Anyone tried Tadalafil daily?

[Rabsie]

Going to Thailand for 3 weeks in January. Last couple of times used Viagra which works fine but you need the 1 hour lead in time which isn’t always convenient as sometimes oppurtunities or must have girls pop up unexpectedly.

This time thought of trying Tadalafil daily 5mg so I am always ready for action. Anyone else tried it. How did it go for you.

TIA

[daviemac]

Discussed here - https://www.ukpunting.com/index.php?topic=388371.0#lastPost

[MysteryManNo.7]

I've not taken it daily but do take the 20mg tablets on demand pre punt as insurance and it works a treat compared to sildenafil as I get none of the side effects I do with Sildenafil and it lasts bloody ages, often 2 days. Additionally, the tablets I have are large and designed to be easy to split into quarters which is really handy.

Obviously with anything like this our bodies are all different and you should visit you GP about it though I realise it's almost impossible to get a GP appointment especially for something like this.

[RandomGuy99]

I've not taken it daily but do take the 20mg tablets on demand pre punt as insurance and it works a treat compared to sildenafil as I get none of the side effects I do with Sildenafil and it lasts bloody ages, often 2 days. Additionally, the tablets I have are large and designed to be easy to split into quarters which is really handy.

Obviously with anything like this our bodies are all different and you should visit you GP about it though I realise it's almost impossible to get a GP appointment especially for something like this.

20mg is a lot.

[Jacksonwood]

20mg is a lot.

I get mine online in 20mg tablets and as others have said they split easily in half (bite on them). Recommended dose is 10mg. I have taken 20mg and it lasts for 3/4 days but prefer to use 10mg on the day required approx 30 mins before action.

[scutty brown]

Be careful
As far as I can make out the small daily dose is mainly intended as part of a mixed treatment for enlarged prostates - there some evidence that it can reduce swelling when used with other drugs. Very contentious though.
Otherwise there is a potential big issue with taking a daily drug which affects blood pressure - you really should chat to your GP

[MysteryManNo.7]

I get mine online in 20mg tablets and as others have said they split easily in half (bite on them). Recommended dose is 10mg. I have taken 20mg and it lasts for 3/4 days but prefer to use 10mg on the day required approx 30 mins before action.

Was gonna say the same thing. Completely depends what tablets I get sent by the online pharmacist but it's either these very small ones which would be difficult to split or the much larger ones that are designed to be split. I've seen others say it before but even if you only plan to take 10mg, buy the 20mg tablets and split them so you have double the amount compared to buying 10mg tablets.

[RandomGuy99]

Be careful
As far as I can make out the small daily dose is mainly intended as part of a mixed treatment for enlarged prostates - there some evidence that it can reduce swelling when used with other drugs. Very contentious though.
Otherwise there is a potential big issue with taking a daily drug which affects blood pressure - you really should chat to your GP

+1

[Marmalade]

The warnings are completely in order and if a person is on lots of meds and/or has serious medical conditions it’s up to that person to look into it or talk to their GP. Yet it’s also worth observing that, especially as we get older, high blood pressure is more common than low blood pressure. If you’re not sure, it’s easy to get a decent monitor and check it occasionally. (Sildenafil and tadalafil potentially lower blood pressure).

Sildenafil is of course also prescribed I think for pulmonary hypertension but it’s also been studied for its usefulness in regular BP lowering effects. I practically had to hit a consultant over the head with the data before he would actually concede it (he eventually just mumbled yes, but it’s not a standard NHS treatment). Tadalafil has a similar potential and further studies have been recommended but not done as yet AFAIK.

The other thing of possible concern is that frequent large variations of blood pressure are not particularly good for you, so if viagra knocks you out of joint it’s worth being more careful.

Most serious interactions are with less common drugs. It’s easy enough to External Link/Members Only. GPs these days often appreciate patients getting better informed before an appointment.

[Marmalade]

Be careful
As far as I can make out the small daily dose is mainly intended as part of a mixed treatment for enlarged prostates - there some evidence that it can reduce swelling when used with other drugs. Very contentious though.
Otherwise there is a potential big issue with taking a daily drug which affects blood pressure - you really should chat to your GP

It’s indicated for both. External Link/Members Only
But good luck trying to get a GP to prescribe it for anything. It’s politically incorrect to say cost is a factor but I think stats and prescribing advice suggest it is as well.

[RandomGuy99]

The warnings are completely in order and if a person is on lots of meds and/or has serious medical conditions it’s up to that person to look into it or talk to their GP. Yet it’s also worth observing that, especially as we get older, high blood pressure is more common than low blood pressure. If you’re not sure, it’s easy to get a decent monitor and check it occasionally. (Sildenafil and tadalafil potentially lower blood pressure).

Sildenafil is of course also prescribed I think for pulmonary hypertension but it’s also been studied for its usefulness in regular BP lowering effects. I practically had to hit a consultant over the head with the data before he would actually concede it (he eventually just mumbled yes, but it’s not a standard NHS treatment). Tadalafil has a similar potential and further studies have been recommended but not done as yet AFAIK.

The other thing of possible concern is that frequent large variations of blood pressure are not particularly good for you, so if viagra knocks you out of joint it’s worth being more careful.

Most serious interactions are with less common drugs. It’s easy enough to External Link/Members Only. GPs these days often appreciate patients getting better informed before an appointment.

And the chance of the occurrence of side effects increases the higher the dose you take, so popping 20mg like it was smarties is probably a bad idea.

[David1970]

Be careful
As far as I can make out the small daily dose is mainly intended as part of a mixed treatment for enlarged prostates - there some evidence that it can reduce swelling when used with other drugs. Very contentious though.
Otherwise there is a potential big issue with taking a daily drug which affects blood pressure - you really should chat to your GP

I was on viagra from my doctor before my heart attack, I stopped taking it as I was worried it would affect blood pressure. My doctor prescribed Tadalafil daily and I have had no side effects, but I don’t get as hard as viagra.

[Marmalade]

And the chance of the occurrence of side effects increases the higher the dose you take, so popping 20mg like it was smarties is probably a bad idea.

As with any medicine. (Though unlike Smarties, even the 40 mg isn’t really big enough to choke on).
I don’t recommend cutting them in half as it tends to waste bits. Just bite a bit off and keep the rest for later in the week. 

[Marmalade]

I was on viagra from my doctor before my heart attack, I stopped taking it as I was worried it would affect blood pressure. My doctor prescribed Tadalafil daily and I have had no side effects, but I don’t get as hard as viagra.

Pleased to hear you got in on prescription!

Are prescriptions free in England, same as Scotland, or do you have to pay?

[Doc Holliday]

Pleased to hear you got in on prescription!

Are prescriptions free in England, same as Scotland, or do you have to pay?

Only if you are in one of the exemption categories otherwise it is currently £9.65 per item.

Generic sildenafil is available to everyone on NHS prescription. Viagra on private prescription only.

Tadalfil is available on NHS prescription to anyone to whom teh following applies

Diabetes
Multiple sclerosis
Parkinson’s disease
Poliomyelitis
Prostate cancer
Severe pelvic injury
Single gene neurological disorder
Spina bifida
Spinal cord injury
Treatment for renal failure by renal dialysis
Prostatectomy
Radical pelvic surgery
Renal failure treated by transplant
Also, if erectile dysfunction (ED) is judged to cause you considerable distress, you could also qualify for an NHS prescription of Tadalfil. However, for this you need to be seen and assessed by a specialist.

For everyone else Tadalafil can be prescribed on Private prescription. With all private prescriptions for ED meds there is no prescription charge by the prescriber only the Pharmacy.

Tadalafil cannot be prescribed on the NHS by a GP for Benign Prostatic Hyperplasia only by a Specialist and I gather it's use for such has declined due to lack of evidence re its effcetiveness?

Also I think in many areas now daily Tadalafil 5 mg may not available on NHS prescription?

[Andywb]

Only if you are in one of the exemption categories otherwise it is currently £9.65 per item.

Generic sildenafil is available to everyone on NHS prescription. Viagra on private prescription only.

Tadalfil is available on NHS prescription to anyone to whom teh following applies

Diabetes
Multiple sclerosis
Parkinson’s disease
Poliomyelitis
Prostate cancer
Severe pelvic injury
Single gene neurological disorder
Spina bifida
Spinal cord injury
Treatment for renal failure by renal dialysis
Prostatectomy
Radical pelvic surgery
Renal failure treated by transplant
Also, if erectile dysfunction (ED) is judged to cause you considerable distress, you could also qualify for an NHS prescription of Tadalfil. However, for this you need to be seen and assessed by a specialist.

For everyone else Tadalafil can be prescribed on Private prescription. With all private prescriptions for ED meds there is no prescription charge by the prescriber only the Pharmacy.

Tadalafil cannot be prescribed on the NHS by a GP for Benign Prostatic Hyperplasia only by a Specialist and I gather it's use for such has declined due to lack of evidence re its effcetiveness?

Also I think in many areas now daily Tadalafil 5 mg may not available on NHS prescription?

My GP recently prescribed me 5mg daily tadafil for benign prostatic hyperplasia. I take the tadalafil jointly with tamsulosin hydrochloride.  Previously I only had the tamsulosin.  The two together have markedly reduced my prostate symptoms. I do not have ED, but he did say he could not prescribe it for ED anyway.

[Rabsie]

Thanks for the input guys.

I got it from Lloyds Pharmacy online. You have to do a generic questionnaire before they proscribe it. It is marketed as and intended for daily use.

Coincidently I had a health check up recently and my blood pressure is fine.

Has anyone had any experience with how good it is for just being able to get a good erection on demand given the right stimulation?

[Marmalade]

Only if you are in one of the exemption categories otherwise it is currently £9.65 per item.

Generic sildenafil is available to everyone on NHS prescription. Viagra on private prescription only.

Tadalfil is available on NHS prescription to anyone to whom teh following applies

Also, if erectile dysfunction (ED) is judged to cause you considerable distress, you could also qualify for an NHS prescription of Tadalfil. However, for this you need to be seen and assessed by a specialist.

For everyone else Tadalafil can be prescribed on Private prescription. With all private prescriptions for ED meds there is no prescription charge by the prescriber only the Pharmacy.

Tadalafil cannot be prescribed on the NHS by a GP for Benign Prostatic Hyperplasia only by a Specialist and I gather it's use for such has declined due to lack of evidence re its effcetiveness?

Also I think in many areas now daily Tadalafil 5 mg may not available on NHS prescription?

So it looks as though we get a better deal in Scotland, and congrats to Andywb getting tadalafil (I imagine a lot of older gents have benign prostatic hyperplasia but not get offered tadalafil – it's still on the BNF list for that but local guidelines may discourage prescribing it including External Link/Members Only).

I think there's worry over the NHS generally. And with due cause. In a survey published recently we're not even in the top twenty countries. I went for a scan recently, came clear, nothing wrong, but the concern is not some much finding a problem as not being offered treatment in a reasonable time period. What they do now is send you an annual letter saying sorry you haven't been seen in the statutory 8 weeks or whatever it is and they're doing their best.

It may have declined due to concern over possible adverse conditions too. Or cost. It's funny how medicines that aren't cheap are often considered medically inadvisable, but when the generics become available suddenly the 'evidence' looks brighter.[/list]

[Doc Holliday]

So it looks as though we get a better deal in Scotland, and congrats to Andywb getting tadalafil (I imagine a lot of older gents have benign prostatic hyperplasia but not get offered tadalafil – it's still on the BNF list for that but local guidelines may discourage prescribing it including

Yes Tadalafil is still licenced for use for BPH, but not recommended for prescribing on NHS since the NICE decision in 2013 based on lack of evidence it was cost effective

External Link/Members Only
External Link/Members Only

This usually means many local CCG's then followed suit egs

External Link/Members Only
External Link/Members Only

So Andy has done well for his GP to prescribe it and it is good to hear he has found it beneficial in combination 

[Andywb]

Yes, it sounds as though I have been fortunate.

My full story is that I was invited to have a medication review with the practice pharmacist.  I had read some papers published in medical journals about taking tadalafil in combination with tamsulosin for BPH after researching my prostate issues. I was therefore in a position to raise the possibility with the pharmacist. Luckily she was aware of the research and agreed it was worth trying.  I then saw my GP and explained I would like ti give it a shot. He said No, but then a few days later he phoned and said he had discussed it with the pharmacist and that she was correct. I had to take blood pressure readings at home for a week before being prescribed.  My blood pressure is slightly raised and tadalafil can reduce blood pressure. It has (not suprisimgly) given my erections a boost so it is a win all round. But the main, and intended benefit,  is for BPH. It had an almost instant impact on my prostate symptoms so worth discussing with your GP even if you subsequently to pay for the prescription privately. As discussed above getting proper advice is a good idea because of potential side effects which can be quite serious.

[Doc Holliday]

That's great Andy .. we all love a happy ending!

[Thephoenix]

Yes, it sounds as though I have been fortunate.

My full story is that I was invited to have a medication review with the practice pharmacist.  I had read some papers published in medical journals about taking tadalafil in combination with tamsulosin for BPH after researching my prostate issues. I was therefore in a position to raise the possibility with the pharmacist. Luckily she was aware of the research and agreed it was worth trying.  I then saw my GP and explained I would like ti give it a shot. He said No, but then a few days later he phoned and said he had discussed it with the pharmacist and that she was correct. I had to take blood pressure readings at home for a week before being prescribed.  My blood pressure is slightly raised and tadalafil can reduce blood pressure. It has (not suprisimgly) given my erections a boost so it is a win all round. But the main, and intended benefit,  is for BPH. It had an almost instant impact on my prostate symptoms so worth discussing with your GP even if you subsequently to pay for the prescription privately. As discussed above getting proper advice is a good idea because of potential side effects which can be quite serious.

As you say side effects are important.

I also have BHP and recently had a transurethral cystolitholapaxy which is basically a device shoved down your peehole which contains a camera, crushing machine and vacuum cleaner to remove bladder stones.
The urologist prescribed finastaride and tamsulosin and I asked about tadalafil as an alternative but he said they weren't cost effective.

It's just as well really as although the tamsulosin helped to relax the small muscle from the bladder and helped my BHP symptoms, it also had the same effect on the small muscle from my stomach causing severe reflux every time I laid down.
(Not helped by failed reflux surgery a few years ago by a young surgeon on his first attempt at the procedure).

All the ED meds cause similar reflux problems but at least the short acting ones only cause the side effects to last a couple of days, whereas if I've taken a 10mg tadalafil the side effects persevere for much longer.

[Strawberry]

For anyone who has more than 10 prescription items per year may be worth knowing you can buy a pre-pay annual certificate for a little over £100.

[RandomGuy99]

For anyone who has more than 10 prescription items per year may be worth knowing you can buy a pre-pay annual certificate for a little over £100.

Hidden Image/Members Only

[Marmalade]

All the ED meds cause similar reflux problems but at least the short acting ones only cause the side effects to last a couple of days, whereas if I've taken a 10mg tadalafil the side effects persevere for much longer.

You seem like a man that’s been round the block a few times Phoenix. So I expect you’ve tried the usual stuff for acid reflux. Otherwise I’d mention things like a simple antacid or H2 blocker; or a sildenafil jellie mostly absorbed sublingually (depending which side of that fence you’re on).

In my youth I found that cimetidine (an old H2 blocker) seemed to increase the effect of the sildenafil. I worked out its an CYP inhibitor which would account for it (especially CYP3A4). The doc will more likely prescribe something like ranitidine (one of those meds they often dispense like smarties). The effect of cimetidine was subsequently External Link/Members Only (though it might not be a big enough difference for some people to notice) and was still considered ‘safe’.

 

[JustaPunter]

20mg is a lot.

20mg is the standard dose for on demand usage.

5mg is the standard dose for daily usage

[Thephoenix]

You seem like a man that’s been round the block a few times Phoenix. So I expect you’ve tried the usual stuff for acid reflux. Otherwise I’d mention things like a simple antacid or H2 blocker; or a sildenafil jellie mostly absorbed sublingually (depending which side of that fence you’re on).

In my youth I found that cimetidine (an old H2 blocker) seemed to increase the effect of the sildenafil. I worked out its an CYP inhibitor which would account for it (especially CYP3A4). The doc will more likely prescribe something like ranitidine (one of those meds they often dispense like smarties). The effect of cimetidine was subsequently External Link/Members Only (though it might not be a big enough difference for some people to notice) and was still considered ‘safe’.

Thanks for your comments.
Yes I've tried every PPI under the sun over the years.
None have worked. They actually seem to make it worse.
Prior to my reflux surgery I'd been sleeping in an armchair for a few years unable to lie down.
The surgery helped with the heartburn but not with the throat symptoms.
I've now got severe throat reflux (LPR) and difficulty swallowing.
The ENT consultant is referring me back to gastro.
I don't want to face further surgery, so I'm just trying to control the symptoms by sleeping on a 'ski slope', strict diet, little or no evening meal and guzzling Gaviscon Advance.

I'm stupid taking any ED meds as they all give me a  number of  severe side effects which have definitely worsened with age.

The lure and fantasy of punting sometimes make me throw caution to the wind, but I'm always sorry afterwards when the side effects kick in.
I've already been warned by my cardiologist about mixing ED meds with my BP meds,  but the spirit is willing but the flesh is weak.

As many have testified, it's a hard hobby to give up.

[Marmalade]

Thanks for your comments.
Yes I've tried every PPI under the sun over the years.
None have worked. They actually seem to make it worse.
Prior to my reflux surgery I'd been sleeping in an armchair for a few years unable to lie down.
The surgery helped with the heartburn but not with the throat symptoms.
I've now got severe throat reflux (LPR) and difficulty swallowing.
The ENT consultant is referring me back to gastro.
I don't want to face further surgery, so I'm just trying to control the symptoms by sleeping on a 'ski slope', strict diet, little or no evening meal and guzzling Gaviscon Advance.

I'm stupid taking any ED meds as they all give me a  number of  severe side effects which have definitely worsened with age.

The lure and fantasy of punting sometimes make me throw caution to the wind, but I'm always sorry afterwards when the side effects kick in.
I've already been warned by my cardiologist about mixing ED meds with my BP meds,  but the spirit is willing but the flesh is weak.

As many have testified, it's a hard hobby to give up.

Aye getting old can old can be a bummer (no pun intended).

Have you tried the ‘Gervais manoevre’ on your cardiologist?


It went like this… His doctor gave him some pain killers for something and said he couldn’t drink while taking them. He replied “Well that’s no good. Give me some that I can drink with!”


(Not completely unbelievable. You can’t drink with co-cocodamol but you can drink with etoricoxib).


Specialists rarely care outside their own field. Like, why should he care if you can’t fuck prostitutes?? Simpler to tell you not to. But health care guidance to doctors instructs them to treat the whole person. Plenty of studies show sex is good for you, not just the solo kind, and if it’s an important part of your lifestyle and well-being he should fucking listen and try to be helpful (maybe he does, I don’t know, but they can be infuriatingly obdurate.

Anyway. Good luck with it all!

[JontyR]

The doc will more likely prescribe something like ranitidine (one of those meds they often dispense like smarties).

Unlikely.
External Link/Members Only

[Marmalade]

Ranitidine was a typo. Trust the troll to notice it. Thanks.
I meant to type famotidine.
Ranitidine was temporarily halted due to a contaminated batch. Also of interest perhaps, equivalent tablet of famotidine is about a quarter of the size of ranitidine.

[fredhiggins]

I can't believe that at 56 I need some ED help but it seems common I guess.

[RandomGuy99]

20mg is the standard dose for on demand usage.

5mg is the standard dose for daily usage

Are you sure?

According to the NHS website the standard dose is 10 mg when needed

External Link/Members Only

Hidden Image/Members Only

Hidden Image/Members Only

Hidden Image/Members Only

[Marmalade]

@RandomGuy

Standard medical procedure is to begin with the lowest dose possibly effective. Then, increase if necessary.

So 50mg would normally be prescribed and, if not effective, increased to 100mg if no counter-indications.

Tip on getting dosage of anything increased when going back to your doctor:
e.g. prescription painkillers, sleeping tablets)

1. Wait at least six weeks. That long is a general time period for testing to see if they work. Your doctor knows that so if you go back too early he may just give it a bit longer.
2. Best not to say “they don’t work”. If they don’t work at all then a stronger dose probably won’t either. Say something like, “they seem to work a bit but I wonder if there’s something a bit stronger”. Or “confess” to occasionally taking. Or ask if there’s anything else (this is best if you know there is but want the doctor to suggest it),
3. Check what the GP is allowed to prescribe. Check an interaction list for any other meds you’re on (mild to medium interactions may often be ignored. Serious ones ones won’t. These are usually in red.) Check interactions with existing conditions while you’re at it. There may a way round them even if contra-indicated, especially if the conditions are mild. The GP will generally appreciate this and it makes you look sensible. Asking for something he can’t prescribe makes you look a dufus unless you have a very good case. If it’s a drug that needs a specialist ‘approval’ that’s also good to know. Don’t ask for stuff off-label (ie something that will theoretically work but isn’t officially prescribed for that) unless have an ‘alternative’ reason.

4. Ignore the label on most supplements that says ask your GP first. Your GP won’t have a clue. Most will just recommend a balanced diet or nameless multivitamin at best. Main exception is St John’s Wort — fucks up too many prescription meds. Other exceptions they like but may be posters on the waiting room wall saying they may be helpful rather than GP advice, are B12 and CoQ10 especially if you are taking certain meds eg some statins.
5. Be nice to your doctor. Most of them won’t admit it but do actually believe they’re God!

[RandomGuy99]

@RandomGuy

Standard medical procedure is to begin with the lowest dose possibly effective. Then, increase if necessary.

So 50mg would normally be prescribed and, if not effective, increased to 100mg if no counter-indications.

Tip on getting dosage of anything increased when going back to your doctor:
e.g. prescription painkillers, sleeping tablets)

1. Wait at least six weeks. That long is a general time period for testing to see if they work. Your doctor knows that so if you go back too early he may just give it a bit longer.
2. Best not to say “they don’t work”. If they don’t work at all then a stronger dose probably won’t either. Say something like, “they seem to work a bit but I wonder if there’s something a bit stronger”. Or “confess” to occasionally taking. Or ask if there’s anything else (this is best if you know there is but want the doctor to suggest it),
3. Check what the GP is allowed to prescribe. Check an interaction list for any other meds you’re on (mild to medium interactions may often be ignored. Serious ones ones won’t. These are usually in red.) Check interactions with existing conditions while you’re at it. There may a way round them even if contra-indicated, especially if the conditions are mild. The GP will generally appreciate this and it makes you look sensible. Asking for something he can’t prescribe makes you look a dufus unless you have a very good case. If it’s a drug that needs a specialist ‘approval’ that’s also good to know. Don’t ask for stuff off-label (ie something that will theoretically work but isn’t officially prescribed for that) unless have an ‘alternative’ reason.

4. Ignore the label on most supplements that says ask your GP first. Your GP won’t have a clue. Most will just recommend a balanced diet or nameless multivitamin at best. Main exception is St John’s Wort — fucks up too many prescription meds. Other exceptions they like but may be posters on the waiting room wall saying they may be helpful rather than GP advice, are B12 and CoQ10 especially if you are taking certain meds eg some statins.
5. Be nice to your doctor. Most of them won’t admit it but do actually believe they’re God!

Interesting, but the standard on demand dose of Tadalafil still seems to be 10mg.

I am lucky to be on no medication.  I just take a multivitamin daily.

[scutty brown]

Ranitidine was a typo. Trust the troll to notice it. Thanks.
I meant to type famotidine.
Ranitidine was temporarily halted due to a contaminated batch. Also of interest perhaps, equivalent tablet of famotidine is about a quarter of the size of ranitidine.

It wasn't a contaminated batch: the actual generic manufacturing method was a problem, resulting in trace impurities of nitrosamines.
What I don't know is whether Glaxo's original process for Zantac had the same problem, or just the generic made-in-India process.
But when you consider it was one of the biggest selling drugs in the world with no known actual real life issues arising from the impurities then the decision by the Indian government to block manufacture has to be questioned.

[yesbby]

Can I ask about the daily dose method. Are you taking a daily low dose as a kind of background buzz that means you’re pretty much ready to go at all times, or do you still have to time it so there’s a four hour window where it works optimally?

[RandomGuy99]

Can I ask about the daily dose method. Are you taking a daily low dose as a kind of background buzz that means you’re pretty much ready to go at all times, or do you still have to time it so there’s a four hour window where it works optimally?

The lower daily dose means you're primed ready to go at all times.

From External Link/Members Only

Hidden Image/Members Only

The effects, good and bad, of Tadalafil can last up to 36 hours.

[Marmalade]

It wasn't a contaminated batch: the actual generic manufacturing method was a problem, resulting in trace impurities of nitrosamines.
What I don't know is whether Glaxo's original process for Zantac had the same problem, or just the generic made-in-India process.
But when you consider it was one of the biggest selling drugs in the world with no known actual real life issues arising from the impurities then the decision by the Indian government to block manufacture has to be questioned.

You're nit-picking my words aren't you? I don't mind. They were, at least in theory, 'bad batches' afaiia. 'contaminant' was the official wording I believe.

On April 1, 2020, the FDA requested manufacturers to withdraw all prescription and over-the-counter (OTC) ranitidine drugs (Zantac, others) from the market immediately, due to the presence of a contaminant known as N-Nitrosodimethylamine (NDMA). Although the FDA did not observe unacceptable levels of NDMA in many of the samples they tested, they have determined that the impurity in some ranitidine products increases over time and when stored at higher than room temperatures.

... the article goes on and goes back and forth so no-one quite knows what to believe except that there's definitely a supply problem for one reason or another.

[JustaPunter]

It wasn't a contaminated batch: the actual generic manufacturing method was a problem, resulting in trace impurities of nitrosamines.
What I don't know is whether Glaxo's original process for Zantac had the same problem, or just the generic made-in-India process.
But when you consider it was one of the biggest selling drugs in the world with no known actual real life issues arising from the impurities then the decision by the Indian government to block manufacture has to be questioned.

You do realise that is what contaminated means?
It doesn’t really matter how the contamination gets in the product. Incompetence, equipment failure, poor production processes or accident.

If something gets in the product that isn’t meant to be there then it’s contaminated.

[weldermike]

I use Kamagra gel and after about 20 minutes I feel the effects and I’m good to go
They are about 1700b for a box of 50 in the pharmacy in Pattaya but as I normally buy from people selling on Soi Honey, I’m not 100% sure, I buy a box for 700b

[big-al93]

I use Kamagra gel and after about 20 minutes I feel the effects and I’m good to go
They are about 1700b for a box of 50 in the pharmacy in Pattaya but as I normally buy from people selling on Soi Honey, I’m not 100% sure, I buy a box for 700b

I'm not sure what the price of a different drug in a different country has to do with a thread about Tadalafil Daily? 

[scutty brown]

You do realise that is what contaminated means?
It doesn’t really matter how the contamination gets in the product. Incompetence, equipment failure, poor production processes or accident.

If something gets in the product that isn’t meant to be there then it’s contaminated.

You're missing my point. It wasn't a single batch that had the problem. It was the entire Indian production from several manufacturers, all using an inherently incorrect process.

[weldermike]

I'm not sure what the price of a different drug in a different country has to do with a thread about Tadalafil Daily? 

He said he was going to Thailand and I thought this could be an option

[RandomGuy99]

The OP isn't factoring in his refractory period before he can cum again. There's more it than just getting hard... well .. that is if he wants to cum in all his bookings.

[Marmalade]

I use Kamagra gel and after about 20 minutes I feel the effects and I’m good to go
They are about 1700b for a box of 50 in the pharmacy in Pattaya but as I normally buy from people selling on Soi Honey, I’m not 100% sure, I buy a box for 700b

Useful info.

[pantywetter]

I take around 5mg every other day and it feels like it works better that way as it lasts 48 hours.

I think I’m OK without it, but I quite like having the high quality boners and quick recovery so I’m going to keep it going for a while.

[newhere456]

I have been prescribed 2.5mg daily, alongside sildenafil 50mg as required.

The low dose daily is almost fully effective, but I find I need Sildenafil to get me over the line still - although timing the dose seems less critical than it was.

Speak to your GP, or Urologist.

[Marmalade]

I have been prescribed 2.5mg daily, alongside sildenafil 50mg as required.

The low dose daily is almost fully effective, but I find I need Sildenafil to get me over the line still - although timing the dose seems less critical than it was.

Speak to your GP, or Urologist.

Sounds like an interesting example of the effective combination.