Balkan Pharmaceuticals Esculap
Men's Health


Manufacturer: Balkan Pharmaceuticals
Pharmaceutical name: Tadalafil
Pack: 1 x 60 tabs (20 mg/tab)

Out of stock

Esculap Detailed

Esculap by Balkan Pharmaceuticals

Esculap - mens health drug, this drug is also known as Cialis and is made by Balkan Pharmaceuticals.
Esculap is an oral drug that is used for treating impotence (the inability to attain or maintain a penile erection). It is in a class of drugs called phosphodiesterase inhibitors that also includes sildenafil (Viagra) and vardenafil (Levitra).
Erection of the penis is caused by the filling of the penis with blood. Filling occurs because the blood vessels that bring blood to the penis increase in size and deliver more blood to the penis, and, at the same time, the blood vessels that take blood away from the penis decrease in size and remove less blood from the penis.
Sexual stimulation that leads to an erection causes the production and release of nitric oxide in the penis. The nitric oxide causes an enzyme, guanylate cyclase, to produce cyclic guanosine monophosphate (cGMP). It is the cGMP that is primarily responsible for increasing and decreasing the size of the blood vessels carrying blood to and from the penis, respectively, and causing the erection. When the cGMP is destroyed by another enzyme, phosphodiesterase-5, the blood vessels return to their normal size, blood leaves the penis, and the erection ends. Tadalafil prevents phosphodiesterase-5 from destroying cGMP so that cGMP stays around longer. The persistence of cGMP leads to a more prolonged engorgement of the penis with blood.
Long-acting type 5 phosphodiesterase isoenzyme inhibitors are a class of drugs currently prescribed for the treatment of erectile dysfunction in males. Tadalafil Citrate was made available after the initial drug, sildenafil citrate, had been on the market for several years. While sharing many of the pharmacokinetic properties and type 5 phosphodiesterase isoenzyme inhibitory activity profiles, there are several differences in the actions of the drugs although for the most part the results experienced by the user are relatively the same. The major difference between the drugs is the active life of tadalafil citrate. By extending the active life of the drug to approximately thirty-six to forty-eight hours, this allows users to be far less restricted in their dosing protocol and, for lack of a better word, spontaneity.
For the purposes of steroid users the use of Esculap is rather limited beyond that of a "recreational" purpose. One exception to this may be once a steroid user is coming off of anabolic-androgenic steroids and have suffered a significant reduction in their ability to perform sexually and/or their sex drive. The use of drugs such as Esculap can help to alleviate some of the difficulty many have during this period of time.
Type 5 phosphodiesterase isoenzyme inhibitors such as tadalafil citrate work by causing the smooth-muscles to relax in the cavernosal arteries. This in turn allows penile vasodilation and erection to occur in response to sexual stimuli. This response allows one to achieve and maintain an erection and will help with doing so for a number of causes of the erectile dysfunction.
The effects produced by type 5 phosphodiesterase isoenzyme inhibitors can include other benefits such as a reduction in blood pressure and exhibiting other cardioprotective properties. This reduction in blood pressure includes a lowering of arterial pressure, systolic and diastolic. Other heart protecting effects such as an improvement in atherosclerotic disease and endothelial function can also be observed with sustained use of the drug. These benefits, while having been proven under clinical settings, have not been put into practice in any substantive way by medical professionals on any large scale.
Nearly all of the research and scientific study of the drug Esculap has been conducted using male subjects. A small number of studies however have been done with female users. For the most part these studies have indicated that for the purpose of sexual function there appears to be a benefit that females could render from the use of Esculap, at this time however not enough research has been completed to be able to make recommendations about the safe and effective use of Esculap for females.


For most individuals, the recommended starting dose of Esculap is 10 mg per day taken before sexual activity. Depending on the adequacy of the response or side effects, the dose may be increased to 20 mg or decreased to 5 mg a day. The effect of Esculap may last up to 36 hours. Individuals who are taking medications that increase the blood levels of Esculap should not exceed a total dose of 10 mg in 72 hours (See drug interactions). Esculap may be taken with or without food since food does not affect its absorption from the intestine.
The breakdown and elimination of tadalafil from the body may be decreased by erythromycin, ketoconazole (Nizoral), itraconazole (Sporanox), indinavir (Crixivan) and ritonavir (Norvir). Therefore, these drugs may increase the levels of tadalafil in the blood. If these drugs are being used at the same time as tadalafil, the dose of Esculap should be reduced in order to avoid side effects from high levels of Esculap.
Esculap exaggerates the increases in heart rate and lowering of blood pressure caused by nitrates, e.g. nitroglycerin, isosorbide dinitrate (Isordil), isosorbide mononitrate (Imdur, Ismo, Monoket), nitroglycerin (Nitro-Dur, Transderm-Nitro) that are used primarily for treating heart pain (angina). In patients who take nitrates for angina, Esculap could cause heart pain or possibly even a heart attack by exaggerating the increase in heart rate and the lowering of blood pressure. Therefore, Esculap should not be used with nitrates. Esculap also exaggerates the blood pressure lowering effects of some alpha-blocking drugs e.g., terazosin (Hytrin) that primarily are used for treating high blood pressure or enlargement of the prostate. Individuals who take these alpha-blockers should be on a stable dose of the alpha-blocker before Esculap is started. In such situations, tadalafil should be started at the lowest dose. If the patient is already taking tadalafil, the alpha-blocker should be started at the lowest dose. Esculap and alcohol both lower blood pressure. Therefore, combining Esculap with alcohol may cause excessive drops in blood pressure and cause dizziness, headaches and increased heart rate.


For the most part Esculap is well tolerated by the vast majority of users, but some risks do exist. The most commonly referred to side effect is long lasting erections requiring medical intervention. These are relatively rare and are almost never seen when a user is using the correct dosage of the drug. But if such a condition does arise the user should seek medical attention as significant physical harm can come to the user if they allow the symptom to persist for a lengthy period of time.
A more dramatic and concerning negative side effect that has more recently been publicized to a great extent is visual impairment linked to the use of type 5 phosphodiesterase isoenzyme inhibitors such as tadalafil citrate. This visual impairment is caused when blood flow to the optic nerve is disrupted; a condition known as nonarteritic ischemic optic neuropathy. This condition appears to be possible with all type 5 phosphodiesterase isoenzyme inhibitors used to treat erectile dysfunction. It is extremely rare in it's occurrences in users of the drugs but has been linked in some cases of the condition. The direct causal connection between the drugs and nonarteritic ischemic optic neuropathy has not been established however. If a user is to develop eyesight difficulty while using Esculap they should consult with a physician as soon as possible.
As indicated earlier, Esculap has the ability to help lower blood pressure in some users. This positive effect is counteracted however by the possibility of causing problematic drops in blood pressure in users with already relatively low blood pressure readings. For this reason users who have low blood pressure should at the very least be careful when administering the drug and in the more severe cases of the condition should avoid the drug completely.

Esculap Reviews
Jan 4, 2011 (13:20)

To Montréal, Canada. Very fast shipping (10 days).
Second time I order on this Website and always a great experience/great deals.
Excellent quality.
Will always go through customs (don\'t ask why) :)

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