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In healthy individuals, less than 0.0005% of the administered dose was found in sperm.

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Binding to proteins does not change with impaired renal function.

Healthy elderly patients (65 years and more) had a lower clearance of Cialis 20 Mg Price Uae when administered, which was expressed in an increase in AUC by 25% compared with healthy individuals aged 19 to 45 years. This difference is not clinically significant and does not require dose adjustment.

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Cialis Buy Japan is mainly metabolized with the participation of the CYP3A4 isoenzyme. Selective inhibitor of CYP3A4, ketoconazole (400 mg/day) increases the AUC of Buy Cialis Over The Counter Canada in a single dose by 312% and SMACNA 22%, and ketoconazole (200 mg/day) increases the AUC of Cialis 20 Mg Price Uae in a single dose by 107% and Smachna 15% relative to the AUC values for Cialis 20 Mg Price Uae Smartelco one. Ritonavir (200 mg 2 times a day), an inhibitor of isoenzymes CYP3A4, 2C9, 2C19 and 2D6, increases the AUC of Buy Cialis Miami in a single dose by 124% without changing Cmax. Although no specific interactions have been studied, it can be assumed that other HIV protease inhibitors such as saquinavir and CYP3A4 isoenzyme inhibitors such as erythromycin and Itraconazole increase Buy Cialis Denmark activity.

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Clinical pharmacology

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In vitro studies have shown that Cialis Buy Pakistan is a selective PDE-5 inhibitor. PDE-5 is an enzyme found in the smooth muscles of the cavernous body, in the smooth muscles of the vessels of the internal organs, in skeletal muscles, platelets, kidneys, lungs and cerebellum. The effect of Cialis 20 Mg Price Uae on PDE-5 is more active than on other PDES. Cialis 20 Mg Price Uae is 10,000 times more powerful against PDE-5 than against PDE-1, PDE-2, PDE-4 and PDE-7, which are localized in the heart, brain, blood vessels, liver, leukocytes, skeletal muscles and other organs. Cialis Generico Online Mexico is 10,000 times more active in blocking PDE-5 than PDE-3, an enzyme that is found in the heart and blood vessels. This selectivity for PDE-5 versus PDE-3 is important because PDE-3 is an enzyme involved in cardiac muscle contraction. In addition, Cialis 20 Mg Price Uae is approximately 700 times more active against PDE-5 than against PDE-6, which is found in the retina and is responsible for photo transmission. Cialis Online Snabb Leverans is also showing the action in 9000 times more potent against PDE-5 compared with its effect on PDE-8, PDE-9, PDE-10 and 14 times more potent against PDE-5 compared to PDE-11. Tissue distribution and physiological effects of PDE-8 — PDE-11 inhibition have not yet been clarified.

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