Cost of different doses of Cialis

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Bob D
Regular Member


Date Joined Mar 2008
Total Posts : 199
   Posted 8/1/2009 11:44 PM (GMT -6)   
Is the cost of Cialis comparable as to the dose. In other words is a 10mg dose one half the
cost of a 20mg and is a 5mg one half the cost of 10mg?

Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 8/2/2009 3:06 AM (GMT -6)   
No. Where I am, the cost of the 10 and 20 is about the same per pill -- at least that is what my doc told me. So he advises the larger pills, cutting them for smaller doses.

I haven't taken any yet, and at this stage, have only 2x20mg samples, which I am saving for the right "moment" -- where 1 moment = 36 hours :-)
Pre-op:
Age 63 at diagnosis, now 64.
No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4 of 12 cores.
Operation:
Non-nerve sparing RRP on 7 March 2008.
Two nights in hospital; catheter out after 7 days.
Post-op:
Continent; no pads needed from the get-go.
Pathology showed organ confined and negative margins. Gleason downgraded to 4+4=8.
PSAs:
6-week : <0.05
7-month: <0.05
13-month: 0.07 (start of a trend?)
ED:
After a learning curve, Bimix injections (0.2ml) are working well. VED also works but we find it inferior to Bimix.
14 months: Occasional nocturnal erections.


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 8/2/2009 4:52 AM (GMT -6)   
I left the Uro on Friday with a packet of seven 5mg tabs to be taken every other day supposedly to get blood flowing. I'm scared to death they will work. (Between that fear, the constant leaking, and that oh-by-the-way-I-have-no-prostate thing I'm pretty sure I won't have to worry.)
Since insurance will pay for a 30 day supply, why don't doctors always prescribe the 20mg? Aren't we smart enough to split them ourselves? I figure the cost to make 5, 10, 20mg has to be virtually identical.
Age 56. Perfectly healthy with no problems until getting the results of my first routine PSA test on April 8th: 17.8. My GP does not believe in general PSA screening so I did not get results during my 50 year physical.
May PSA: 22.6, 3 weeks later: 23.2.
June 10 Biopsy 7 out of 12 cores positive, Gleason 6=3+3.
Bone scan and C/T scan negative.
Radical prostatectomy by Da Vinci on 7/21/2009.
Left nerve gone, right spared.
----------------------------
7/31/2009: Catheter removed and Pathology report received
Gleason 3+4=7 Tumor size: 2.5 x 1.8 cm location: both lobes and apex.
No Malignancy in Seminal Vesicle, vasa deferentia, lymph nodes 0/13
Prostate mass 56 grams. Pathologic Stage: pT3aN0MX


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 8/2/2009 11:02 AM (GMT -6)   
I don't know if it is the way that drug companies price things or the way that insurance pays but it seems to me that there are lots of meds for which that price per pill is the same at different strengths.

I wonder if there are ethical issues for a doctor to prescribe high dose pills and then tell you to cut them up.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan, Bone scan 1/09 both negative.

Robotic surgery 03/03/09 Catheter Out 03/08/09
Pathology: Lymph nodes & Seminal vesicles negative
Margins positive, Capsular penetration extensive Gleason 4+3=7
6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
10 weeks: no pad at night -- slight leakage day/1 pad.
3 mo. PSA 0.0 - now light pads


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 8/2/2009 2:49 PM (GMT -6)   
When it comes to Cialais and Viagra, you'll find most insurance companies consider a 30 supply to be 3 or 4 pills. Size doesn't make any difference in most pharmacies.

Thats why most guys are heading to India's ADC, where you cab get 120 100 mg Viagara fir less than $100 inckuding shipping.

I think it is ethical to prescribe larger doses to be splut if desired. Many pain meds say take 1 or 2 every 6 hours or something like that. What's the diff ?
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks due to anatomical issues with location of ureters with respect to bladder neck.  Try 3 tubes where no tubes are supposed to be for 2 weeks !
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)


CPA
Veteran Member


Date Joined Feb 2008
Total Posts : 655
   Posted 8/2/2009 6:20 PM (GMT -6)   
Greetings, everyone.  Count me as one of the guys who gets his meds from ADC in India.  The Cialis version looks just like the name brand here and only comes in 20mg strength.  Cost is about .75 per pill as I remember. One other thing to note about Cialis is that the patent is still valid so ADC can not ship to the USA for consumption in the USA.  They will send you an email and ask you to confirm that it is for use outside the USA. I order both Levitra and Cialis and use the Levitra in the USA and the Cialis when I travel overseas (just got back from a 17 day overseas trip).  David

Diagnosed Dec 2007 during annual routine physical at age 55
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 pos; 2 marginal
Gleason 3+3; upgraded to 4+3 post surgery
RRP 4 Feb 08; both nerves spared
Good pathology - no margins - all encapsulated
Catheter out Feb 13 - pad free Feb 16
PSA every 90 days - ZERO's everytime!
Great wife and family who take very good care of me


Jstars
Regular Member


Date Joined Oct 2005
Total Posts : 489
   Posted 8/2/2009 9:58 PM (GMT -6)   
I too have gotten nearly all my ED drugs from ADC. However, whenever I go to the Uro I always humor them by accepting their prescriptions for Cialis. Here is the frustrating part. She keeps writing the prescription for 30 x 5 mg and CVS filled it for only 5 tablets. My uro PA said I should have mailed it in to Medco instead since they have a contract with them to fill the scripts as written. HAH I say. I had the next 30 x 5mg dutifully mailed in and just got it back this weekend. And what did they send?? 15 x 5 mg instead of 30 ... AND to add insult to injury put a refill date of 09/03/2009. And to torment even more, instructions are to Take 1 Tablet Daily.

Obviously their drug management people have a great sense of humor and love to joke around.

I sure would be pissed with all this if I was not fully secure with my nearly unlimted ADC stash for all my daily needs. I can badmouth Medco when I got to see my Uro on Friday -- and hey maybe MUSE will work better. (but at $10 each).

Anyone else have Fun With Medco on ED drugs -- they are truly the Evil Satan of the insurance industry.
Age 58, 195lbs, 6'4", 57 at DX, PSA Aug2008 7 4 ... June2007 4.7 (BPH + LUTS)
Biopsy Nov2008 1 of 12 cores 5%, Gleason 3+3 - Sona showed size 140+ cc (110 grams post op).
02/03/09 open RRP surgery , Nerve sparing both sides, 1 day in hospital, Day 4 first BM,
Pathology Report: All margins clear - No Invasive spread - no change in Gleason score.
02/18/09 Cath out, passed a 1cm oblong STONE within hours.
03/06/09 Started Levitra@20mg / Viagra@100mg / (04/01) Cialis@20mg -- no real effect (thru 07/2009).
04/01/09, 07/07/09 PSA <0.1 - Stone Was Oxalate stone -- X-ray showed no additional stones.
Next up (so to speak) -- MUSE(1000mg) -- on 08/07/09.


Mavica
Regular Member


Date Joined Jun 2008
Total Posts : 407
   Posted 8/3/2009 10:35 AM (GMT -6)   
Piano said...
I haven't taken any yet . . .
 
Worried Guy said...
Since insurance will pay for a 30 day supply, why don't doctors always prescribe the 20mg?
Plano's comments surprised me, because everything I've read on the topic says that Surgeon's/Urologists, almost unanimously, strongly recommend taking Cialis (or Viagra, or other similar meds) starting soon after surgery to aid in the blood flow to/through the penis for healing and ED issues.
 
Worried Guy's comments reminded me that muy Blue Cross/Blue Shield (Illinois) policy pays only for 8 Cialis (or Viagra) pills monthly and that I pay full-price for the amount of pills above that.  I don't think any of the insurance companies, nor the VA, pays for an unlimited supply.

Age:  59 (58 at diagnosis - June, 2008)

April '08 PSA 4.8 ("free PSA" 7.9), up from 3.5 year prior

June '08 had biopsy, 2 days later told results positive but in less than 1% of sample

Gleason's 3+3=6

Developed sepsis 2 days post-biopsy, seriously ill in hospital for 3 days

Dr. recommended robotic removal using da Vinci

Surgery 9/10/08

Northwestern Memorial Hospital, Chicago, IL

Dr. Robert Nadler, Urologist/Surgeon

Post-op Gleason's:  3+3, Tertiary 4

Margins:  Free

Bladder & Urethral:  Free

Seminal vesicles:  Not involved

Lymphatic/Vascular Invasion:  Not involved

Tumor:  T2c; Location:  Bilateral; Volume:  20%

Catheter:  Removed 12-days after surgery

Incontinent:  Yes (1/2 light pads per day)

Combination of Cialis and MUSE (alprostadil) three times weekly started 9-27-08

Returned to work 9-29-08 (18-19 days post-op)

PSA test result, post-op, 10/08: 0.0; 12/08: 0.0; 4/09: 0.0

 


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 8/3/2009 12:01 PM (GMT -6)   
I think the stance of most of the major insurance companies is that ED drugs are recreational drugs and you should be grateful that they let you have any fun at all.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan, Bone scan 1/09 both negative.

Robotic surgery 03/03/09 Catheter Out 03/08/09
Pathology: Lymph nodes & Seminal vesicles negative
Margins positive, Capsular penetration extensive Gleason 4+3=7
6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
10 weeks: no pad at night -- slight leakage day/1 pad.
3 mo. PSA 0.0 - now light pads


Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 8/3/2009 8:18 PM (GMT -6)   
Mavica said...
Piano said...

I haven't taken any yet . . .
Plano's comments surprised me, because everything I've read on the topic says that Surgeon's/Urologists, almost unanimously, strongly recommend taking Cialis (or Viagra, or other similar meds) starting soon after surgery to aid in the blood flow to/through the penis for healing and ED issues.

The situation is different for the non-nerve-spared. There the consensus seems to be that oral ED meds have no benefit. However, in my case now with some evidence of nerve function returning, I'm willing to give the ED meds a try -- especially if I can score some freebies! I haven't rushed to try mine yet as I'm not expecting a miracle, and the other options (injections and pump) work well enough.
Pre-op:
Age 63 at diagnosis, now 64.
No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4 of 12 cores.
Operation:
Non-nerve sparing RRP on 7 March 2008.
Two nights in hospital; catheter out after 7 days.
Post-op:
Continent; no pads needed from the get-go.
Pathology showed organ confined and negative margins. Gleason downgraded to 4+4=8.
PSAs:
6-week : <0.05
7-month: <0.05
13-month: 0.07 (start of a trend?)
ED:
After a learning curve, Bimix injections (0.2ml) are working well. VED also works but we find it inferior to Bimix.
14 months: Occasional nocturnal erections.


Bob D
Regular Member


Date Joined Mar 2008
Total Posts : 199
   Posted 8/4/2009 10:45 PM (GMT -6)   
Thanks all. I have to pay 100% for ED meds. I will ask the doc for 20mg and cut them in quarters. 5mg works great for me but cutting them is a pain.
    1. Age 59, psa 4.7 in Jan. 08. Biopsy: one positive sample out of 13. 1% of one sample cancer. Prostate removed on 3/5/08. Open Surgery. Northeast Georgia Medical Center, Gainesville Ga. Nerves spared. Cath out 12 days later. Continence good. No pads needed since 6/10/08. First PSA: Less than 0.1 on 6/17/08. First erection five days post op and have been improving well since then. Full erection now possible (less than four months post op) with the assistance of Cialis.  Post Op Biopsy : No malignant cells in lymph node. Gleason 3=4=7. Tumor on both lobes. Urethral margins/apex free of neoplasia. Right and left seminal vesicles free of neoplasia. No invasion of prostatic capsule of the resection margins are noted by the tumor. Tumor occupies 10 to15% of the prostate gland. Path staging T2c, NO, MX- Group staging II.  Focal areas of perineural invasion by tumor are noted. 80% natural erections and full erections with 10mg Cialis. 9/22/08-Took 10mg Cialis on Monday night, had very usable full hard erection at night, the next morning, and the following Thursday morning, 60 hours after original dose !! Orgasm quality Excellent.!!!!! I am pleased with the progress so far. Married to same wonderful woman for 39 years. She is still beautiful and sexy as ever. A great help in my recovery !!: 3/12/09: Full natural erections with penetration. 10mg Cialis makes them easier to maintain but I have had several med free full erections lately, Yipieeee !!!!!!!  3/24/09: One year PSA <0.1.  3/28 & 3/29: had sex with full naturals with no meds. Erections are gained and maintained with very little manipulation. Getting more like pre op every day. 5/30/09, I take only 5mg Cialis every 2 or 3 days. This greatly assists my full naturals and provides great staying power and no manipulation required and allows sex anytime !! Lenght and girth are back to pre op size due to regular "workouts".
    1.  


      Jstars
      Regular Member


      Date Joined Oct 2005
      Total Posts : 489
         Posted 8/6/2009 7:53 AM (GMT -6)   
      Bob,

      If you really have to pay for them yourself, in the short-term, while waiting for your ADC supply, you should just beg a bunch from your Uro (and any other Doc you can tag for free samples). Guys who don't have money to spare even for ADC will hit up each Doc they have for some (they all have tons of samples).

      Also I commented before on the fact that, in the early months after surgery, if nothing happens with any dose you try at first then that is probably the way it is going to be for quite a while (you're not the lucky 5%) and it will keep not happening for months.

      So that is probably another reason why Uro's recommend the 5 mg Cialis per day -- it would stretch the supply out longer -- whether it be samples -- or stingy insurance allocations).

      As for me I just keep blasting away with a full dose of C, V or L every day -- my own form of Watchful Waiting ;-)
      Age 58, 195lbs, 6'4", 57 at DX, PSA Aug2008 7 4 ... June2007 4.7 (BPH + LUTS)
      Biopsy Nov2008 1 of 12 cores 5%, Gleason 3+3 - Sona showed size 140+ cc (110 grams post op).
      02/03/09 open RRP surgery , Nerve sparing both sides, 1 day in hospital, Day 4 first BM,
      Pathology Report: All margins clear - No Invasive spread - no change in Gleason score.
      02/18/09 Cath out, passed a 1cm oblong STONE within hours.
      03/06/09 Started Levitra@20mg / Viagra@100mg / (04/01) Cialis@20mg -- no real effect (thru 07/2009).
      04/01/09, 07/07/09 PSA <0.1 - Stone Was Oxalate stone -- X-ray showed no additional stones.
      Next up (so to speak) -- MUSE(1000mg) -- on 08/07/09.

      Post Edited (JimStars) : 8/6/2009 11:22:52 AM (GMT-6)


      Cajun Jeff
      Veteran Member


      Date Joined Mar 2009
      Total Posts : 4106
         Posted 8/6/2009 9:05 AM (GMT -6)   
      I just got my e-mail from ADC confirming my order. My Dr. is stingy with the pills.
      Jeff T Age 57
      9/08 PSA 5.4, referred to Urologist
      9/08 Biopsy: GS 3/4=7
      10/08 Nerve sparing open RRP- Path Report: GS 3+3=7 Stg. pT2c, margins clear
      3 mts: PSA .05 undetectable
       10th month  PSA <0.01
      ED- 5 mg Cialis daily, pump daily, going to try MUSE next


      offpsa
      New Member


      Date Joined Jun 2009
      Total Posts : 15
         Posted 8/7/2009 8:20 AM (GMT -6)   
      Any of you gentlemen want to give me the link to ADC India? I've googled it but I come up with several options.

      Thanks!

      James C.
      Veteran Member


      Date Joined Aug 2007
      Total Posts : 4462
         Posted 8/7/2009 3:14 PM (GMT -6)   
      www.alldaychemist.com. The 3 generics are Sildenafil citrate (Viagra), Vardenafil (Levetra) and Tadalafil (Cialis)
      James C. Age 62
      Co-Moderator- Prostate Cancer Forum
      4/07 PSA 7.6, referred to Urologist, recheck 6.7
      7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
      9/07 Nerve sparing open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
      22 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix 30/1/20-.10ml 2X week continues
      PSA's: .04 each test since surgery

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