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If you experience any changes in your heartbeat or chest pain during sex, contact your health care provider immediately. Specifically, you should inform your health care provider of any alpha-blocker, antifungal, HIV protease inhibitor, or high blood pressure medication you are taking. Remember to mention any herbal products you use, especially St. John’s wort. Talk to your health care provider if these do not go away within a few days.

The requirements for managing your medication through telehealth services depend on the telehealth laws in your state. Cialis has a longer half-life than Viagra, meaning it is effective as needed for a longer time. Cialis is effective for roughly 18 hours, while Viagra is only effective for four hours. You could take Cialis in the afternoon, and it should be effective that evening, any time overnight, and the next morning. Urologic Surgeons of Washington is a proud member of Privia Medical Group.

When PDE5 is blocked, cGMP levels increase, leading to the relaxation of smooth muscle cells in blood vessels. This increases blood flow, which can help treat conditions like erectile dysfunction and pulmonary hypertension. PDE5 inhibitors improve symptoms of erectile dysfunction (ED) by preventing the breakdown of a substance called cyclic GMP (cGMP). CGMP acts as a vasodilator, which means it relaxes smooth muscle and widens blood vessels allowing more blood flow into tissue. This also increases blood flow into the corpus cavernosum