily), increased tadalafil 20-mg single-dose exposure (AUC) by 124% with no change in Cmax, relative to the values for tadalafil 20 mg alone. Although specific interactions have not been studied, other HIV protease inhibitors would likely increase tadalafil exposure [see Dosage and Administration (2.4)].Cytochrome P450 Inducers — Studies have shown that drugs that induce CYP3A4 can decrease tadalafil exposure.CYP3A4 (e.g., Rifampin) — Rifampin (600 mg daily), a CYP3A4 inducer, reduced tadalafil 10-mg single-dose exposure (AUC) by 88% and Cmax by 46%, relative to the values for tadalafil 10 mg alone. Although specific interactions have not been studied, other CYP3A4 inducers, such as carbamazepine, phenytoin, and phenobarbital, would likely decrease tadalafil exposure. The reduced exposure of tadalafil with the coadministration of rifampin or other CYP3A4 inducers can be anticipated to decrease the efficacy of CIALIS for once daily use; the magnitude of decreased efficacy is unknown.7.3 Potential for CIALIS to Affect Other DrugsCytochrome P450 Substrates — CIALIS is not expected to cause clinically significant inhibition or induction of the clearance of drugs metabolized by cytochrome P450 (CYP) isoforms. Studies have shown that tadalafil does not inhibit or induce P450 isoforms CYP1A2, CYP3A4, CYP2C9, CYP2C19, CYP2D6, and CYP2E1.CYP1A2 (e.g.
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Tadalafil did not affect alcohol plasma concentrations and alcohol did not affect tadalafil plasma concentrations. [See Warnings and Precautions (5.9) and Clinical Pharmacology (12.2)].7.2 Potential for Other Drugs to Affect CIALIS[See Dosage and Administration (2.4) and Warnings and Precautions (5.10)].Antacids — Simultaneous administration of an antacid (magnesium hydroxide/aluminum hydroxide) and tadalafil reduced the apparent rate of absorption of tadalafil without altering exposure (AUC) to tadalafil.H2Antagonists (e.g. Nizatidine) — An increase in gastric pH resulting from administration of nizatidine had no significant effect on pharmacokinetics.Cytochrome P450 Inhibitors — CIALIS is a substrate of and predominantly metabolized by CYP3A4. Studies have shown that drugs that inhibit CYP3A4 can increase tadalafil exposure.CYP3A4 (e.g., Ketoconazole) — Ketoconazole (400 mg daily), a selective and potent inhibitor of CYP3A4, increased tadalafil 20 mg single-dose exposure (AUC) by 312% and Cmax by 22%, relative to the values for tadalafil 20 mg alone. Ketoconazole (200 mg daily) increased tadalafil 10-mg single-dose exposure (AUC) by 107% and Cmax by 15%, relative to the values for tadalafil 10 mg alone [see Dosage and Administration (2.4)].Although specific interactions have not been studied, other CYP3A4 inhibitors, such as erythromycin, itraconazole, and grapefruit juice, would likely increase tadalafil exposure.HIV Protease inhibitor — Ritonavir (500 mg or 600 mg twice daily at steady state), an inhibitor of CYP3A4, CYP2C9, CYP2C19, and CYP2D6, increased tadalafil 20-mg single-dose exposure (AUC) by 32% with a 30% reduction in Cmax, relative to the values for tadalafil 20 mg alone.
Heavy meals
Ritonavir (200 mg twice daily), increased tadalafil 20-mg single-dose exposure (AUC) by 124% with no change in Cmax, relative to the values for tadalafil 20 mg alone. Although specific interactions have not been studied, other HIV protease inhibitors would likely increase tadalafil exposure [see Dosage and Administration (2.4)].Cytochrome P450 Inducers — Studies have shown that drugs that induce CYP3A4 can decrease tadalafil exposure.CYP3A4 (e.g., Rifampin) — Rifampin (600 mg daily), a CYP3A4 inducer, reduced tadalafil 10-mg single-dose exposure (AUC) by 88% and Cmax by 46%, relative to the values for tadalafil 10 mg alone. Although specific interactions have not been studied, other CYP3A4 inducers, such as carbamazepine, phenytoin, and phenobarbital, would likely decrease tadalafil exposure. The reduced exposure of tadalafil with the coadministration of rifampin or other CYP3A4 inducers can be anticipated to decrease the efficacy of CIALIS for once daily use; the magnitude of decreased efficacy is unknown.7.3 Potential for CIALIS to Affect Other DrugsCytochrome P450 Substrates — CIALIS is not expected to cause clinically significant inhibition or induction of the clearance of drugs metabolized by cytochrome P450 (CYP) isoforms. Studies have shown that tadalafil does not inhibit or induce P450 isoforms CYP1A2, CYP3A4, CYP2C9, CYP2C19, CYP2D6, and CYP2E1.CYP1A2 (e.g.
1. They Look Different
Theophylline) — Tadalafil had no significant effect on the pharmacokinetics of theophylline. When tadalafil was administered to subjects taking theophylline, a small augmentation (3 beats per minute) of the increase in heart rate associated with theophylline was observed.CYP2C9 (e.g. Warfarin) — Tadalafil had no significant effect on exposure (AUC) to S-warfarin or R-warfarin, nor did tadalafil affect changes in prothrombin time induced by warfarin. Nitrates — Administration of CIALIS to patients who are using any form of organic nitrate, is contraindicated. In such circumstances, nitrates should still only be administered under close medical supervision with appropriate hemodynamic monitoring [see Contraindications (4.1), Dosage and Administration (2.4) and Clinical Pharmacology (12.2)]. Theophylline) — Tadalafil had no significant effect on the pharmacokinetics of theophylline. When tadalafil was administered to subjects taking theophylline, a small augmentation (3 beats per minute) of the increase in heart rate associated with theophylline was observed.CYP2C9 (e.g. Warfarin) — Tadalafil had no significant effect on exposure (AUC) to S-warfarin or R-warfarin, nor did tadalafil affect changes in prothrombin time induced by warfarin. Nitrates — Administration of CIALIS to patients who are using any form of organic nitrate, is contraindicated. In such circumstances, nitrates should still only be administered under close medical supervision with appropriate hemodynamic monitoring [see Contraindications (4.1), Dosage and Administration (2.4) and Clinical Pharmacology (12.2)]. Alpha Blockers — Caution is advised when PDE5 inhibitors are coadministered with alpha blockers. Clinical pharmacology studies have been conducted with coadministration of tadalafil with doxazosin or tamsulosin [see Warnings and Precautions (5.6), Dosage and Administration (2.4) and Clinical Pharmacology (12.2)]. Antihypertensives — PDE5 purchase cialis professional inhibitors, including tadalafil, are mild systemic vasodilators. [See Warnings and Precautions (5.6) and Clinical Pharmacology (12.2)]. Alcohol — Both alcohol and tadalafil, a PDE5 inhibitor, act as mild vasodilators.
- Cialis tadalafil 10mg tablets are used to treat erectile dysfunction.
- They typically start working within 30 to 60 minutes after ingestion.
- The effects of Cialis can last up to 36 hours, providing flexibility.
- Cialis is available by prescription and should be used under medical supervision.
- Common side effects include headache, flushing, and indigestion.
- Cialis tadalafil 10mg is often taken once daily or as needed.
- It works by relaxing blood vessels to increase blood flow to the penis.
- Alcohol consumption may interact negatively with Cialis, reducing effectiveness.
- Do not take Cialis if you are using nitrate medications for chest pain.
- Cialis is also used to treat benign prostatic hyperplasia (BPH).
- Storage: Keep Cialis tablets in a cool, dry place away from children.
[See Warnings and Precautions (5.9) and Clinical Pharmacology (12.2)].
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Cialis Generic | 5mg | 30 + 4 Pills | 53.56€ 51.01€ | |
| Cialis Soft Tabs | 20mg | 60 + 4 Pills | 159.37€ 151.78€ | |
| Cialis Generic | 20mg | 270 + 10 Pills | 335.21€ 319.25€ | |
| Cialis Generic | 60mg | 60 + 4 Pills | 145.06€ 138.15€ | |
| Cialis Generic | 2.5mg | 60 + 4 Pills | 83.43€ 79.46€ | |
| Cialis Generic | 2.5mg | 270 + 10 Pills | 199.64€ 190.13€ | |
| Cialis Generic | 10mg | 30 + 4 Pills | 63.32€ 60.30€ | |
| Cialis Black | 80mg | 360 + 20 Pills | 639.78€ 609.31€ | |
| Cialis Black | 80mg | 10 Pills | 43.27€ 41.21€ | |
| Cialis Original | 20mg | 8 Pills | 61.70€ 58.76€ | |
| Cialis Black | 80mg | 180 + 10 Pills | 356.64€ 339.66€ |
[See Dosage and Administration (2.4) and Warnings and Precautions (5.10)]. Nizatidine) — An increase in gastric pH resulting from administration of nizatidine had no significant effect on pharmacokinetics. Cytochrome P450 Inhibitors — CIALIS is a substrate of and predominantly metabolized by CYP3A4. Studies have shown that drugs that inhibit CYP3A4 can increase tadalafil exposure.
- Cialis tadalafil 10mg tablets are prescribed for watchful monitoring initially.
- Patients should report chest pain or vision changes while on Cialis.
- Cialis is not recommended for use in women or children.
- The drug is contraindicated in patients with severe liver or kidney disease.
- Avoid grapefruit juice, which may increase Cialis blood levels.
- Use caution if you have a history of heart disease.
- Some medications can increase Cialis's side effects; always disclose all drugs.
- Cialis may interact with blood pressure medications, affecting their efficacy.
- Always inform your physician about any new health issues during treatment.
- Do not adjust your Cialis dosage without medical advice.
- Follow-up appointments help optimize treatment and manage side effects.
CYP3A4 (e.g., Ketoconazole) — Ketoconazole (400 mg daily), a selective and potent inhibitor of CYP3A4, increased tadalafil 20 mg single-dose exposure (AUC) by 312% and Cmax by 22%, relative to the values for tadalafil 20 mg alone.
The drug Cialis is popular because you can take it every day. But should you?
Ketoconazole (200 mg daily) increased tadalafil 10-mg single-dose exposure (AUC) by 107% and Cmax by 15%, relative to the values for tadalafil 10 mg alone [see Dosage and Administration (2.4)]. Although specific interactions have not been studied, other CYP3A4 inhibitors, such as erythromycin, itraconazole, and grapefruit juice, would likely increase tadalafil exposure.
- [Psychological counseling may be beneficial alongside medication for some men with ED.]
- [For BPH, other treatment options include other medications or surgical procedures.]
- [A thorough medical history is essential to rule out other causes of symptoms.]
- [Open communication with your partner about expectations and treatment is important.]
- [Treatment plans should be personalized based on individual health needs and goals.]
HIV Protease inhibitor — Ritonavir (500 mg or 600 mg twice daily at steady state), an inhibitor of CYP3A4, CYP2C9, CYP2C19, and CYP2D6, increased tadalafil 20-mg single-dose exposure (AUC) by 32% cialis no perscription with a 30% reduction in Cmax, relative to the values for tadalafil 20 mg alone. Although specific interactions have not been studied, other HIV protease inhibitors would likely increase tadalafil exposure [see Dosage and Administration (2.4)]. Cytochrome P450 Inducers — Studies have shown that drugs that induce CYP3A4 can decrease tadalafil exposure. CYP3A4 (e.g., Rifampin) — Rifampin (600 mg daily), a CYP3A4 inducer, reduced tadalafil 10-mg single-dose exposure (AUC) by 88% and Cmax by 46%, relative to the values for tadalafil 10 mg alone.
17.7 Sudden Hearing Loss
Safety and efficacy in patients below the age of 18 years has not been established.8.5 Geriatric UseOf the total number of subjects in clinical studies of tadalafil, approximately 25 percent were 65 and over, while approximately 3 percent were 75 and over. No overall differences in efficacy or safety were observed between subjects over 65 years of age compared to younger subjects, therefore no dose adjustment is warranted based on age alone. However, a greater sensitivity to medications in some older individuals should be considered. [See Clinical Pharmacology (12.3)].8.6 Hepatic ImpairmentIn clinical pharmacology studies, tadalafil exposure (AUC) in subjects with mild or moderate hepatic impairment (Child-Pugh Class A or B) was comparable to exposure in healthy subjects when a dose of 10 mg was administered. There are no available data for doses higher than 10 mg of tadalafil in patients with hepatic impairment.
Does it increase sexual desire or shorten the refractory period?
Insufficient data are available for subjects with severe hepatic impairment (Child-Pugh Class C). [See Dosage and Administration (2.3) and Warnings and Precautions (5.8)].8.7 Renal InsufficiencyIn clinical pharmacology studies using single-dose tadalafil (5 to 10 mg), tadalafil exposure (AUC) doubled in subjects with mild (creatinine clearance 51 to 80 mL/min) or moderate (creatinine clearance 31 to 50 mL/min) renal insufficiency. In subjects with end-stage renal disease on hemodialysis, there was a two-fold increase in Cmax and 2.7- to 4.1-fold increase in AUC following single-dose administration of 10 or 20 mg tadalafil. Exposure to total methylcatechol (unconjugated plus glucuronide) was 2- to 4-fold higher in subjects with renal impairment, compared to those with normal renal function. The reduced exposure of tadalafil with the coadministration of rifampin or other CYP3A4 inducers can be anticipated to decrease the efficacy of CIALIS for once daily use; the magnitude of decreased efficacy is unknown. Cytochrome P450 Substrates — CIALIS is not expected to cause clinically significant inhibition or induction of the clearance of drugs metabolized by cytochrome P450 (CYP) isoforms. Studies have shown that tadalafil does not inhibit or induce P450 isoforms CYP1A2, CYP3A4, CYP2C9, CYP2C19, CYP2D6, and CYP2E1. When tadalafil was administered to subjects taking theophylline, a small augmentation (3 beats per minute) of the increase in heart rate associated with theophylline was observed. 8 USE IN SPECIFIC POPULATIONS 8.1 PregnancyPregnancy Category B — CIALIS (tadalafil) is not indicated for use in women. There are no adequate and well controlled studies of CIALIS use in pregnant women.
8.3 Nursing Mothers
Animal reproduction studies in rats and mice revealed no evidence of fetal harm.Non-teratogenic effects — Animal reproduction studies showed no evidence of teratogenicity, embryotoxicity, or fetotoxicity when tadalafil was given to pregnant rats or mice at exposures up to 11 times the maximum recommended human dose (MRHD) of 20 mg/day during organogenesis.
17.1 Nitrates
Cytochrome P450 Inducers — Studies have shown that drugs that induce CYP3A4 can decrease tadalafil exposure. CYP3A4 (e.g., Rifampin) — Rifampin (600 mg daily), a CYP3A4 inducer, reduced tadalafil 10-mg single-dose exposure (AUC) by 88% and Cmax by 46%, relative to the values for tadalafil 10 mg alone. The reduced exposure of tadalafil with the coadministration of rifampin or other CYP3A4 inducers can be anticipated to decrease the efficacy of CIALIS for once daily use; the magnitude of decreased efficacy is unknown. Cytochrome P450 Substrates — CIALIS is not expected to cause clinically significant inhibition or induction of the clearance of drugs metabolized by cytochrome P450 (CYP) isoforms. Studies have shown that tadalafil does not inhibit or induce P450 isoforms CYP1A2, CYP3A4, CYP2C9, CYP2C19, CYP2D6, and CYP2E1.
Dosing Modifications
When tadalafil was administered to subjects taking theophylline, a small augmentation (3 beats per minute) of the increase in heart rate associated with theophylline was observed. 8 USE IN SPECIFIC POPULATIONS 8.1 PregnancyPregnancy Category B — CIALIS (tadalafil) is not indicated for use in women. There are no adequate and well controlled studies of CIALIS use in pregnant women. Animal reproduction studies in rats and mice revealed no evidence of fetal harm.Non-teratogenic effects — Animal reproduction studies showed no evidence of teratogenicity, embryotoxicity, or fetotoxicity when tadalafil was given to pregnant rats or mice at exposures up to 11 times the maximum recommended human dose (MRHD) of 20 mg/day during organogenesis. In one of two perinatal/postnatal developmental studies in rats, postnatal pup survival decreased following maternal exposure to tadalafil doses greater than 10 times the MRHD based on AUC.
ED dosage for occasional use
Signs of maternal toxicity occurred at doses greater than 16 times the MRHD based on AUC. Surviving offspring had normal development and reproductive performance. (See Animal Toxicology and/or Pharmacology Section 13.2)8.3 Nursing MothersCIALIS is not indicated for use in women. It is not known whether tadalafil is excreted into human milk. While tadalafil or some metabolite of tadalafil was excreted into rat milk, drug levels in animal breast milk cialis buy cheap may not accurately predict levels of drug in human breast milk.8.4 Pediatric UseCIALIS is not indicated for use in pediatric patients. In one of two perinatal/postnatal developmental studies in rats, postnatal pup survival decreased following maternal exposure to tadalafil doses greater than 10 times the MRHD based on AUC.
| Storage Conditions | Recommended Temperature | Humidity | Shelf Life | Additional Notes |
|---|---|---|---|---|
| In a cool, dry place | 20°C to 25°C | <60% | 2-3 years | Keep out of direct sunlight |
| Away from moisture | Controlled environment | Store in original packaging | ||
| Keep out of reach of children | Ambient conditions | Ensure safety from accidental ingestion |
Signs of maternal toxicity occurred at doses greater than 16 times the MRHD based on AUC. Surviving offspring had normal development and reproductive performance. (See Animal Toxicology and/or Pharmacology Section 13.2)8.3 Nursing MothersCIALIS is not indicated for use in women. It is not known whether tadalafil is excreted into human milk. While tadalafil or some metabolite of tadalafil was excreted into rat milk, drug levels in animal breast milk cialis buy cheap may not accurately predict levels of drug in human breast milk.8.4 Pediatric UseCIALIS is not indicated for use in pediatric patients. Safety and efficacy in patients below the age of 18 years has not been established.8.5 Geriatric UseOf the total number of subjects in clinical studies of tadalafil, approximately 25 percent were 65 and over, while approximately 3 percent were 75 and over. No overall differences in efficacy or safety were observed between subjects over 65 years of age compared to younger subjects, therefore no dose adjustment is warranted based on age alone.
| Side Effect | Frequency | Severity | Recommended Action |
|---|---|---|---|
| Headache | Common | Mild | Usually temporary; OTC pain relief can help |
| Dyspepsia (Indigestion) | Common | Mild | Dietary adjustments or antacids |
| Muscle Aches | Less common | Mild | Rest or analgesics |
| Flushing | Common | Mild | Cooling measures; usually transient |
| Vision Changes | Rare | Moderate | Seek medical advice if sudden vision disturbance occurs |
However, a greater sensitivity to medications in some older individuals should be considered.
7. Interactions
Alpha Blockers — Caution is advised when PDE5 inhibitors are coadministered with alpha blockers. Clinical pharmacology studies have been conducted with coadministration of tadalafil with doxazosin or tamsulosin [see Warnings and Precautions (5.6), Dosage and Administration (2.4) and Clinical Pharmacology (12.2)]. Antihypertensives — PDE5 purchase cialis professional inhibitors, including tadalafil, are mild systemic vasodilators. [See Warnings and Precautions (5.6) and Clinical Pharmacology (12.2)]. Alcohol — Both alcohol and tadalafil, a PDE5 inhibitor, act as mild vasodilators.
How often can I take it?
[See Warnings and Precautions (5.9) and Clinical Pharmacology (12.2)]. [See Dosage and Administration (2.4) and Warnings and Precautions (5.10)]. Nizatidine) — An increase in gastric pH resulting from administration of nizatidine had no significant effect on pharmacokinetics. Cytochrome P450 Inhibitors — CIALIS is a substrate of and predominantly metabolized by CYP3A4. Studies have shown that drugs that inhibit CYP3A4 can increase tadalafil exposure.
Comparison with actions of other PDE5 inhibitors
CYP3A4 (e.g., Ketoconazole) — Ketoconazole (400 mg daily), a selective and potent inhibitor of CYP3A4, increased tadalafil 20 mg single-dose exposure (AUC) by 312% and Cmax by 22%, relative to the values for tadalafil 20 mg alone. Ketoconazole (200 mg daily) increased tadalafil 10-mg single-dose exposure (AUC) by 107% and Cmax by 15%, relative to the values for tadalafil 10 mg alone [see Dosage and Administration (2.4)]. Although specific interactions have not been studied, other CYP3A4 inhibitors, such as erythromycin, itraconazole, and grapefruit juice, would likely increase tadalafil exposure. HIV Protease inhibitor — Ritonavir (500 mg or 600 mg twice daily at steady state), an inhibitor of CYP3A4, CYP2C9, CYP2C19, and CYP2D6, increased tadalafil 20-mg single-dose exposure (AUC) by 32% cialis no perscription with a 30% reduction in Cmax, relative to the values for tadalafil 20 mg alone. Although specific interactions have not been studied, other HIV protease inhibitors would likely increase tadalafil exposure [see Dosage and Administration (2.4)]. [See Clinical Pharmacology (12.3)].8.6 Hepatic ImpairmentIn clinical pharmacology studies, tadalafil exposure (AUC) in subjects with mild or moderate hepatic impairment (Child-Pugh Class A or B) was comparable to exposure in healthy subjects when a dose of 10 mg was administered.
- Cialis tadalafil 10mg tablets are manufactured by Eli Lilly and Company.
- Always follow your doctor’s dosage instructions when taking Cialis.
- Do not exceed the prescribed dose to avoid adverse effects.
- Cialis can be taken with or without food for convenience.
- The medication may cause dizziness, so avoid driving if affected.
- Inform your doctor of any other medications you are taking before use.
- Cialis does not protect against sexually transmitted diseases.
- Use Cialis responsibly to minimize the risk of priapism, a painful erection.
- For best results, take Cialis approximately 30 minutes before intimacy.
- Drinking large quantities of alcohol while on Cialis can impair performance.
- Consult your healthcare provider before discontinuing Cialis treatment.
There are no available data for doses higher than 10 mg of tadalafil in patients with hepatic impairment. Insufficient data are available for subjects with severe hepatic impairment (Child-Pugh Class C). [See Dosage and Administration (2.3) and Warnings and Precautions (5.8)].8.7 Renal InsufficiencyIn clinical pharmacology studies using single-dose tadalafil (5 to 10 mg), tadalafil exposure (AUC) doubled in subjects with mild (creatinine clearance 51 to 80 mL/min) or moderate (creatinine clearance 31 to 50 mL/min) renal insufficiency. In subjects with end-stage renal disease on hemodialysis, there was a two-fold increase in Cmax and 2.7- to 4.1-fold increase in AUC following single-dose administration of 10 or 20 mg tadalafil. Exposure to total methylcatechol (unconjugated plus glucuronide) was 2- to 4-fold higher in subjects with renal impairment, compared to those with normal renal function.
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