- 1 About SPIMACO
- 2 Scientific Studies on Tadalafil
- 3 Description and Mechanism of Action of Tadalafil
- 4 Snafi Benefits for Erectile Dysfunction
- 5 Recommended Doses and Duration of Therapy
- 6 Adverse Reactions and Warnings
- 7 Drug Interactions
- 8 Customer Reviews
- 9 Price, Forms and Snafi Dosage
- 10 Reference List
- 11 Editor's Rating
Snafi 20mg/10mg Tablet contains the active ingredient Tadalafil.
In addition to ED (Erectile Dysfunction), Tadalafil is also indicated in the treatment of pulmonary arterial hypertension a well as for treating urinary symptoms associated with BPH (Benign Prostate Hyperplasia). The approved doses for erectile dysfunction range from 2.5 mg to 20 mg doses, however, for pulmonary arterial hypertension, 40 mg oral Tadalafil dose is recommended. Tadalafil is more selective in its action and is better at inhibiting Phosphodiesterase enzyme, and has least effects on other Phosphodiesterase enzymes, unlike Sildenafil and Vardenafil. Available as film-coated tablets, this product can be consumed with or without meals. There are no indications or dosing information of this medication for children. Tadalafil is contraindicated in patients who are allergic to its ingredients or those who are already on nitrates for some other indications such as chest pain. 
Established in 1986, Saudi Pharmaceutical Industries & Medical Appliances Corporation (SPIMACO) is a Saudi company that develops, manufactures and sells pharmaceutical products and medical devices. SPIMACO Addwaeih is spread across many countries worldwide; it is very successful in national and international markets and has been approved by regulatory bodies, complying with all the rules and regulations. SPIMACO also has good relations with other pharmaceutical companies around the world and is dedicated to providing the best-quality of pharmaceutical products meeting the international standards.
Products marketed within Kingdom of Saudi Arabia are Gliptamet (Sitagliptin Phosphate), Neorin (Desloratadine), Levox (Levofloxacin), Paleta Glipten, Ferose-F (Iron), Lejam (Dapoxetine), Hepavir (Entecavir), Montel (Montelukast Sodium), Co-Irbetel (Irbesartan/Hydrochlorothiazide), Irbetel (Irbesartan/Hydrochlorothiazide), Agout (Febuxostat), Etoria (Etoricoxib), Pregadex (Pregabalin), Rantudil (Acemetacin), Entapro (Escitalopram), Quetta (Quetiapine) and Respira (Diskair) among others. Other than Kingdom of Saudi Arabia, SPIMACO operates in other countries such as United Arab Emirates, Kuwait, Bahrain, Qatar, Oman, Egypt, Sudan, Lebanon, Jordan, Yemen, Libya, Algeria and Iraq. Products in the international ,market include Ceclor (Cefaclor), Cipromax (Ciprofloxacin), Fluconazole (Fluconazole), Klavox (Clavulanate-potentiated Amoxicillin), Lorinase (non-sedating Anti-histamine), Zimax (Azithromycin), Sortive (Losartan), Tovast (Atorvastatin), Diatab (Glibenclamide), Formit (Metformin), Glaze (Gliclazide), Glim (Glimepiride), Peptazol (Lansoprazole), Proton (Pantoprazole), Verine (for irritable bowel syndrome), Ferosac (Iron), Ferose, Rofenac (Anti-rheumatic), Sapofen (Analgesic and antibiotic), and Snafi (Tadalafil) among others. The therapeutic categories of the products manufactured by this pharmaceutical company are anti-Infective, cardio-vascular, Diabetes, Gastrointestinal tract, Iron supplement men’s health, musculoskeletal, psychiatric and respiratory medications. SPIMACO is currently producing many drug product and formulations. Dosage forms manufactured in SPIMACO include mouthwashes, creams, antiseptic products, suppositories, ointments, tablets, gels, capsules, suspensions, and injections. 
Scientific Studies on Tadalafil
Published in the journal, “Circulation”, Nazzareno Galiè in his study, “Tadalafil Therapy for Pulmonary Arterial Hypertension” demonstrated the role of Tadalafil in the treatment of pulmonary arterial hypertension. This pulmonary arterial hypertension could either be idiopathic or due to an underlying condition of the patient. Patients groups were given a placebo, 2,5 mg, 10 mg, 20 mg or 40 mg oral Tadalafil once daily over sixteen weeks. In this study, the distance walked by the patients in six minutes was assessed and those subjects who would complete this sixteen-week course would enter extension studies involving long-term trials. Tadalafil was found to increase the distance walked by the subjects in six minutes, with increasing doses of Tadalafil i.e. dose-dependent effects. Tadalafil was also found to delay the onset of clinical worsening of pulmonary arterial hypertension. The conclusion was made that 40 mg oral dose of Tadalafil helps improve exercise tolerance and enhances the quality of life with less worsening of the cases. 
“Pharmacotherapy of Sexual Dysfunctions: Current Status” by Ajith Avasthi, published in the Indian Journal of Psychiatry, reviewed the effects of erectile dysfunction on the psychological conditions of the patient and overall relationship of the couple. In this work, Avasthi stressed on the fact that prior to any treatment, there should be a complete check-up of the patient involving every aspect of his health which includes, physical examination and psychological conditions. The inability of a person to attain or to maintain an erection limits the person’s sexual activity and affects not only the individual’s self-esteem but also has serious effects on the couple if the problem persists. Ajith Avasthi describes the erection as a vascular event for which, an undisturbed endothelium is required. Different treatment options were discussed in this article, including oral agents and injectables. The first oral agent to be discussed is Sildenafil (Phosphodiesterase inhibitor) which was voted to be a good medication for ED treatment with fewer side effects. Other oral agents include 5-HT inhibitors, alpha blockers such as Yohimbine and Phentolamine, D1 and D2 blockers (Dopamine receptor blockers) e.g. Apomorphine, and opioid antagonists such as Naltrexone. Intracavernous injections can also be used as a treatment of ED in which Phentolamine mesylate, Papaverine or other vasoactive peptides are injected. The author focuses on the fact that the treatment option should be chosen only after the pathophysiology of the patient’s condition is known so that we can achieve better outcomes with the right treatment. 
Syed Tabrez Ali in his study, “effectiveness of sildenafil citrate (viagra) and tadalafil (Cialis) on sexual responses in Saudi men with erectile dysfunction in routine clinical practice”, published in Pakistan Journal of Pharmaceutical Sciences, Ali compared Sildenafil and Tadalafil and studied the outcomes of Saudi men who had erectile dysfunction. The trials were done on 150 Saudi men with ED, out of these 150, fifty were untreated, fifty were asked to take Sildenafil 100 mg orally once a day, an hour before sexual activity. The third group had to take oral Tadalafil 20 mg daily, twenty minutes before sexual activity. The trials went on for three months and the domains that were covered in the comparisons were a sexual function, orgasmic function, and intercourse function. As a result, Tadalafil was found to be a better alternative than Sildenafil because Sildenafil is short-acting and needs to be taken before sexual activity, however, effects of Tadalafil stay for twenty-four hours after administration. 
Description and Mechanism of Action of Tadalafil
Tadalafil is a PDE5 inhibitor. In the presence of sexual stimulation, Nitric Oxide is produced by neurons that are called non-adrenergic non-cholinergic neurons. Nitric Oxide causes activation of guanylate Cyclase and increases the synthesis of cGMP (cyclic Guanosine Monophosphate) which then causes the smooth muscles to relax and inflow of blood from the arteries take place. This blood flow causes an erection. Tadalafil works to increase the amount of cGMP produced and thereby helps attain as well as maintain penile erection. 
Snafi Benefits for Erectile Dysfunction
Tadalafil has the approval from FDA to be prescribed for erectile dysfunction. It is the third drug to be approved especially for this purpose. Snafi is a good treatment option for impotence and helps the patient attain the erection and also maintain it. This drug can be used when needed, or daily dosing for 3 months or more can be given as prescribed by the doctor.
Recommended Doses and Duration of Therapy
When taken on as needed basis for Erectile Dysfunction: 10 mg orally before sexual act, either with food or without food. The dose can be increased up to 20 mg or taken as low as 5 mg depending on the patient’s tolerance and efficacy.
When taken once daily: 2.5 mg per day oral dose, either taken with or without food; daily dosing is irrespective of sexual activity. The dose can be increased up to 5 mg per day.
Doses need to be adjusted when taken with other medications such as anti-fungal drugs. 
Adverse Reactions and Warnings
A headache, nausea, back pain, myalgia, flushing, RTI (Respiratory Tract Infection), dyspepsia, nasopharyngitis, nasal congestion, genitourinary tract infection, bronchitis, hypertension, epistaxis, amnesia, and arthralgia.
Tadalafil should be taken with caution in case of any anatomic deformity of the penis, or in the case of any bleeding disorder. FDA also has warned about chances of developing vision loss and visual differences in patients. This must be monitored by the doctor very closely.
Drugs such as Telaprevir, Isosorbide Mononitrate, Boceprevir, Isosorbide dinitrate and nitroglycerin are completely contraindicated. Serious interactions are possible with Itraconazole, Erythromycin, amyl nitrate, Clarithromycin, Darunavir, Indinavir, cobicistat, ritonavir, Nelfinavir, Ketoconazole, and Nicardipine. Other interactions with drugs such as some beta blockers, alfuzosin, Doxazosin, Clotrimazole, Ethacrynic acid and Enalapril, among many others must be monitored closely. Hypersensitivity such as exfoliative dermatitis and Stevens-Johnson syndrome are possible in patient allergic to this medication.
According to some reviews, people call this drug a “miracle drug” that helped them restore their self-esteem and brought them out of their disturbed psychological state. Some users also have found Tadalafil better than Sildenafil because of its long-acting pharmacodynamic effects and there is no need of taking the drug twenty minutes before an intercourse.
In addition to the benefits of this drug, patients must be educated about drug interactions and must consult a doctor if they are considering Tadalafil with other medications taken at the same time. Even minor interactions can sometimes be more pronounced in some patients with certain underlying conditions or agents in their foods. The review in the above picture clearly states that this person was taking other medications and co-administration was not to be started unless told by a doctor. 
Price, Forms and Snafi Dosage
Tadalafil is available as tablets usually film-coated. This product is available in online drugstores and can be purchased easily. A pack of two tablets costs around USD 4.97, while the shipping charges are not mentioned anywhere. The delivery methods and options are not specified anywhere on the internet. The price of a unit would be around USD 2. 42.
No shipping info found unless the order has been made!
Information on delivery to Australia, Canada or the US is not mentioned on the online pharmacy. When taxes are excluded, the price is reduced to USD 4.03.
- Medscape: Tadalafil. Attainable at: http://reference.medscape.com/drug/adcirca-cialis-tadalafil-342873
- SPIMACO. Attainable at: http://www.spimaco.com.sa/
- Galiè N, Brundage BH, Ghofrani HA, Oudiz RJ, Simonneau G, Safdar Z, Shapiro S, White RJ, Chan M, Beardsworth A, Frumkin L. Tadalafil therapy for pulmonary arterial hypertension. Circulation. 2009 Jun 9;119(22):2894-903. Attainable at: http://circ.ahajournals.org/content/119/22/2894.short
- Avasthi A, Biswas P. Pharmacotherapy of sexual dysfunctions: Current status. Indian journal of psychiatry. 2004 Jul;46(3):213. Attainable at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951646/pdf/IJPsy-46-213.pdf
- Ali ST. EFFECTIVENESS OF SILDENAFIL CITRATE (VIAGRA TM) AND TADALAFIL (CIALIS TM) ON SEXUAL RESPONSES IN SAUDI MEN WITH ERECTILE DYSFUNCTION IN ROUTINE CLINICAL PRACTICE. Pak. J. Pharm. Sci. 2008 Jul 1;21(3):275-81. Attainable at: http://www.pjps.pk/wp-content/_uploads/pdfs/CD-PJPS-21-3-08/Paper-12.pdf
- Drugs.com: Tadalafil. Attainable at: https://www.drugs.com/comments/tadalafil/
- Medicine net: Tadalafil. Attainable at: http://www.medicinenet.com/tadalafil/article.htm
- Tadalafil Reviews. Attainable at: http://www.tadacipgroup.com/reviews