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pharmachologic effect generic Cialis An agent for treating erectile dysfunction is a reversible selective inhibitor of specific PDE5 cGMP. When sexual arousal causes local release of nitric oxide, inhibition of PDE5 by tadalafil leads to an increase in the level of cGMP in the cavernous body of the penis. The consequence of this is relaxation of the smooth muscles of the arteries and blood flow to the tissues of the penis, which causes an erection. Tadalafil is ineffective in the absence of sexual stimulation. In vitro studies have shown that tadalafil is a selective PDE5 inhibitor. PDE5 is an enzyme found in the smooth muscles of the corpora cavernosa, in the smooth muscles of the vessels of internal organs, in skeletal muscles, platelets, kidneys, lungs, and cerebellum. The action of tadalafil on PDE5 is more active than on other phosphodiesterases. Tadalafil is 10,000 times more active against PDE5 than PDE1, PDE2, PDE4, which are localized in the heart, brain, blood vessels, liver, and other organs. Tadalafil is 10,000 times more active in blocking PDE5 than PDE3, an enzyme found in the heart and blood vessels. This selectivity for PDE5, compared with PDE3, is important because PDE3 is an enzyme involved in the contraction of the heart muscle. In addition, tadalafil is approximately 700 times more active with respect to PDE5 than with PDE6, which is found in the retina and is responsible for photo transmission. Tadalafil is also 10,000 times more active in relation to PDE5, compared with its effect on PDE7-PDE10. Valid for 36 hours. The effect is manifested 16 minutes after ingestion in the presence of sexual arousal. Tadalafil in healthy individuals does not cause a significant change in systolic and diastolic pressure compared to placebo in the supine position (average maximum decrease is 1.6 / 0.8 mm Hg, respectively) and standing (average maximum decrease is 0.2 / 4.6 mm Hg. respectively). Tadalafil does not cause a significant change in heart rate. Tadalafil does not cause changes in color recognition (blue / green), due to its low affinity for PDE6. In addition, there is no effect of tadalafil on visual acuity, electroretinogram, intraocular pressure and pupil size. There was no clinically significant effect on sperm characteristics in men who took tadalafil in daily doses for 6 months.