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    The most common side effects include: headache, dyspepsia (i.e., pain or an uncomfortable feeling in the upper middle part of your stomach), back pain, myalgia (i.e., muscle pain), nasal congestion, flushing, and pain in limb. When Taken As Needed: The starting dose is usually 10 mg as needed prior to sexual activity but it depends on the individual. It has been shown to improve erectile function, compared to placebo, up to 36 hours post dose. When Taken Daily: The starting dose is 2.5 mg, taken at approximately the same time every day, without regard to timing of sexual activity. Based on effectiveness and tolerability, your physician may recommend an increase to 5 mg. Cialis has been shown to take effect in as little as 30 minutes. After single oral-dose administration, the maximum observed plasma concentration (Cmax) of tadalafil is achieved between 30 minutes and 6 hours (median time of 2 hours). Absolute bioavailability of tadalafil following oral dosing has not been determined. Cialis (tadalafil) relaxes muscles of the blood vessels and increases blood flow to particular areas of the body. Cialis is used to treat erectile dysfunction (impotence) and symptoms of benign prostatic hypertrophy (enlarged prostate). Another brand of tadalafil is Adcirca, which is used to treat pulmonary arterial hypertension and improve exercise capacity in men and women. Do not take Cialis while also taking Adcirca, unless your doctor tells you to. Do not take Cialis if you are also using a nitrate drug for chest pain or heart problems, including nitroglycerin, isosorbide dinitrate, isosorbide mononitrate, and some recreational drugs such as "poppers". Taking tadalafil with a nitrate medicine can cause a sudden and serious decrease in blood pressure. Some medicines can cause unwanted or dangerous effects when used with Cialis.

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    Cialis is a popular prescription drug used by many men in order to combat erectile dysfunction. That being said, there are factors such as health status, medication use and potential secondary effects that can render Cialis as an unsuitable option for some. Firstly, it is important to remember that you should only buy and use Cialis with a prescription from a registered doctor. This is because there are certain criteria which need to be met to ensure the safe use of the drug. There are particular health conditions that mean you should not take Cialis. It is also important to mention if you are using or have used other erectile dysfunction treatments. All medicines have the potential to cause side effects, although not all users go on to experience them. As a pain management physician, I see patients with acute and chronic pain, resulting from multiple causes, everyday. Acute pain is classified as symptoms lasting from onset to 30 days. Chronic pain is considered to be pain that lasts from 3-6 months and longer. Many times acute pain can resolve on its own, and is typically due to muscle sprains and strains. Simple measures such as rest and time are usually enough to resolve these issues. Many people use over-the-counter remedies, such as anti-inflammatories like ibuprophen, or topical analgesics, like my favorite all natural topical pain reliever, Kineti Cream, with good success. By the time I see the patient in acute or chronic pain, the primary care physician has tried simple measures to address the pain and it still persists.

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