Tell your doctor if you have or have had any of the following medical conditions: buy cialis canada Vardenafil relaja los músculos de los vasos sanguíneos y aumenta el flujo de sangre en regiones particulares del cuerpo.
The specified medical conditions are diabetes, multiple sclerosis, Parkinson's disease, poliomyelitis, prostate cancer, an operation to remove the prostate gland (prostatectomy), radical pelvic surgery, renal failure treated by dialysis or transplant, severe pelvic injury, single gene neurological disease, spinal cord injury and spina bifida.Penile erection during sexual stimulation is caused by increased penile blood flow resulting from the relaxation of penile arteries and corpus cavernosal smooth muscle. This response is mediated by the release of nitric oxide (NO) from nerve terminals and endothelial cells, which stimulates the synthesis of cGMP in smooth muscle cells. Cyclic GMP causes smooth muscle relaxation and increased blood flow into the corpus cavernosum. The inhibition of phosphodiesterase type 5 (PDE5) enhances erectile function by increasing the amount of cGMP. Tadalafil inhibits PDE5. Because sexual stimulation is required to initiate the local release of nitric oxide, the inhibition of PDE5 by tadalafil has no effect in the absence of sexual stimulation.
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Corresponding Author: Jiali Han, PhD, Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, 714 N Senate Ave, Indianapolis, IN 46202 (jialhan@iu.edu). Quinidine
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