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Tadalafil is a selective, reversible inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5). When sexual stimulation causes the local release of nitric oxide, inhibition of PDE5 by tadalafil produces increased levels of cGMP in the corpus cavernosum. This results in smooth muscle relaxation and inflow of blood into the penile tissues, thereby producing an erection.
This effect of age is not clinically significant and does not warrant a dose adjustment. Pharmacokinetics determined with a population approach in patients with erectile dysfunction are similar to pharmacokinetics in subjects without erectile dysfunction. The rate and extent of absorption of tadalafil are not influenced by food, thus CIALIS may be taken with or without food. The time of dosing (morning versus evening) had no clinically relevant effects on the rate and extent of absorption. (2) Postmarketing surveillance reported adverse reactions not observed in placebo-controlled clinical trials.
Oxytocin, a hormone released during sexual arousal, is believed to contribute to sexual pleasure and satisfaction. Certain groups of people are more 
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