Tadalafil Drugs Compared: Cialis Vs. Adcirca

Tadalafil: So Much More Than ‘The Weekend Pill’

My Canadian Pharmacy Rx receives heaps of emails from customers with requests to review a new or long-existing drug, which we always do with pleasure. We actually encourage such inquisitiveness in our readers, since increased awareness about conditions, prevention and available treatments makes us health-savvy and more mindful in our choices. A quick note though: before you request a review, do check out the respective section of our website: chances are that we’ve already got the drug you need covered.

In case with tadalafil (generic name for Cialis and Tadacip), things are not as straight-forward though. True it is that we’ve been revisiting the topic of oral ED treatments, and PDE5 inhibitors class in particular, many a time. But it seems that the more attention we devote to those bad boys, the more versatile they become. The instances of off-label use of tadalafil and other inhibitors of phosphodiesterase type 5 may be anecdotal rather than systematic, but new drugs based on these substances spring into being with consistent regularity, and their applications are but a far cry, if at all connected to, their effects on the erectile function in men.

The capacity to do greater good is inherently immanent to tadalafil. The substance, legitimately celebrated for its heavy-duty longevity, is in this time and age of pharmacological science used for many other beneficial purposes. Benign prostate hyperplasia (BPH), pulmonary arterial hypertension (PAH), diabetes, high blood pressure – just to name a few. A curious historical footnote on PDE5 inhibitors is that the very first one of them, sildenafil citrate, the bellwether of the class which we all now know as the freakishly famous Viagra, was the result of research work aimed at finding a PAH medicine.

The substance tadalafil branded as Cialis burst on the scene some five years later, boasting a whole new level of longevity. This goes to show just how essentially multitasking the substance can be when put to some right use, inspiring one scientific breakthrough right after another. So stay with us to learn more productive facts about the world’s favorite ‘Weekend Pill’, as it is lovingly monikered by doctors and patients. In the article below we will try to bring you along with us on two other basic use of tadalafil than the one you are only too familiar with right now, ED treatment.

The Common Denominator: Tadalafil In Cialis And Adcirca

While the brand name of Cialis seems to be on everybody’s lips in the industry and among rank and file consumers, if we were to drop the name of Adcirca it would hardly ring a bell. This is because until fairly recently, tadalafil had only received large-scale manufacturing as an ED drug called Cialis (commercialized Tadacip when produced by a generic manufacturer based in India).

Adcirca is a tadalafil preparation that is indicated for the use in adult population suffering from the aforementioned conditions of BPH and PAH. It allows to address issues with exercise capacity that manifest themselves symptomatically in individuals ailed by PAH which is linked to Ehlers-Danlos syndrome (EDS).

Ehlers-Danlos syndrome (EDS, or collagen vascular disease) is a congenital connective tissue defect that affects the joints, skin and blood vessels. Changes in the connective tissue happen due to defective collagen, one of the body’s basic building materials and the most common protein in humans. Collagen represents nearly a third of the total body protein content. There are combinations of at least 25 different collagen in skin, bone, tendons, cartilage, blood vessels, gums, basement membranes, cornea, vitreous of the eye and supporting tissues in the internal organs. Collagen chains bind together in threes to form threads (fibrils) with great strength. In Ehlers-Danlos Syndrome fibrils have a sparser and altered structure that allows the strength of the tissues become weaker. It provides increased joint mobility, overstretched and / or soft skin and sometimes fragile vessel walls. Other proteins with similar functions is becoming known, and in some cases of Ehlers-Danlos Syndrome have found changes in any of these proteins.

Adcirca is successfully implemented as a means to treat benign prostatic hyperplasia (also called BPH), which is non-cancerous (ie not linked to tumors) enlargement of the prostate gland, exclusively male organ. BPH is also more commonly called benign prostatic hypertrophy or, sometimes, benign prostatic obstruction.

The prostate has two main periods of growth during the life of a man:

The first occurs early in puberty, when the prostate doubles in size;
The second period begins at age 25 and continues throughout most of his life.
This condition often occurs during the second phase of growth.

Gradually the gland enlarges, it compresses and crushes the urethra. The bladder walls tend to thicken. Over time, the bladder can weaken, lose the ability to empty itself completely and then hold a little ‘residual urine. The narrowing of the urethra and urinary retention (the failure to complete emptying of the bladder) cause many of the problems associated with benign prostatic hyperplasia.

There is a number of criteria to meet in order to qualify for the treatment of the above conditions with Adcirca: patients should not have concomitant conditions of low blood pressure, myocardial infarction experienced in the recent months or be particularly sensitive to tadalafil and other chemical substances contained in Adcirca. Another contraindications include loss of sight in one or both eyes because of of non-arteritic anterior ischemic optic neuropathy (NAION). Tadalafil and other PDE5 inhibitors are not compatible with nitrates and other drugs of PDE5 class used for ED treatment.

A pill of Adcirca is normally taken at tadalafil 40 mg strength twice daily with no regard to meal timing, subject to adjustment as seen necessary by the prescriber, especially in geriatric population and individuals with comorbidities (kidney or liver dysfunction).

Adcirca For When BPH And ED Conditions Coincide

One in ten men suffers from erectile dysfunction, and in 50% of cases it is accompanied by enlarged prostate gland hypertrophy which in its turn affects 16% of population. Both condition can be very taxing for both body and psyche, causing understandable physical disturbance and intrapersonal difficulty.

The correlation between prostate and erection troubles is well established. And not only that; when you have strong disappointment in the sexual sphere becomes easy to fall into a state of stress and depression. This does nothing but accentuating and aggravating the physiological damage. Erection problems arise as a result. And this is not a shortcut known by many people. It is important that every man is interested in the relationship between erectile dysfunction and prostate. As the prostate health problems are statistically very frequent and may occur as early as age 30, or earlier. And it is very easy that erectile dysfunction lead to a psychological demolition of the man who experiences the problem.

Because of sexual disappointment that might happen with their partners, real episodes of sexual performance anxiety become an issue as well. Sexual performance anxiety, being one of the most common causes of erection problems will only get worse the bigger picture. still feeding more the erectile dysfunction, bringing the man into an endless spiral of cause-deepening effect.

Having suspected of having a prostate problem and strong suspicions that the prostate report and erection is compromised, you should immediately consult your doctor to perform specific analysis. To check which type of prostatitis is, or whether it is different matter. It will then be an andrologist or urologist to determine the appropriate pharmacological therapy.

But it must be said that the drug treatments are aimed mostly to the suppression of symptoms rather than to eliminate the real root causes of the various prostate problems. In fact very often they do not prove effective drugs. This makes that the relationship between the prostate and erection is increasingly evident and compromised. In relation to this, tadalafil found in Adcirca is a wiser choice that entails medicating the cause and curbing symptoms at the same time.

Furthermore, since the issue of drug compatibility is a constant challenge with both drug prescribers and their takers, it is often rather tricky to appoint therapy for both conditions with pharmaceutical products that do not clash or diminish each other’s effects. Easily then, Adcirca is an optimal solution that treats both conditions at one intake. Or rather, as it is the case with BPH, at two intakes daily.

We would like to remind you that appointing a drug is a task that should be performed by your doctor, be it urologist, GP, sexologist or any other professional healthcare provider whom you trust. And while at My Canadian Pharmacy www.mycanadianpharmacyrx.com you can receive qualified medical consulting, your physical presence is important for a thorough examination to take place. It is also important to introduce necessary lifestyle changes to fend off the diseases for as long as possible when the therapy is over.

Clinical Studies On Adcirca

The results of a post-factum analysis of a clinical trial published on ARD have shown that subpopulation of individuals suffering comorbidity of pulmonary arterial hypertension and connective tissue disease – particularly those with a disease against the background of systemic sclerosis, benefit from the initial appointed therapy consisting of simultaneous administration of ambrisentan and tadalafil in a way comparable to those with idiopathic (iPAH) or hereditary (hPAH) patients. The study is of particular importance as it responds to certain (so far existing) uncertainties as for PAH-based therapies advantages in any form of pulmonary arterial hypertension associated connective tissue disease.

The data received in the analysis were published in Annals of the Rheumatic Diseases, have shown that subpopulation of individuals with pulmonary arterial hypertension associated with connective tissue disease (CTD-PAH) in particular those affected by systemic sclerosis disease, benefit from the initial therapy consisting of ambrisentan and tadalafil administered simultaneously in a way comparable to patients with idiopathic (iPAH) or hereditary (HPAH) patients.

This a clinical study bearing certain scientific importance as it responds to certain (so far existing) uncertainties linked to the benefit of PAH-based therapies in certain instances of pulmonary arterial hypertension associated connective tissue disease.

IPAH and CTD-PAH (in particular Ssc-PAH) have been the main subgroups of all drug-regression studies of PAHs. “A recent meta-analysis, which compares the response to therapy in iPAH and pulmonary arterial hypertension associated connective tissue disease, concluded that its treatment is less effective than that for iPAH and in terms of increasing the distance traveled to the test of 6MWD deambulation that reduces the incidence of aggravation instances registered clinically – remind authors in their introduction to work.

Not only that:’Observational data – researchers continue – coming from patients with SSc-PAH, show a reduction in survival compared to those registered in iPAH patients despite the decline in a more modest hemodynamic defect. In addition, non-SSc-pulmonary arterial hypertension associated connective tissue disease patients show survival curves comparable to those registered in iPAH patients when treated with PAH-targeted therapies.’

This attenuated response, particularly documented in a short-term trial, has led to the hypothesis that the 6MWD test used may be an unsuitable termination in individuals with Ssc-PAH:’The increase in prevalence of occlusive venous disease – explain the researchers – of occult involvement of the left heart, associated pulmonary disease, and musculoskeletal incidents in individuals with Ssc-PAH were suggested as possible explanations of what was observed in this cluster of subjects.

The trial is a randomized, double blind study called to draw parallels and find differences between the efficacy and safety of ambrisentan and tadalafil combination versus both monotherapy drugs in patients with functional class WHO / NYHA II and III and pulmonary hypertension.

The study demonstrated the ability of with naïve PAH treatment versus ambrisentan administered concomitantly ambrisentan and tadalafil to halve the risk of clinical failure (primary endpoint) in patients and tadalafil in monotherapy (p = 0.001).

The aim of this post-factum study was to verify the risk to benefits ratio of this combination treatment in the population of patients with pulmonary arterial hypertension associated connective tissue disease, as well as in the subgroup of patients with Ssc-PAH, as well as to discover data on individuals suffering from iPAH and hPAH in order to investigate the existence of different responses to treatment based on the PAH etiology.

The study originally randomized 500 patients (2: 1: 1) administered ambrisentan plus tadalafil (n = 253) or only ambrisentan (n = 126) or tadalafil alone (n = 121) titled from 5 mg to 10 mg one once during 24 hours and from 20 mg to 40 mg once during 24 hours, respectively for ambrisentan and tadalafil.

The main termination of the trial was the time at the first clinical failure incident, taken for time from randomization to death for any cause, hospital admission due to worsening pulmonary hypertension, disease progression, or unsatisfactory clinical response in long period.

Ambrisentan is an A receptor antagonist for endothelin (ETA). while tadalafil is a phosphodiesterase-5 (PDE5) inhibitor. Both drugs are approved in the United States, Europe and other monotherapy countries to be administered once a day for the use in individuals with pulmonary hypertension (WHO 1 group), in patients with class acting

The American Food and Drug Administration has approved tadalafil (Adcirca) for pulmonary arterial hypertension (PAH) therapy. The drug, available in form of oral medication, is approved for this therapeutic effect at a dose of 40 mg to be administered once daily.

Tadalafil is the active substance of the drug Cialis approved in 2003, a phosphodiesterase inhibitor for several years available for erectile dysfunction therapy and marketed in over 100 countries.

Adcirca is designed to minimize the instances of inadequate response to physical activity in PAH patients, who include hypertension patients due to various origin such, including idiopathic disease development and PAH caused by genetic factors, as well as those linked to scleroderma and heart disease.

In the PHIRST-1 study, a randomized, double-blind, placebo-controlled, phase II trial lasting 16 weeks, PAH patients in the 6-minute walk test improved the 33-meter distance. In the patients treated with the drug, there was also a slowdown in the clinical deterioration measured by evaluating several parameters: death, lung transplantation, hospitalization, beginning of new therapies, worsening of the WHO class. In United States, United Therapeutics has the rights to develop and market the drug, in this indication obtained by Eli Lilly who developed the molecule.

The state of affairs has a very high degree of difficulty. The effect is equivalent to that of endothelin receptor antagonists but the cost is lower.

Pulmonary hypertension means high blood pressure in the pulmonary artery of the lung. Many different diseases can cause a pressure increase in the pulmonary edema. Pulmonary arterial hypertension (PAH) is such a disease. It primarily affects the pulmonary arteries’ finest branches (arterioles) and causes smooth muscle cells in the vessel wall to grow in both size and number. The vessel walls become thickened and have an increased tendency to contract (vasoconstriction), which causes the blood flow in the vessels to be difficult. Flow resistance or lung resistance is most commonly measured in Wood Units, but also in dune s / cm5, with 1 Wood Unit = 80 dynes / cm5.

As the flow mood increases, the right heart rate must work harder and push up a higher pressure in the pulmonary edema to maintain normal blood flow through the lungs. The increasing pressure leads to increased breathlessness and condition reduction. When the right chamber is no longer capable of generating the pressure needed, blood flow decreases through the lungs, and thus also the blood flow throughout the body. At this stage, symptoms and signs of right ventricular disease such as pancreatic nose, nausea, leg edema and neck vein are added.

One of the drug groups introduced in recent years for the treatment of PAH is 5-phosphodiesterase inhibitors (PDEIs), with two approved substances (sildenafil and tadalafil). These cause vasodilation and counteract cell proliferation. The treatment aims at lowering lung vessel resistance and pulmonary artery pressure, improving right ventricle function and thus cardiac output (CO), improving patient performance, reducing symptoms and improving survival.

How serious is the state? The state of affairs has a very high degree of difficulty. What effect does the action have?

At PAH, 5-phosphodiesterase inhibitors are produced an improved workability with a walking distance increasing by an average of 14-69 meters compared with placebo over a follow-up period of up to four months (moderately strong scientific basis):

an improved functional class with at least one class according to the New York Heart Association (NYHA) Functional Classification at 17-35% compared with placebo (limited scientific evidence)
an improved hemodynamics in the lung vessels with a decrease in pulmonary artery resistance in the lung artery of 122-376 dynes / cm5 and improved pump capacity at 0.2-0.9 l / min / m2 (strong scientific basis). The scientific evidence is insufficient to assess the effect of 5-phosphodiesterase inhibitors on mortality in PAH. The effect is clinically relevant because it improves work ability. However, the follow-up time in the studies is limited to 3-4 months.

Does the action have any side effects or unwanted effects?

Side effects reported in most studies in patients treated with 5-phosphodiesterase inhibitors compared to placebo include headache, which is usually transient, as well as flutter and hypotension.

What studies are included in the review?

The review includes six randomized controlled trials. The findings are based on data from 1,036 people for workability, 1,016 people for mortality, 769 for function class, 611 subjects for pulmonary artery resistance and 611 subjects for cardiac output.

Is there any information in the studies?

For PAH 5-phosphodiesterase inhibitors, long-term effects and studies of sufficient size and duration for survival analysis are lacking. There are also no comparative studies between the two substances sildenafil and tadalafil in the 5-phosphodiesterase inhibitor group.

The result showed that the cost of sildenafil was dominant (generated lower costs and higher efficacy) based on a lifetime perspective compared to only conventional standard treatment at PAH (certain health-economic evidence).