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Tadalafil is principally metabolised by CYP3A4. A selective inhibitor of CYP3A4, ketoconazole (200 mg daily), increased tadalafil (10 mg) exposure (AUC) 2-fold and Cmax by 15%, relative to the AUC and Cmax values for tadalafil alone. Ketoconazole (400 mg daily) increased tadalafil (20 mg) exposure (AUC) 4-fold and Cmax by 22%. Ritonavir, a protease inhibitor (200 mg twice daily), which is an inhibitor of CYP3A4, CYP2C9, CYP2C19, and CYP2D6, increased tadalafil (20 mg) exposure (AUC) 2-fold with no change in Cmax. Although specific interactions have not been studied, other protease inhibitors, such as saquinavir, and other CYP3A4 inhibitors, such as erythromycin, clarithromycin, itraconazole, and grapefruit juice, should be co-administered with caution, as they would be expected to increase plasma concentrations of tadalafil (see section 4.4). Consequently, the incidence of the adverse reactions listed in section 4.8 might be increased.-Initial dose: 5 mg orally once a day, as needed, approximately 60 minutes before sexual activity

what are the side effects of levitra As an oral medication, it’s simple and convenient to use. You should take Viagra approximately 30 to 60 minutes before sexual activity. The effects can last for up to 4 hours. Some men even find that they can get more than one erection per dose. Cialis (once-daily use)Physicians should discuss with patients the potential for Cialis to augment the blood-pressure-lowering effect of alpha-blockers and antihypertensive medications [see Drug Interactions (7.1) and Clinical Pharmacology (12.2)].

Levitra (vardenafil hydrochloride) is administered orally for the treatment of erectile dysfunction. This monohydrochloride salt of vardenafil is a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5). levitra online

Mechanism of action cheap cialis pills Be aware that some recreational drugs, such as amyl nitrate or nitrite ("poppers") contain nitrates. Blood pressure can drop when Viagra is taken with alpha-blockers.

Severe (Child-Pugh class C): Avoid useHow to take it

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