Mitteilungsblätter Nr.47 04.01.2006 15:21 Uhr Seite 1 Vereinigung ehemaliger Schüler des Rethel- und Goethe-Gymnasiums e. V. 52. Jahrgang Städt. Reform-Realgymnasiuman der Rethelstraßeeingeweiht 30. April 1903zerstört 3. November 1943 Städt. Goethe-Gymnasiuman der Lindemannstraßeeingeweiht 1911 Das Rethel-Gymnasiuman der Graf-Recke-Straßeeingeweiht 12. März 1960Zusammenlegung mit dem Goethe-Gymnasium 20. Juli 1983
Jonalis-20-brochuer-correction_18_07_2013decreased to 5 mg a day. The effect of tadalafil may last up to 36 15. Stomach ulcer hours. Individuals who are taking medications that increase the 16. Retinitis pigmentosa blood levels of tadalafil should not exceed a total dose of 10 mg Tadalafil Tablet 17. Peyronie s disease (physical deformity of the penis) in 72 hours (See drug interactions). For once daily use without regard to sexual activity the recommended dose is 2.5 to 5 mg 19. High cholesterol 20. Pre-existing eye problems The recommended dose for BPH, or BPH and ED is 5 mg daily. 21. One who smoke or are over 50 years old Tadalafil may be taken with or without food since food does not affect its absorption from the intestine.
Tablets: 2.5, 5, 10 and 20 mg.
Tadalafil should be stored at room temperature between 15-30
C (59-86 F).
Use with caution Tadalafil Tablet CHILDREN
The breakdown and elimination of tadalafil from the body may
Only the double helix structure is a reason for all lives that crawl on the ground. The spiral that the reason for the hundreds weaves keeps be decreased by erythromycin, ketoconazole (Nizoral), the unlimited potential secret. itraconazole (Sporanox), indinavir (Crixivan) and ritonavir Only the double helix structure is a reason for all lives that crawl on the ground. The spiral that the reason for the hundreds weaves keeps the unlimited potential secret. Therefore, these drugs may increase the levels of tadalafil in the blood. If these drugs are being used at the same time as tadalafil, the dose of tadalafil should be reduced in order to avoid side effects from high levels of tadalafil.
Erectile dysfunction Pharmaceutical Pvt. Ltd.
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tadalafil is 10 mg per day taken before sexual activity (tadalafil for use as needed). Depending on the adequacy of the Tel : +91-22-28924143/28907454 response or side effects, the dose may be increased to 20 mg or available, the more durable the erection. It inhibits the PDE5 10. Blurred vision enzyme, preserving cGMP levels, therefore aiding erection 11. Abnormal ejaculation viability and durability Erection of the penis is caused by the filling of the penis with blood. Filling occurs because the blood 12. Prolonged erections vessels that bring blood to the penis increase in size and deliver more blood to the penis and at the same time, the blood vessels 14. General ill feeling that take blood away from the penis decrease in size and 15. Irregular heartbeat remove less blood from the penis. 16. Swelling in hands, ankles, or feet Sexual stimulation that leads to an erection causes the 17. Shortness of breath production and release of nitric oxide in the corpora cavernosa 18. Lightheadedness of the penis. The nitric oxide causes an enzyme guanylate cyclase, to produce cyclic guanosine monophosphate (cGMP). Tadalafil is an oral drug that is used for treating impotence (the It is the cGMP that is primarily responsible for increasing and inability to attain or maintain a penile erection) and Benign decreasing the size of the blood vessels carrying blood to and In pre-existing heart disease:
Prostatic Hyperplasia (BPH). from the penis, respectively, and causing the erection. When It is in a class of drugs called phosphodiesterase inhibitors that the cGMP is destroyed by enzyme phosphodiesterase-5, the also includes sildenafil (Celebration) and vardenafil . Erection blood vessels return to their normal size, blood leaves the of the penis is caused by the filling of the penis with blood. Filling penis, and the erection ends. It prevents phosphodiesterase-5 occurs because the blood vessels that bring blood to the penis from destroying cGMP so that cGMP stays around longer. The increase in size and deliver more blood to the penis, and, at the persistence of cGMP leads to a more prolonged engorgement 5. Palpitations and increased heart rate same time, the blood vessels that take blood away from the of the penis with blood. It relaxes muscles and increases blood 6. Vision changes penis decrease in size and remove less blood from the penis. flow to particular areas of the body. Sexual stimulation that leads to an erection causes the production and release of nitric oxide in the penis. The nitric oxide causes an enzyme, Guanylate Cyclase, to produce cyclic 1. Hypersensitivity to this drug Absorption: It is readily absorbed from the bloodstream and the Guanosine Monophosphate (cGMP). It is cGMP that is 2. Patients on nitrate therapy primarily responsible for increasing and decreasing the size of bioavailability is about 40%.
3. Patients taking a adrenergic receptor antagonist blood vessels carrying blood to and from the penis, Distribution: It is widely distributed in protein bound form (96%
respectively, and causing an erection. When the cGMP is bound to plasma protein) mostly to tissues. Metabolism: It is destroyed by another enzyme, phosphodiesterase-5, the blood metabolized in the liver by an enzyme known as CYP3A4 and vessels return to their normal size, blood leaves the penis, and 1. Do not take this drugs more than once a day the erection ends. Tadalafil prevents phosphodiesterase-5 others to produce active N-Desmethyl derivatives.
2. Contact doctor if erection is painful or lasts from destroying cGMP so that cGMP stays around longer. The Excretion: It is primarily excreted in the feces (80%) and small
longer than 4 hours persistence of cGMP leads to a more prolonged engorgement amount in the urine.
of the penis with blood.
The mechanism whereby tadalafil improves the symptoms of 4. Recent history a heart attack (within the past 90 BPH is not clear, but phosphodiesterase-5 also is present in the muscles of the bladder and the prostate, and it has been 5. Recent history of stroke or congestive heart suggested that the relaxation of these muscles may make the 1.Facial flushing failure (within the past 6 months) passage of urine less difficult, for example, by reducing the pressure in the muscle surrounding the opening to the urethra that controls the flow of urine from the bladder. Tadalafil was approved by the FDA in November 2003.
5. Flu-like symptoms 10. Kidney disease This Prescription (Rx) drug is a phosphodiesterase enzyme (PDE5) inhibitor. This enzyme is responsible for the 11. Sickle cell anemia degradation cyclic guanosine monophosphate (cGMP) 12. Multiple myeloma produced in reaction to sexual stimulation. The more cGMP is 9. Low blood pressure
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