Warning labels
— Cialis side effect: “may uncommonly cause ... vision changes, such as seeing a blue tinge to objects or having difficulty telling the difference between the colors blue and green.”

Eli Lilly has changed its labels on Cialis due to side effects. Patients with heart disease or high blood pressure should be warned about the elevated risk of NAION when taking anti-impotence pills.

How Effective is Cialis?
Several studies have been done with Cialis, and I have presented some of the summary findings from different research studies:

Serotonin increasing drugs can cause sexual dysfunction in women.  Three women with medication-induced sexual dysfunction derived benefit from using 20 mg of Cialis before anticipated sexual activity. Cialis appeared to be well tolerated. Journal of Sexual and Marital Therapy. 2006 Jan-Feb;32(1):1-3.

This 12-week, double-blind, parallel, placebo-controlled study was conducted at 25 sites in Canada to evaluate the efficacy and safety of oral Cialis for the treatment of ED. Fifty percent and 62% of patients treated with Cialis 10 mg and 20 mg, respectively, achieved successful sexual intercourse after their first dose, compared with 31% with placebo. Journal of Sexual Medicine. 2005 Sep;2(5):685-98.

In men with ED, Viagra and Cialis were both effective and well tolerated. After treatment with Viagra and Cialis, 29% of men chose Viagra and 71% chose Cialis for ED therapy during an 8-week extension. British Journal of Urology Int. 2005 Dec;96(9):1323-32.

Daily use of Cialis provided erectile dysfunction improvement in 69 percent of users while Cialis use on demand provided benefits in 42 percent of users. The drug was well tolerated with Cialis side effects including headache, dyspepsia, and facial flushing as the most frequent adverse events. Journal of Sexual Medicine, 2004 Nov;1(3):292-300.

A 32-year-old male presented with recurrent nosebleeds during sexual intercourses. The patient controlled the bleeding each time with sponge packs and gauzes. During the consultation, he volunteered that the trigger for the nosebleeds appeared to have been the use of phosphodiesterase (PDE)-5 inhibitors, Viagra and Cialis. This first report of Cialis side effect of epistaxis after PDE-5 inhibitors in a young patient opens the possibility that in the next years the number of similar cases might increase. International Journal of Impotence Research. 2006 Mar-Apr;18(2):213-4.

A healthy 46-year-old man went to the Emergency Department with a 36-hour history of persistent, painful erection after taking the cyclic guanylyl monophosphate-specific phosphodiesterase 5 inhibitor Cialis. After confirmation of ischemic priapism and failure of bedside management in the Emergency Department, the patient underwent operative caverno-spongiosal shunting. Postoperatively, the erection initially rebounded but gradually receded with manual compression over 48 hours. At outpatient follow-up, the patient remained flaccid without erections. This is one of the first reports of Cialis side effect of priapism. Urology. 2005 Aug;66(2):432.

The potential mechanisms underlying back pain and/or myalgia experienced by men taking Cialis were investigated. An integrated analysis of 10 placebo-controlled Cialis clinical trials showed that the incidence of back pain and/or myalgia was 9% in patients receiving Cialis 10 mg (N=394), 8% in patients receiving Cialis 20 mg (N=883) and 3% in placebo-treated patients. Although the mechanism of back pain and/or myalgia remains unknown, these Cialis side effects appear to be self-limiting and a general effect of phosphodiesterase 5 inhibition. International Journal of Impotence Research. 2005 Sep-Oct;17(5):455-61.

Many men with erectile dysfunction (ED) have hypertension as a comorbid condition. Recent guidelines recommend thiazide diuretics as first-line therapy for hypertension. We analyzed data from 14 randomized, double-blind, placebo-controlled trials to evaluate the efficacy of Cialis 20 mg for the treatment of ED in men on thiazides. Of the 2501 patients, 163 were on concomitant thiazides (116 Cialis /47 placebo) and 159 (98%) were reported to have hypertension. The Cialis group showed a significantly greater mean baseline to endpoint improvement on all efficacy outcome measures compared to placebo-treated patients regardless of concomitant thiazide use. More importantly, the responses to Cialis were similar regardless of concomitant thiazide use. Additionally, responses to Cialis were comparable between thiazide and nonthiazide users regardless of baseline ED severity. International Journal of Impotence Research. 2005 Sep-Oct;17(5):450-4.

The mean per-patient percentages of successful intercourse attempts for the 24-hour time point were 41%, 55%, and 67% for placebo and Cialis 10 and 20 mg, respectively; for the 36-hour time point. The most common Cialis side effects were headache, back pain, dyspepsia, and nasopharyngitis. Both 10- and 20-mg Cialis improved erectile function for up to 36 hours postdosing in men with ED of varied severity. Journal of Andrology. 2005 May-Jun;26(3):310-8.

74% of sexual intercourse attempts were successful in Cialis -treated patients, compared with 29% in placebo-treated patients. The most common Cialis side effects were headache, dyspepsia, flushing, back pain, pain in limb and myalgia. These Cialis side effects were mostly mild to moderate. British Journal of Urology International. 2004 Oct;94(6):871-7.

At Cialis doses of 10 mg and 20 mg, the mean success rate for intercourse attempts  was 58% and 68%, respectively, compared with 31% in the placebo group. Cialis was effective up to 36 h after dosing and was effective regardless of disease severity and causes, and in patients of all ages. The most frequent Cialis side effects were headache, dyspepsia, back pain and myalgia. British Journal of Urology International. 2004 Jun;93(9):1276-81.

Cialis and Heart
Since the introduction of the first PDE5 inhibitor, Viagra, in 1998, and subsequent impotence drugs such as Levitra and Cialis, there has been concern about the side effects of these agents on the heart and their safety in patients with cardiovascular disease. Since Cialis causes vasodilation, it has blood pressure lowering ability. These Cialis side effects are usually mild and produce few symptoms. When combined with the nitric oxide donor nitroglycerine, however, blood pressure drops may be profound and life threatening. Cialis is contraindicated with nitrates.

Cialis effective for erectile dysfunction help in men with spinal cord injury
Nearly 85 percent of men with spinal cord injury given Cialis to be used as needed for a 12 week period had improvement in erections. The most common Cialis side effects were headache and urinary tract infection. Just one in four men with a spinal cord injury can achieve erections adequate for intercourse on their own. Cialis is effective for a longer period of time than Viagra and Levitra, and unlike the shorter-acting drugs, it does not interact with fatty foods, Giuliano and colleagues note. Archives of Neurology, November 2007.

Cialis in China
April 2007 - Eli Lilly & Co., maker of impotence drug Cialis, hopes that Chinese couples who might resort to traditional aphrodisiacs to resolve sexual problems will seek marital bliss with its own drug remedy. Eli Lilly & Co. launched a marketing campaign for Cialis in the world's most populous country with the release of a survey showing that 45 percent of middle-aged Chinese couples had experienced erectile dysfunction problems. Since only one third of those couples had thought about seeking treatment, Eli Lilly believes that efforts to boost awareness of the problem would increase sales of Cialis, whose long-lasting effects have given it the nickname "the weekender." Cialis, which has been distributed to 5,000 Chinese pharmacies this month, is effective for up to 36 hours, longer than rival drugs on the market, according to Eli Lilly. Erectile dysfunction has historically been treated in China with traditional medicines containing herbs or animal parts such as tiger penis and rhinoceros horns. Cialis, although growing faster globally than Viagra, still lags its rival, which was launched in China by Pfizer, the world's largest drugmaker, in 2000. Levitra, an impotence drug developed jointly by Bayer AG, GlaxoSmithKline Plc and Schering-Plough Corp., is also available in China. Worldwide sales of Lilly's Cialis jumped 30 percent to $971 million.

Cialis review

These are reports from Cialis users:
Q. I took a dose of Cialis that my doctor gave me. I had body ache and headache. It did not appeal to me.
   A. Not all drugs work for everyone, including Cialis.

Q. I just wanted to ask about your "Passion Rx" supplement as far as what you say it seems to me it probably does work, the problem I have is I have tried so many different products in my years, I'm 58, I'm in very good health no problems and I take no prescription medication except for an occasional supplement for sexual performance, I have tried "Viagra" and "Cialis" and a slew of herbal supplements and have not been happy with any of them. I would appreciate your unbiased opinion on whether you think this Passion Rx should
work any better for me, and also please sign me up for your newsletter.
   A. We find up to 80 percent of passion rx with yohimbe users are satisfied with the results, but we cannot predict an individual person's response, that is impossible to predict. As a rule, about 60 to 70 percent of Viagra or Cialis users are content with the results.

Q. I am 50 years old and am facing severe erectile dysfunction where my penis cannot erect anymore. During my teens I was full of lust and had to resort to frequent masturbation of an average of 2 to 3 times per day. But now I can't even get it erected without medication. I tried Passion RX and several other herbs but problem is once I get erected, before I finished putting on the condom, the penis is flaccid and no matter how I try or do after that it cannot erect anymore. The erection lasted only about 1 to 2 minutes even after taking Passion Rz and other herbs like Maca, Tongkat Ali, Horny Goat Weed and Testerol (which is made up of Beta Ecdysterone (30 gm)), Tribulus Terrestris 40% (200 mg) and Pepsin (10mg). However, if I take Cialis, the penis can erect for a long time and I have no problem with a full intercourse but I have difficulty ejaculating. If I don't take Cialis, my penis gets erected for a short while and goes limp immediately after that as if the flood that rush to the penis have suddenly been drained away. Arousal actions like masturbation to get it erect again after that only end in vain and draw pain and guilt in me although my wife says: "It's OK. I understand." but that makes me feel really guilty that I failed her. What is the reason for the Blood to just suddenly drained out of the penis? How come when I take Cialis I have no problem to stay erect at all? But Cialis is a prescription drug and it is embarrassing to go to the clinic with the nurse giggling away when they hand over the prescription to me. I really don't feel like going to the doctors for prescription because it is humiliating infront of the nurses who seem to think of me as an abnormal being. I know that Horny Goat Weed (Tribulus Terrestris) has the properties of a PDE5 inhibitor like Cialis or Viagra do but how come it does not work on me like Cialis can?
   A. Herbs take longer to work, they are not to be taken an hour or two or even the same day as intercourse, but they need to be built up in the body over time. The herbs increase libido, sensation, blood flow and overall sexual enjoyment, but they are not as specific as Cialis in terms of pure erection enhancement. Also, we have found that if Passion Rx is taken on an empty stomach in the morning, it works best if you don't eat anything for at least an hour, maybe two hours. You could consider doing this for 2 days on, one or more days off. If Passion Rx does not work, Passion Rx with yohimbe could, or alternating between them, or taking Prostate Power Rx on the off days.

Q. I just thought I would share my experiences with Passion Rx. Over two months ago, I chanced upon this sexual enhancing product. I was impressed by its list of ingredients, including maca, tribulus, muira puama, and yohimbe bark, and many others. Until this time, I have been dependent on Cialis - there was no way I could perform without it. Sometimes, even with Cialis, I had to have the greatest concentration else, I will lose it. I have been on testosterone patches and got no relief. So, I decided to take the plunge and ordered one Passion Rx with yohimbe. Around the 3rd week, I noticed that i started having spontaneous hard-ons. One night, during that week, my wife took me by surprise in the morning (I left the new pack of Cialis I just bought in my office and couldn't run downstairs before the action, so I decided to go ahead. I was surprised -- we did it. In the past, this would not have been possible, i would have lost my erection half-way.. But now I realized that I had so much libido -- the desire was strong. I decided to take the capsules for one more week. By the 4th week, I could have sex with my woman without taking the Cialis. In fact, I have used only 8 out of the 100 Cialis tabs that had arrived about 3 months ago. Interestingly, I noticed differences in how I feel even with a condom. Previously, I could not sustain an erection with a condom on, even when I take the Cialis. But now, without the Cialis and on this supplement alone, I can use a condom and still complete the act without losing it. I am so happy with your product that I reordered a second bottle and taking it now. I don't know when I would have to stop -- but realized that I can skip a couple of days and still have a long term effect. Thanks for a great product.