Alli over the counter cialis is an effective, reversible, selective inhibitor of phosphodiesterase type 5 (PDE 5) specific to cyclic guanosine monophosphate (cGMP). When sexual stimulation causes local release of nitric oxide, inhibition of PDE 5 by Cialis leads to increase of cGMP levels in the cavernous body of penis. It results in the relaxation of arterial smooth muscles and blood flow to the tissues of the penis that causes erections. Cialis has no effect when sexual stimulation is absent. Cialis improves erection and let’s achieve a successful sexual intercourse. The drug acts for 36 hours. If sexual arousal is present the effect appears even after 16 minutes after the medication was taken. Inform your doctor if you have hypotension or hypertension, cardiac failure, coronary artery disease, deformations of the penis, sickle-cell anaemia, multiple myeloma, leukaemia, retinitis pigmentosa, and also a history of cardiac dysfunction, myocardial infarction, stroke arrhythmia, life-threatening arrhythmia, cardiovascular problems, allergies. Do not take Super P-Force together with other ED medication. Super P-Force cannot be used in patients with allergy to the medication and its components and also in individuals treated with nitrates (such as nitroglycerin). This combination can cause very low blood pressure potentially dangerous to result in a stroke, heart attack, or death. Do not take this medication if you are under 18 y.o.