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Penile erection is a hemodynamic process initiated by the relaxation of smooth muscle in the corpus cavernosum and its associated arterioles. During sexual stimulation, nitric oxide is released from nerve endings and endothelial cells in the corpus cavernosum. Nitric oxide activates the enzyme guanylate cyclase resulting in increased synthesis of cyclic guanosine monophosphate (cGMP) in the smooth muscle cells of the corpus cavernosum. The cGMP in turn triggers smooth muscle relaxation, allowing increased blood flow into the penis, resulting in erection. The tissue concentration of cGMP is regulated by both the rates of synthesis and degradation via phosphodiesterases (PDEs). The most abundant PDE in the human corpus cavernosum is the cGMP-specific phosphodiesterase type 5 (PDE5); therefore, the inhibition of PDE5 enhances erectile function by increasing the amount of cGMP. Because sexual stimulation is required to initiate the local release of nitric oxide, the inhibition of PDE5 has no effect in the absence of sexual stimulation.Common Levitra side effects may include: using cialis 28. Zusman RM, Morales A, Glasser DB, Osterloh IH "Overall cardiovascular profile of sildenafil citrate." Am J Cardiol 83 (1999): c35-44Uncommon (0.1% to 1%): Penile hemorrhage, hematospermia

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Sudden loss of vision levitra commercial Take one Cialis tablet every day at about the same time of day.Product Type HUMAN PRESCRIPTION DRUG LABEL Item Code (Source) NDC:0173-0828Available pharmacodynamic/toxicological data in animals have shown excretion of tadalafil in milk. A risk to the suckling child cannot be excluded. CIALIS should not be used during breast feeding.

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viagra for sale Pharmacokinetics0173-0831-13Since Viagra enhances sexual arousal in men by increasing the blood flow to the penis, the Bermans theorized that the drug could have a similar effect on women, increasing the blood flow to the female genitals and thereby producing better arousal, sensation and lubrication in the genital area. As stated earlier, Cialis is a potent drug that affects on the biochemical processes in the body, therefore some side effects are likely. However none of them should be easily dismissed. Ideally the patient should not suffer from any side effects. If at all any symptoms are observed, the medication should be stopped and due medical advice needs to be taken immediately. If patient experiences a sudden tingling in the chest or a pain or giddiness, and a numb feeling during sexual intercourse then it is a cause for worry. This indicates intolerance to Cialis and a doctor should be consulted immediately. Following are other major side effects that can occur:

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