Apcalis

Apcalis is a medicine prescribed for erectile dysfunction (ED). ED is defined as a difficulty in initiating or maintaining penile erection adequate for sexual activity. [1]  Tadalafil is also approved by FDA for benign prostatic hyperplasia.

Although Apcalis is considered to be as effective as viagra, its effects last longer around 36 hours, and for that reason, it is known as the “weekend pill” as the drug can last the majority of the patient’s weekend.[2]

In this article, we’ll intend to cover everything you need to know about Apcalis. 

What is Apcalis?

Apcalis is a drug based on tadalafil, the substance that has made it possible for men to achieve an erection for experiencing satisfying sexual intercourse. The drug in the form of Cialis is manufactured by Eli Lilly and company. 

Erectile dysfunction is a common pathology associated with men. Men who are having this condition are not able to achieve complete sexual intercourse which leads to various psychosocial issues like problems in relationships, stress, depression, and anxiety. 

Apcalis acts by inhibiting an enzyme known as PDE5 (phosphodiesterase type 5) in the body. Due to this inhibition, cGMP (cyclic guanosine monophosphate) degradation is inhibited and its level increases. This increase in cGMP helps in the relaxation of smooth muscles of the arteries in the penis, improving blood flow.

The medicine is taken 30 minutes to 60 minutes before the sexual activity and lasts for up to 36 hours.[2] However, the medicine must be taken as prescribed by the doctor and you must provide the information regarding your medical history and information of all the medications that you are taking.

What’s the Dose of Apcalis?

Apcalis is available in a single dose of 20 mg. Other tadalafil-based drugs are available in lower doses like 2.5 mg, 5 mg, or 10 mg. The lower dose is suitable for treating symptoms associated with BPH.

The medication must be used “as needed”. That means it is not used for daily use. It should be taken into consideration that tadalafil 20 mg is the maximum recommended dose of the drug. So, do not take more than 1 pill in a day. The minimum gap between the intake of 2 pills should be at least 36 hours.

The drug with this dosage can be taken at any time of the day, about 20 minutes before the sexual intercourse. The advantage of using an oral jelly form of Apcalis is that it does not need any liquid to swallow and it has a faster onset of action since the absorption of medicine starts from the oral cavity itself.[1]

How Long Does Apcalis Last?

Apcalis begins to show its effects within 20 minutes after its intake and lasts for around 36 hours, making it one of the longest-lasting ED medications.

The drug owes its long duration to the slow half-life of the active ingredient. It takes roughly 17.5 hours for exactly half of the drug to be metabolized. Compare this to 4 hours with Viagra and 6 hours with Levitra.

How Much Does Apcalis Cost?

The cost of the tablet is somewhere around $3.5.

Depending on the need, the generic medicine tadalafil can be found as a cheaper option.

The History of Apcalis

In August 1991, Tadalafil was discovered under a partnership between Glaxo and ICOS to develop a new drug. 

In 1998, ICOS Corporation and Eli Lilly and Company formed the Lilly ICOS, LLC, a joint venture company to further develop and commercialize tadalafil as a treatment for ED. [5] 

Two years later, Lilly ICOS, LLC, filed a new drug application with the FDA for compound IC351 (under the tadalafil generic name, and the Cialis brand name). In 2003, FDA approved tadalafil for the treatment of erectile dysfunction (ED). In 2011, FDA approved the use of tadalafil for signs and symptoms of benign prostatic hyperplasia (BPH). The FDA has also approved tadalafil for the treatment of both BPH and erectile dysfunction (ED) where the two conditions co-exist. Apcalis is used as a brand name for tadalafil.

Tadalafil is no longer protected under patent. So, the generic form is available under various brand names.

Who Should Take Apcalis?

Apcalis is indicated for men suffering from erectile dysfunction and those having risk factors of erectile dysfunction. It does not work if sexual arousal is the major problem as it is not a stimulant. 

For sexual arousal and improving erection other measures should also be followed like regular exercise, eating a healthy diet, plenty of fluids, stress management, avoiding alcohol or smoking, and foreplay before involving in sexual activity.

Furthermore, Apcalis must be prescribed by your doctor. Before prescribing, the doctor would assess your current and past medical condition and all the medicines you are taking.

The risk of using Apcalis needs to be weighed with the potential benefits before a prescription is written.

Is Apcalis Safe?

Apcalis is generally safe medicine for occasional use but there may be some common side effects involved. Severe side effects are rare but possible. So, the medicine must be prescribed by a doctor, and the side effect profile must be monitored.

The most common side effects reported were headaches and dyspepsia, followed by back pain, nasal congestion, myalgia, and flushing. [6] Most of these side effects subside on their own with time but if it persists or becomes bothersome, you must see your doctor.

The following lists contain some but not all the side effects of Apcalis:

Some common side effects that may be seen with Apcalis are:

• back pain
• muscle pain
• headache
• nasal congestion
• dyspepsia
• gastroesophageal reflux
• congestion
• dizziness
• ringing in the ears
• tachycardia, palpitations, hypotension, hypertension
• dyspnea, epistaxis
• abdominal pain
• rash, hyperhidrosis (excessive sweating)

Some of the serious side effects may include sudden loss of vision, sudden loss of hearing, and sudden drop in blood pressure leading to heart attack or stroke.

Apcalis Drug Interactions

Apcalis could interact with certain medicines, herbs, or supplements. Sometimes the interactions can lead to serious deteriorating outcomes. Thus, you need to provide information regarding any form of medicine that you are taking to your doctor before the prescription. This could prevent those unwanted outcomes.

Below is a list of medications that can interact with Apcalis. This list doesn’t contain all drugs that may interact with Apcalis.

Some common drugs that may interact with Apcalis include:

Nitrates

You shouldn’t take Apcalis if you’re taking a medication called nitrate. This type of drug may be used for chest pain. Taking nitrates along with Apcalis can cause a serious decrease in your blood pressure[3] 

Alpha-Blockers

Apcalis and alpha-blockers are both vasodilators that can cause blood pressure to drop below healthy limits. Taking both drugs in combination must be done carefully under the supervision of a trained medical professional.

Antihypertensives

Likewise, the due to blood pressure lowering effects of both the medicines, blood pressure may be low leading to dizziness and a faintish feeling.

Alcohol

The effects of mixing alcohol and Apcalis include Low blood pressure, dizziness, headaches, and increased heart rate. It might also affect the efficacy of Apcalis.

Antacids

If you’re taking Apcalis and use antacids to treat heartburn, the antacids may decrease the level of Apcalis that your body absorbs. This means that you may not get the full dose of Apcalis, so it may not work as well to treat your ED or symptoms of BPH.

CYP3A4 Inhibitors

Apcalis is primarily metabolized in the liver by the CYP3A4 enzymes. Taking other drugs that are metabolized by this enzyme can affect the rate of decay for Apcalis. This can lead to a prolonged half-life of the drug and elevated concentrations in the bloodstream. This can increase the risk of developing side effects.

Common CYP3A4 Inhibitors Include:

• Sodium Valproate
• Isoniazid
• Cimetidine
• Ketoconazole
• Omeprazole

CYP3A4 Inducers

Opposite to CYP3A4 inhibitors, some medications increase the activity of this enzyme — leading to faster metabolism of Apcalis. This may reduce the effectiveness of the medicine.

Common CYP3A4 Inducers Include:

• Rifampin
• Carbamazepine
• Phenytoin
• Phenobarbital
• Griseofulvin

Who Should Avoid Taking Apcalis?

It is better to avoid intake of medicine in the following situations: 

• hypersensitivity to tadalafil or any other substance present in the drug

• therapy with drugs containing organic nitrates;

• limitations of the sexual activity recommended by the doctor in patients suffering from cardiovascular diseases:
  •  myocardial infarction in the last 90 days, 
  • unstable angina, class II-IV heart failure,
  •  arterial hypotension (BP less than 90/50 mmHg), 
  • uncontrolled arterial hypertension, ischemic stroke in the last 6 months;

• loss of vision in one eye following non-arteritic anterior ischemic optic neuropathy;

• contextual intake of doxazosin, stimulators of guanylate cyclase, such as Riociguat, as well as drugs for the treatment of erectile dysfunction;

• severe kidney failure.

How Does Apcalis Work?

Erectile dysfunction is a condition in which a person cannot achieve an erection or maintain it. Erection occurs, when smooth muscles in the penis relax, causing blood flow in the penis. Cyclic guanosine monophosphate (cGMP) is a chemical in your body that relaxes the muscles in the penis and increases blood flow into the penis. With ED, this activity isn’t working properly, so you can’t have or maintain an erection.

Apcalis works by inhibiting an enzyme called phosphodiesterase 5. The enzyme is responsible for the metabolism and removal of cGMP from blood. Inhibiting this enzyme increases the level of cGMP in the blood, which causes smooth muscle to relax and increases blood flow to the penis.

Arousal is still needed to send the signal to the penis to trigger the erection in the first place. So, Apcalis only works when sexual arousal is present. 

Can Women Use Apcalis Too?

Apcalis is not approved for use in women because the only accepted conditions for prescribing the drug are benign prostatic hyperplasia and erectile dysfunction — both of which are male-specific health conditions.

In men, Apcalis improves blood flow to their penis by blocking the action of an enzyme called PDE5. This enzyme is also found in the vagina and the clitoris of women. So in theory, if a woman takes Apcalis, it could increase blood flow to her genitals but the amount of PDE5 found in women is less than that of men. So, the studies have not shown enough evidence to suggest the use of Apcalis in women.

Also, the sexual problems in women often have a lot to do with reduced sexual desire and arousal. Apcalis is unlikely to address these issues.[4]

Apcalis Alternatives

Apcalis is just one of several brand-name PDE5 inhibitors used for treating erectile dysfunction.

Some pharmaceutical alternatives for Apcalis include:

• Sildenafil (Viagra)
• Vardenafil (Levitra, Staxyn, and Vivanza)
• Avanafil (Stendra)
• Mirodenafil (Mvix)
• Udenafil (Zydena)

Tadalafil is also no longer protected under patent law, which means there are generic versions of the drug available at a much lower cost than the official brand name version of the drug.

Natural Alternatives To Apcalis

While there are natural PDE5 inhibitors and other forms of erectile dysfunction supplements, nothing in the natural world is as reliable as Apcalis or other prescription medications.

Many of these natural substances lack the clinical testing and proof necessary to recommend these products for erectile dysfunction ethically.

However, there are a few promising candidates worth mentioning:

Horny Goat Weed (Epimedium spp.) — this plant contains a compound called icariin, which is a relatively strong PDE5 inhibitor similar to Apcalis 

L-Arginine — this amino acid is one of the required precursors for nitric oxide production, which in turn promotes the activity of cGMP to promote erection 

Korean Red Ginseng (Panax quinquefolium) — KRG extracts have been shown to improve nitric oxide production promote dilation of the arteries in the penis promote erection 

Where to Buy Apcalis?

Apcalis is a prescription-only medication. It means you can get it only under the prescription of a certified doctor. After being prescribed by the doctor, you can get this medicine from a pharmacy or online drug store.

You must tell about your medical condition and any medicines, herbs, or supplements that you are taking to the doctor. The doctor might also assess your general health and may send some investigations if needed.

Then it would be decided by the doctor whether to prescribe the medicine or not. 

References Used

1. Prabhu, C. (2014). Formulation Development and Evaluation of Tadalafil Oral Jelly Comparative with Marketed Product (Doctoral dissertation, Swamy Vivekanandha College of Pharmacy, Tiruchengode, Tamilnadu, India).
2. Coward, R. M., & Carson, C. C. (2008). Tadalafil in the treatment of erectile dysfunction. Therapeutics and Clinical Risk Management, 4(6), 1315.
3. Kloner, R. A., Hutter, A. M., Emmick, J. T., Mitchell, M. I., Denne, J., & Jackson, G. (2003). Time course of the interaction between tadalafil and nitrates. Journal of the American College of Cardiology, 42(10), 1855-1860.
4. Monte, G. L., Graziano, A., Piva, I., & Marci, R. (2014). Women taking the “blue pill”(sildenafil citrate): such a big deal?. Drug Design, Development and Therapy, 8, 2251.
5. Daugan, A., Grondin, P., Ruault, C., Le Monnier de Gouville, A. C., Coste, H., Linget, J. M., … & Labaudinière, R. (2003). The discovery of tadalafil: A novel and highly selective PDE5 inhibitor. 2: 2, 3, 6, 7, 12, 12a-hexahydropyrazino [1 ‘, 2 ‘: 1, 6] pyrido [3, 4-b] indole-1, 4-dione analogues. Journal of medicinal chemistry, 46(21), 4533-4542.\
6. Frajese, G. V., Pozzi, F., & Frajese, G. (2006). Tadalafil in the treatment of erectile dysfunction; an overview of the clinical evidence. Clinical interventions in aging, 1(4), 439.