Extra Super Cialis represents a significant advancement in the pharmacological management of two common male sexual health disorders: erectile dysfunction (ED) and premature ejaculation (PE). This combination medication leverages the proven efficacy of two active pharmaceutical ingredients, Tadalafil and Dapoxetine, to address both the vascular and neuropsychological components of sexual dysfunction. Tadalafil, a long-acting phosphodiesterase type 5 (PDE5) inhibitor, facilitates robust and sustained erectile function by enhancing blood flow to the corpus cavernosum. Dapoxetine, a selective serotonin reuptake inhibitor (SSRI) with a rapid onset and short half-life, is specifically approved for the treatment of premature ejaculation, increasing intravaginal ejaculatory latency time (IELT) and improving control over ejaculation. This comprehensive profile details the pharmaceutical characteristics, clinical applications, and essential safety information for healthcare providers and informed patients.

Features

• Active Ingredients: Tadalafil (20 mg) and Dapoxetine (60 mg) per tablet
• Pharmacological Class: PDE5 Inhibitor + SSRI
• Mechanism of Action: Dual-action; vasodilation (Tadalafil) and serotonin reuptake inhibition (Dapoxetine)
• Onset of Action: Approximately 30-60 minutes for Tadalafil; 1-2 hours for Dapoxetine
• Duration of Effect: Up to 36 hours for Tadalafil’s erectile effects; 24-hour period for Dapoxetine’s effects on subsequent ejaculation
• Administration: Oral tablet, taken with or without food (high-fat meals may delay Tadalafil absorption)
• Available Strengths: Standard formulation (Tadalafil 20mg / Dapoxetine 60mg)

Benefits

• Provides a comprehensive solution for men suffering from both erectile dysfunction and premature ejaculation concurrently
• Enables spontaneous sexual activity due to Tadalafil’s extended 36-hour therapeutic window
• Significantly improves control over ejaculation and increases satisfaction for both partners
• Reduces anxiety related to sexual performance through reliable pharmacological support
• Offers a simplified treatment regimen compared to taking multiple separate medications
• Enhances overall quality of life and intimate relationship satisfaction

Common use

Extra Super Cialis is primarily indicated for the treatment of erectile dysfunction in adult men, characterized by the consistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance. Concurrently, it addresses premature ejaculation, defined as ejaculation that always or nearly always occurs prior to or within about one minute of vaginal penetration (lifelong PE) or a clinically significant reduction in latency time, often less than 3 minutes (acquired PE), which causes marked distress or interpersonal difficulty. It is suitable for men who have been diagnosed with both conditions and for whom combination therapy is deemed appropriate after medical evaluation. The medication is intended for use immediately prior to anticipated sexual activity and is not recommended for continuous daily dosing in this formulation.

Dosage and direction

The recommended dosage is one tablet (containing Tadalafil 20 mg and Dapoxetine 60 mg) taken orally with a full glass of water, approximately 1-3 hours before anticipated sexual activity. The tablet may be taken with or without food, though consumption with a high-fat meal may delay the absorption of Tadalafil and slightly postpone the onset of action. Patients should not exceed one tablet within a 24-hour period. The timing should be adjusted based on individual response and tolerance; for some individuals, taking the medication 2 hours before activity may provide optimal results. It is crucial to note that sexual stimulation is required for the erectile response to occur. Healthcare providers may adjust the dosing regimen based on efficacy and tolerability, particularly in patients with renal or hepatic impairment, where dosage reduction or avoidance may be necessary.

Precautions

Prior to initiating therapy with Extra Super Cialis, a thorough medical evaluation should be conducted to assess cardiovascular status, as sexual activity carries potential cardiac risk. Use with caution in patients with anatomical deformation of the penis, history of priapism, bleeding disorders, active peptic ulceration, or severe renal/hepatic impairment. This medication may cause dizziness or syncope; patients should be cautioned about operating machinery or driving until they understand how the drug affects them. Alcohol consumption should be limited as it may increase the risk of orthostatic hypotension, dizziness, and may exacerbate certain side effects. Patients should be screened for a personal or family history of bipolar disorder or mania before use, given the SSRI component. Regular follow-up is recommended to monitor treatment efficacy and side effects.

Contraindications

Extra Super Cialis is strictly contraindicated in patients with known hypersensitivity to Tadalafil, Dapoxetine, or any excipients in the formulation. Concurrent administration with organic nitrates (e.g., nitroglycerin, isosorbide mononitrate/dinitrate) or nitric oxide donors in any form is absolutely contraindicated due to the risk of profound hypotension. It is also contraindicated in patients taking potent CYP3A4 inhibitors (e.g., ketoconazole, ritonavir) due to significantly increased Tadalafil exposure. The medication must not be used in men with cardiac conditions where sexual activity is inadvisable, such as unstable angina, recent myocardial infarction, or uncontrolled hypertension/hypotension. Concomitant use with monoamine oxidase inhibitors (MAOIs), thioridazine, or other SSRIs/SNRIs is contraindicated due to the risk of serotonin syndrome.

Possible side effect

The most commonly reported adverse reactions are typically mild to moderate and transient. These may include headache, flushing, dyspepsia, nasal congestion, back pain, myalgia, dizziness, insomnia, fatigue, nausea, diarrhea, and increased sweating. Visual disturbances (blurred vision, cyanopsia) have been reported with PDE5 inhibitors. Priapism (a prolonged and painful erection lasting more than 4 hours) is a rare but serious adverse event requiring immediate medical attention to prevent permanent tissue damage. The Dapoxetine component may cause serotonergic effects such as yawning, restlessness, and in rare cases, syncope (often associated with a vasovagal response). As with other SSRIs, there is a potential for serotonin syndrome (symptoms include agitation, hallucinations, tachycardia, hyperthermia) though the risk is lower with intermittent dosing.

Drug interaction

Extra Super Cialis has significant interaction potential. Concomitant use with alpha-blockers (e.g., doxazosin, tamsulosin) may lead to symptomatic hypotension. Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, ritonavir) can markedly increase Tadalafil plasma concentrations—co-administration is contraindicated. Moderate CYP3A4 inhibitors (e.g., erythromycin, grapefruit juice) may increase exposure; caution is advised. Inducers of CYP3A4 (e.g., rifampin, carbamazepine) may decrease Tadalafil concentrations and reduce efficacy. Dapoxetine is metabolized by multiple CYP enzymes (2D6, 3A4, 2C19, 2C9); interactions with inhibitors of these enzymes may increase Dapoxetine levels. Concurrent use with other serotonergic drugs (tramadol, lithium, triptans, other SSRIs/SNRIs, St. John’s Wort) increases the risk of serotonin syndrome.

Missed dose

As Extra Super Cialis is prescribed for use on an as-needed basis prior to sexual activity, the concept of a “missed dose” does not apply in the traditional sense. The medication should be taken only when planned sexual activity is anticipated. If a patient forgets to take the tablet and remembers later, it may still be taken provided sufficient time remains for the drug to take effect (typically at least 1-2 hours before activity). However, patients should never take a double dose to make up for a forgotten one, as this significantly increases the risk of adverse effects without enhancing efficacy. The next dose should be taken at the next occasion of planned sexual activity, adhering to the minimum 24-hour interval between doses.

Overdose

In cases of suspected overdose, immediate medical attention should be sought. Symptoms of Tadalafil overdose may include severe headache, flushing, dyspepsia, prolonged erection, and hypotension. Dapoxetine overdose may manifest as serotonergic toxicity (agitation, confusion, rapid heart rate, dilated pupils, muscle rigidity), dizziness, nausea, vomiting, and syncope. Standard supportive measures should be employed, including monitoring of vital signs and ECG. Treatment is primarily symptomatic; hypotension should be managed with fluid resuscitation and, if necessary, vasopressors (but not nitrates). Priapism requires urgent urological intervention. Hemodialysis is not expected to significantly accelerate elimination of either component due to high protein binding and extensive metabolism.

Storage

Store Extra Super Cialis tablets at room temperature (15-30°C or 59-86°F) in their original packaging to protect from light and moisture. Keep the container tightly closed and out of reach of children and pets. Do not store in bathrooms or other areas with high humidity. Do not use tablets beyond the expiration date printed on the packaging. Proper disposal of unused medication should be conducted in accordance with local regulations, ideally through a medicine take-back program, to prevent accidental ingestion or environmental contamination.

Disclaimer

This information is intended for educational purposes and does not constitute medical advice. Extra Super Cialis is a prescription medication and should only be used under the supervision of a qualified healthcare professional. A thorough medical evaluation is necessary to determine appropriateness of therapy, considering individual health status, contraindications, and potential interactions. The patient information leaflet provided with the medication contains the most complete and updated safety information. Never initiate, discontinue, or change the dosage of this medication without consulting your physician. The manufacturer and distributors are not liable for any consequences arising from the misuse or misinterpretation of this information.

Reviews

Clinical studies and post-marketing surveillance indicate high patient satisfaction with Extra Super Cialis, particularly among men with comorbid ED and PE. In randomized controlled trials, the combination demonstrated statistically significant improvements in International Index of Erectile Function (IIEF) scores and mean intravaginal ejaculatory latency time compared to placebo. Patients report appreciation for the convenience of a single tablet addressing both conditions and the extended window of opportunity provided by Tadalafil. The most frequently cited drawbacks in real-world use are the cost of combination therapy and the occurrence of generally mild side effects like headache and nasal congestion. Overall, it is considered an effective option for appropriately selected patients who have not achieved desired results with monotherapies.