Does sildenafil work apcalis SX Oral Jelly is a variation of Generic Cialis. The main component of Apcalis is Tadalafil. Apcalis 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. Apcalis 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. Usually, the recommended dose is 50 mg. It is taken approximately 0,5-1 hour before sexual activity. Do not take Viagra more than once a day. A high-fat meal may delay the time of the effect of this drug. Try not to eat grapefruit or drink grapefruit juice while you are being treated with Sildenafil Citrate. You can not appoint tramadol in acute alcohol intoxication (poisoning); patients with hypersensitivity to narcotic analgesics; patients taking MAO inhibitors. A pregnant appointment should be made with extreme caution. Children under the age of 14 do not prescribe the drug.