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.

Guidelines for the supply of sildenafil for erectile dysfunction

REMOTE HEALTH ATLAS – Section #: TITLE (SPACE TO RIGHT FLUSH
GUIDELINES FOR THE SUPPLY OF MEDICINES
FOR ERECTILE DYSFUNCTION
Note: where sildenafil 20mg tablets (Revatio®) are prescribed for pulmonary hypertension please refer
to thregarding use under the Highly Specialised Drugs program.
Medicines (including phosphodiesterase 5 inhibitors (sildenafil, tadalafil and vardenafil), alprostadil and papaverine) for erectile dysfunction are not funded under the PBS/ S100 arrangements. Sildenafil is available through Regional Hospital Pharmacies for the treatment of erectile dysfunction via theand the approval of the Regional Senior Rural Medical Practitioner (SRMP) - Operations (Ops). Where the client meets the criteria of these guidelines and is approved the SRMP - Ops the Remote Health Branch will meet the full cost. Where a client does not meet the inclusion criteria, requires supply more frequently than endorsed within this guideline, or supply is not approved by the SRMP - Ops the Rural Medical Practitioner (RMP) may provide a private prescription and the client will need to make their own arrangements for supply, including delivery and payment, with a pharmacy of their choice. Pharmacies that have existing supply arrangements with Remote Health Centres are listed at the bottom of this guideline*. Inclusion criteria:
A medicine for erectile dysfunction may be supplied, with full department funding, only where the client meets the following criteria: paraplegia; or condition is secondary to diabetes; or other specific conditions which may be considered on a case by case basis. Supply under departmental funding arrangements is subject to the prescription being:
written for a maximum of 4 tablets or 5 injections per supply event; and dispensed by the Regional Hospital Pharmacy with a minimum period of 6 months The RMP should include information regarding the aetiology for the erectile dysfunction within the ‘Rationale / Justification’ section of the It is the responsibility of the RMP to inform the client about the restrictions to supply of a medicine for erectile dysfunction when fully funded by RHB, and their options to obtain additional supplies where appropriate. Initial approval for supply of a medicine for erectile dysfunction, will be for one supply
event only, and an assessment of effectiveness must be conducted by the RMP within 6
months, to establish if treatment should be continued. Where continued additional review of
effectiveness must be conducted at a minimum of every 12 months.
*Pharmacies (include but are not limited to) Contact Details:
Pharmacy
Developed by: Remote Health Pharmacy Group Endorsed by: Remote Executive Leadership Group

Source: http://remotehealthatlas.nt.gov.au/guidelines_supply_of_medicines_erectile_dysfunction.pdf