Utovlan over the counter 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. It is preferable not to use Cialis with grapefruit juice, alcoholic beverages, tobacco. If you smoke tobacco and take Cialis concomitantly this may lead to a condition called NAION (sudden optic nerve-related vision loss). Inform your doctor before to take. Cialis if you have abnormal penis, including curved penis and birth defects of the penis, had coronary artery disease, arrhythmia, angina, heart attack or heart failure, hypo- or hypertension, bleeding, stomach ulcers, diabetes, hyperlipidemia (excess of lipids in the blood), sickle-cell anaemia, liver or kidney failure in history.