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The effect persists during 36 hours. Prolonged erections or priapism (painful erections lasting more than 6 hours) are also possible. The main component of Apcalis SX Oral Jellyis Tadalafil.Apcalis SX Oral Jelly is contraindicated in patients who are using any form of organic nitrate, either regularly and/ or intermittently as it is able to potentiate hypotensive effect of nitrates.The recommended dose of Apcalis SX Oral Jelly is 20 mg it should be taken at least 16 minutes before the sexual activity.Most usual side effects of Apcalis SX Oral Jelly are facial flushing (reddening), headaches, stomach upset, diarrhea, flu-like symptoms and nausea. Aggravation of heart problems in patients with pre-existing heart disease using Apcalis SX Oral Jelly was reported. When sexual stimulation causes local release of nitric oxide, inhibition of PDE 5 by Tadalafil leads to increase of cGMP levels in the cavernous body of penis. It works only when sexual stimulation is present. Take Apcalis SX Oral Jelly once daily and do not exceed the recommended dose.Apcalis SX Oral Jelly is an effective, reversible, selective inhibitor of phosphodiesterase type 5 (PDE 5) specific to cyclic guanosine monophosphate (cGMP). Tadalafil has no effect when sexual stimulation is absent. Apcalis SX Oral Jelly helps to achieve good erection during sexual intercourse and works improving blood flow in the penis relaxing arterial smooth muscles. If you smoke tobacco and take Apcalis SX Oral Jelly concomitantly this may lead to a condition called NAION (sudden optic nerve-related vision loss). In more rare cases low blood pressure, blurred vision and changes in color vision, and abnormal ejaculation may occur. It results in relaxation of arterial smooth muscles and blood flow to the tissues of the penis that causes erections. Inform your doctor before to take Apcalis SX Oral Jelly 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 anemia, liver or kidney failure in history. If your erection is longer than 4 hours, seek for immediate medical help as it may permanently damage your penis.It is preferable not to use Apcalis SX Oral Jelly with grapefruit juice, alcoholic beverages, tobacco. Oakland, Montana, District of Columbia, New Mexico, Indiana, CT, Mesa, WV, North Dakota, WI, PA, KS, VA, District of Columbia, Tennessee, Portland, MI, AK, Maryland, Georgia, Missouri, Indiana, Dallas, Chicago, NY, San Antonio, Hawaii, North Carolina, El Paso, Maryland, OR, Oklahoma, North Carolina, WA, Detroit, GA, Michigan, New York, Arizona, Texas, Virginia Beach, Kentucky, Pennsylvania, San Diego, Mississippi, New York, SD, FL, Cleveland, NC, Long Beach, Albuquerque, Phoenix, Illinois, MS, Louisiana, MD, CA, West Virginia, Colorado Springs. Arizona, VT, Tennessee, OH, Nashville-Davidson, Milwaukee, San Jose, Tulsa, WYMinneapolis, Nevada, ND, Michigan, Los Angeles, Texas, Columbus, Missouri, MT, Indianapolis, Louisiana, Wyoming, Denver, Wisconsin, Florida, Massachusetts, AZ, LA, NJ, NV, Omaha, Pennsylvania, South Carolina, NM, Jacksonville, Atlanta, Arkansas, NH, Nebraska, ME, South Dakota, IA, Connecticut, SC, Colorado, Rhode Island, Washington, AL, Oklahoma City, Charlotte, California, Virginia, OK, Idaho, Brookhaven, UT, Seattle, TN, NE, Alaska, IL, Oklahoma, Fresno, Oregon, Maine, New Hampshire, Ohio, Vermont, HI, Minnesota, New Mexico, New Orleans, RI, Philadelphia, Baltimore, DE, NY, Tucson, IN, ID, California, TX, Washington, Kansas, Kansas City, Sacramento, Alabama, Las Vegas, DC, San Francisco, Houston, AR, Oregon, Honolulu, Austin, Wisconsin, Colorado, Fort Worth, Washington, CO, Virginia, Utah, MO, Illinois, KY, Florida, Hempstead, New Jersey, Georgia, Iowa, Delaware, Ohio, Miami, Boston, Hawaii, MA, Nevada, Nebraska, Memphis, Massachusetts, Minnesota, MN,