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Cialis may rival Viagra as a treatment for erectile dysfunction.
The launch of Viagra, the world's first treatment for impotency,
was an instant success. Now, Eli Lilly and ICOS Corporation (Lilly
Icos) have tapped into the vast demand for Viagra with a new drug
called Cialis, Viagra's first direct competitor. There is more to
come from a third drug called Levitra - a pharmaceutical industry
partnership between Bayer and GlaxoSmithKline
The market for Cialis is huge - following the
runaway success of Viagra. An estimated 30 million men in the US
and 175 million worldwide suffer from erectile dysfunction, and
only a fraction are currently using Viagra. The current Viagra market
of around $1.5bn a year could rise to total impotence drug sales
of around $6bn over the next eight years, split between Viagra,
Cialis, Levitra and other second-generation treatments.
As with Viagra, Cialis is likely to be used as a performance
enhancer, rather than just as treatment for an ailment.
All these impotence drugs block an enzyme called phosphodiesterase
5 (PDE-5), which relaxes smooth some kinds of muscle cells and allows
increased blood flow into the penis.
Cialis has key advantages over Viagra and could
develop blockbuster status. Cialis is available on prescription
in the UK, Germany, Denmark, Finland, Sweden and Australia. Cialis
has yet to be approved in the US.
Cialis can last for two days
Cialis starts working faster than Viagra, sometimes in 16 minutes,
and lasts 24 hours or more.In contrast, Viagra usually
works for only four hours after an hour's delay.
As with Viagra, 80% of men with erectile function are able to achieve
an erection with Cialis use and three out of four are able to achieve
sexual intercourse. But in one Cialis study, 59% of previously
impotent men were still able to have sex 36 hours after taking it.
The reason is that the body takes four times as long to get rid
of Cialis than to eliminate Viagra. The half-life of Viagra (time
for blood levels to fall 50%) is 4 hours compared to 17 hours for
Cialis. That means 25% of a Cialis dose is still present in the
body after 35 hours, and 12.5% after more than 50 hours. It also
means that Cialis will accumulate in the body if taken regularly.
Cialis can build up in the body
Someone using one Cialis tablet every two days will find
Cialis levels go on rising to reach a steady state after about a
week. On day 2, when taking a second tablet around 20%
of the original tablet is still in the blood stream. On day 4, 22%
of a single dose will still remain. On day 6 around 24% and so on.
So someone who finds a single dose still has an effect after 36
hours could in theory find that a tablet every other day enables
them to have sex whenever they wish without fear of failure - assuming
reasonable intervals before doing so.
Of course, other factors are important such as the possibility of
more continuous or more serious side effects - after a single
dose 14% experience headaches and 9% heartburn.Taking Cialis in
such a way should not be considered by anywone under any circumstances
without close medical supervision and advice.
In France, it has been dubbed 'Le Weekend' pill.
Unlike Viagra, Cialis does not interact with with food or alcohol
- Viagra is best taken on an empty stomach. GlaxoSmithKline/Bayer's
Levitra is expected to launch in 2003. Pfizer is trying to block
US launches of Cialis and Levitra, but similar legal action in Europe
failed on the grounds that the information to be patented was already
in the public domain.
Cialis for women?
As with Viagra, many will be watching to see if Cialis has
a roled to play in enhancing sexual function in women.
In the majority of cases they are likely to be disppointed since
the female sexual response is complex: there is far more to a fulfilling,
satisfying and exciting sex life than mere pharmacology, and this
is also important in the majority of men.
Various sources February 2003.
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