Tadalafil entfaltet seine Wirkung über eine selektive Hemmung der PDE5, wodurch die Konzentration von cGMP im glatten Muskelgewebe stabil bleibt. Diese biochemische Modulation resultiert in einer langanhaltenden Relaxation der Gefäßwände. Der Wirkstoff wird nach oraler Einnahme effizient resorbiert, mit einer Bioverfügbarkeit von rund 80 %. Seine Halbwertszeit von bis zu 36 Stunden ist innerhalb dieser Substanzklasse außergewöhnlich. Abgebaut wird er in der Leber, hauptsächlich durch CYP3A4, mit anschließender biliärer Exkretion. Typische unerwünschte Wirkungen entstehen durch eine verstärkte Vasodilatation, etwa Kopfschmerzen oder Flush. Pharmakologisch wird cialis generika vor allem durch die verlängerte Wirkungsdauer charakterisiert.

Standard ql list (client friendly document)

Standard Quantity Limit List*
Therapeutic Category
Drug Name
Dispensing Limit
Anti-infectives
CIPRO XR (ciprofloxacin ext-release) 1000 mg CIPRO XR (ciprofloxacin ext-release) 500 mg PROQUIN XR (ciprofloxacin ext-release) 500 mg Cardiology
XARELTO (rivaroxaban) tablet 15 mg & 20 mg Central Nervous System
Standard Quantity Limit List*
Therapeutic Category
Drug Name
Dispensing Limit
Central Nervous System
HORIZANT (gabapentin enacarbil SR) 600 MG EFFEXOR XR (venlafaxine) caps 37.5 mg & 75 mg LEXAPRO (escitalopram) solution 5 mg/5 ml LEXAPRO (escitalopram) tabs 5 mg & 20 mg LUVOX (fluvoxamine) tabs 25 mg & 50 mg PAXIL CR (paroxetine) tabs 25 mg & 37.5 mg PROZAC WEEKLY (fluoxetine delayed-release) Venlafaxine SR (venlafaxine) tabs 225 mg IMITREX (sumatriptan ) Injection 6 mg/0.5 mL IMITREX (sumatriptan ) STATdose 4 mg/0.5 mL & 6 mg/0.5 mL Standard Quantity Limit List*
Therapeutic Category
Drug Name
Dispensing Limit
Central Nervous System
NUVIGIL (armodafinil) 150 mg & 250 mg Dermatology
TACLONEX (calcipotriene/betamethasone dipropionate) TACLONEX SCALP (calcipotriene/betamethasone dipropionate) 120 grams/30 days Endocrinology
Growth Hormones and Related Therapy EGRIFTA (tesamorelin) ACTONEL WITH CALCIUM (risedronate/calcium carbonate) FOSAMAX PLUS D (alendronate/cholecalciferol) Gastroenterology
EMEND (aprepitant) Combo Pack 125 mg/80 mg Standard Quantity Limit List*
Therapeutic Category
Drug Name
Dispensing Limit

Gastroenterology
Antiemetics
Immunology
Miscellaneous
Blood Glucose Monitors (blood glucose monitors) Diabetic Test Strips & Lancets (test strip & lancets) NICODERM (nicotine transdermal) Transdermal NICORETTE, COMMIT (nicotine) Gum, Lozenges SYNVISC, SYNVISC-ONE (sodium hyaluronate)
Obstetrics & Gynecology
DEPO/DEPO-SUBQ PROVERA (medroxyprogesterone) LOSEASONIQUE (ethinyl estradiol/levonorgestrel) SEASONALE (ethinyl estradiol/levonorgestrel) SEASONIQUE (ethinyl estradiol/levonorgestrel) 2 tabs (2 kits)/year (covered for females only) 2 tabs (2 kits)/year (covered for females <17 year PLAN B, NEXT CHOICE (levonorgestrel) 0.75 mg 4 tabs (2 kits)/year (covered for females <17 year Chorionic gonadotropin (chorionic gonadotropin) FOLLISTIM AQ (follitropin beta) Cartridge Standard Quantity Limit List*
Therapeutic Category
Drug Name
Dispensing Limit
Obstetrics & Gynecology
Oncology
LUPRON DEPOT (leuprolide) 11.25 mg & 22.5 mg (3-month) LUPRON DEPOT (leuprolide) 3.75 mg & 7.5 mg (1-month) LUPRON DEPOT (leuprolide) 30 mg (4-month) LUPRON DEPOT (leuprolide) 45 mg (6-month) LUPRON DEPOT-PED (leuprolide) 7.5 mg, 11.25 mg, & 15 mg TRELSTAR (triptorelin) 22.5 mg (6-month) TRELSTAR DEPOT (triptorelin) 3.75 mg (1-month) TRELSTAR LA (triptorelin) 11.25 mg (3-month) AFINITOR (everolimus) 2.5 mg & 10 mg SPRYCEL (dasatinib) 70 mg, 80mg & 100 mg
Ophthalmology
Standard Quantity Limit List*
Therapeutic Category
Drug Name
Dispensing Limit
Respiratory
BECONASE AQ (beclomethasone dipropionate) Albuterol (solution) 2.5 mg/3 mL (0.083%) ATROVENT (ipratropium) Inhalation Solution PROVENTIL (albuterol) Solution 0.083% (2.5 MG/3ML) PROVENTIL HFA, PROAIR HFA, VENTOLIN HFA (albuterol) XOPENEX (levalbuterol) 0.31 mg & 0.63 mg/3 mL 8 vials or suppositories/month (males only) CIALIS (tadalafil) 5 mg, 10 mg & 20 mg Standard Quantity Limit List*
Important note: dinical re ewfor higherquantitiesWII ONLYI:e pro ded fordrugsinthe folloWng dasses: antidepressants,L.MV\IHs,opidds,PDE-Sinhibitors andtrif:(ans. •nis drug list is sltljedto periodeupdates and may not be all inclusive.Drugs affected induded both brand and gereric 'Y'Ihere plicable Md indudes all strengths unless otterWse specifically ncted.lf a targeted dn.g has a newstrergth,it Wllautomatically be addedto thelist.

Source: http://www.botetourtva.us/insurance/documents/kroger_sql_list.pdf