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philzyz
New Member


Date Joined Dec 2009
Total Posts : 1
   Posted 12/25/2009 12:50 AM (GMT -6)   
I want to try takin a daily dose- 2.5 mg- of cialis.  The pills are available in my health plan only in 20 mg size.  They seem to have some coating.  Can I break this into quarters?

bcc
Regular Member


Date Joined Oct 2009
Total Posts : 46
   Posted 12/25/2009 1:07 AM (GMT -6)   
hi i have never heard of this what is it for barry
PSA Aug 07 was 3, Mid 08, 3.5, mid 09, 7.27

First biopsy july 09 - t2a on left . 11 samples taken from 6 blocks. 4 blocks show positive for adenocarcinoma. 1 block 10%, 3 blocks 5%, overall gleason 3 plus 4. No perineural invasion seen. Seminal vesicles clear.

End Oct 2009, bone scan all clear, MRI shows 6mm lesion on bottom left and rest of gland diffused image. Late Nov 2009, a template biopsy of 32 from 20 sites adenocarcinoma, gleason 3 plus 4 at 10 sites; unfortunately spread over both left and right.


Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 12/25/2009 4:03 AM (GMT -6)   
It's certainly common to cut these pills in half, and they cut quite easily. Quarters should also be doable, but I haven't tried that. Pill cutters are available from pharmacists, or you can improvise something.

Barry: Cialis is a common ED drug along with Viagra and Levitra. It is said that they give you erections, but that may be a myth turn A low dose like 5mg will not give an erection, but is supposed to enhance blood flow to the area and so aid recovery. However opinions are divided as to how effective it really it.
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?)
19-month: 0.09 (maybe)
ED:
After a learning curve, Bimix injections (0.2ml) worked well. From 14 months, occasional nocturnal erections. Have "graduated" to just the pump.


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 12/25/2009 6:11 PM (GMT -6)   
If you are looking for data points, 5 mg daily did not do me any good. I did not notice a thing. Bumpoed it up to 20 and still nothing. Oh well...
Jeff
DX Age 56. First routine PSA test on April 8th: 17.8. Start 2 weeks of Cipro to rule out protatitis.
May PSA: 22.6, 3 weeks later: PSA: 23.2.
Biopsy 6/10/09: 7/12 scores positive, Gleason 6=3+3. Bone scan and C/T scan negative.
RP DaVinci -7/21/2009 @ Univ of Roch Medical Center
Left nerve gone, right partial spared.
Catheter removed - 7/31/2009 Pathology report received:
Gleason 3+4=7, Tumor size: 2.5 x 1.8 cm, location: both lobes and apex.
Extraprostatic extension present; Perineural invasion: present, extensive.
No Malignancy in Seminal Vesicle, vasa deferentia, lymph nodes 0/13
Prostate mass 56 grams. Pathologic Stage: pT3aN0MX
Post Surgery Status:
Potency - 12/11 5 months, Still no activity, zip. Using pump daily since 11/11. No effect with 20 mg of Cialis or 100 mg of Viagra. Shots next?
Incontinence - 8/20 4 full pads per day
.. 9/7 3-4 full pads per day (I'm going to try cutting down on fluids. Bad idea. I know.)
. 9/27 2 months: Still 3 pads per day.
11/14 4 months: Still 3 pads per day. 420ml/day, 91 um leak.
12/11 5 months: Still 3 pads per day. 400-450ml/day Experimenting with Nyquil for 10 days: Can sleep through the night but withdrawal is bad. Stopped 12/20.
Post Surgery PSA - 9/3 6 weeks - 0.05; 10/13 3 months - 0.04 undetectable.


Mavica
Regular Member


Date Joined Jun 2008
Total Posts : 407
   Posted 12/25/2009 11:14 PM (GMT -6)   
I wouldn't self-treat. Rather, I'd sit down with my urologist to develop a plan.

Age:  60 (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; 9/09: 0.0

 


mgl
Regular Member


Date Joined Feb 2007
Total Posts : 122
   Posted 12/26/2009 8:52 AM (GMT -6)   
You can buy a pill splitter for a few dollars and it works well to cut them in quarters
50 years old
gleason 3+4=7 psa5.8 clinical stageT3a
Da vinci surgery April10 2007 Mayo clinic Rochester, Mn.
extraprostatic extension Gleason -same
pelvic lymph nodes -negative
Catheter out April 19
psa aug 2007 0.28
37 treatments IMRT ended 10/26/07
psa Jan 29 2008 0.10
psa april 30 0.14
psa aug 21, 0.16
psa dec 17 o8 , 0.16
psa apr 09, 0.21
psa aug 09, 0.26


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 12/26/2009 10:58 AM (GMT -6)   
Philz,

If CIalis 20 is available, perhaps daily is available with your health plan but, not on the list? Make a call to find out about any up coming / changes. Couldn't hurt. Ours has had a couple of changes that didn't hit the annual list...maybe yours too :>)

PS: Daily Cialis isn't a bad way to go really. Quite a few post prostatectomy men have mentioned, the low daily dose makes an on demand, short acting ( viagra or levitra) dose work more effectively.
 Hilarem datorum diligit Deus


Jstars
Regular Member


Date Joined Oct 2005
Total Posts : 489
   Posted 12/26/2009 7:51 PM (GMT -6)   
Philz,

If your plan only covers 20mg size, consider yourself lucky! Godless BeanCounting Medco only specifies in 5mg x 15 for me. So if you get more than 4 x 20mg a month consider yourself lucky again.

But getting more out of an insurance company could a mixed blessing. For instance, in my case they charge (to me) about $1 per 5mg. If i somehow were to get enough for, say 20mg every other day the cost would probably go up by 4 times.

But, no worries mate. Just look into off-shoring some from a place like All Day Chemist. about a dollar each for full dose 'generics'. (and use your local coverage as a supplemental (but meager) addition to the main stash

(also like Worried, even 20mg does nothing for me yet .. can't say for 'blood flow' -- since i have not shriveled up to nothing I guess it is helping there!)
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 11/2009).
04/01/09, 07/07/09, 10/01/09 PSA <0.1 - Stone Was Oxalate stone -- X-ray no stones.
08/09 - started MUSE@1000mcg ... pump&plump - success(80-90%) (alpro ache).
09/09 @500mcg +pump&plump + 2 advil - success(80-90%) - (less Alpro ache).
10/09 TrimixGel (500/300/100mcg): 1st:60%, 2nd:(pump&plump) 60%, 3rd(added 500mcg muse):70-80% -- (no Alpro aches!) but none @ useful hardness!

Post Edited (JimStars) : 12/26/2009 6:55:13 PM (GMT-7)


MrGimpy
Veteran Member


Date Joined Jul 2009
Total Posts : 504
   Posted 12/27/2009 7:21 PM (GMT -6)   
perhaps the 2.5mg would be ok for a person just experiencing limited ED without having a prostate removed

My Dr told me to not bother with anything less than the 20mg dose, that a full dose would be required to jump start an erection after prostate removal. But even a 20 did not work ( so far)

Cutting a 20mg in half by hand is simple, getting it into 4's may be a bit harder , the pill is tear drop shaped and would be difficult to gauge accurately the dosage
Stats:
Age: 52
PSA (2008)=1.9
Biopsy on Jan 09, 2009
One (1) out of twelve (12) cores was positive, plus external nodule found
Gleason Score = 3+3
Surgery (Da Vinci, robotic prostatectomy): 4/7/09
Removed Catheter: 04/19/09
100% bladder control - Pad free 7/09
PSA 7/09 undetectable, under .0


mikey1955
Veteran Member


Date Joined Dec 2008
Total Posts : 672
   Posted 12/27/2009 7:32 PM (GMT -6)   

Hi Phil,

Welcome.

Do you have prostate cancer and have you had treatment or looking at treatment? Can you post your details?

Cialis, Levitra and Viagra didn't do much for me except for a headache and stuffy nose. Trimix  looks like it will for me.

I did try cutting pills in the past. Not too bad with the pill cutter...except pill shape can make it harder as already mentioned (cutting the pill, that is).


-Nov/Dec 07, March 08 and Dec 08: Severe perineum pain . Septra/Bactrim for 8 months for diagnosed prostatitis.
-PSA start of 2008: 5.3..... PSA June of 2008: 7.3
-14 DRE all benign or nothing felt
-TRUS Biopsy Nov 08: 5 of 8 cores positive GS 3+3 or 6. 30-65%. Perineural invasion.
-General Health: pretty good, 5' 10", 180 lbs, slim.
-Open RP surgery: May 09 both nerve bundles spared. Bilateral lymph node dissection performed. Discharged 48 hours after surgery.
-Post Surgery Pathology: pT3a N0 MX, extraprostatic extension (EPE), stage III prostate cancer, lymph nodes clear, seminal vesicles clear, Gleason upraded to 3+4 GS 7. EPE within surgical margins. Other than prostate and EPE, all tissue removed negative for cancer involvement.
-Bladder control within 48 hours of catheter removal
-ED ongoing but improving significantly with Trimix at 7 months post-op. Oral ED meds didn't do much.


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 12/28/2009 10:50 AM (GMT -6)   
Oral meds aren't reliable in the first 9-12 months postoperatively. Taking them daily isn't about the erection but rather, the cellular action :>)
 Hilarem datorum diligit Deus


MrGimpy
Veteran Member


Date Joined Jul 2009
Total Posts : 504
   Posted 12/28/2009 12:31 PM (GMT -6)   
I heard quite the opposite, oral meds taken at bedtime promote nocturnal erections which help to restore normal sized erections is extremely important post op until erections sufficient to have intercourse are regained.

Penis atrophy is a major issue that can be avoided by getting nocturnal erections asap after surgery.

Injections, VED or other means can be substituted, the key thing is to get a fully erect penis however you can as often as you can, even if intercourse is not involved in order to restore full function later
Stats:
Age: 52
PSA (2008)=1.9
Biopsy on Jan 09, 2009
One (1) out of twelve (12) cores was positive, plus external nodule found
Gleason Score = 3+3
Surgery (Da Vinci, robotic prostatectomy): 4/7/09
Removed Catheter: 04/19/09
100% bladder control - Pad free 7/09
PSA 7/09 undetectable, under .0


Bob D
Regular Member


Date Joined Mar 2008
Total Posts : 199
   Posted 12/29/2009 12:04 AM (GMT -6)   
I have found Cialis to be very effective, please see my history below. They cut well most of the time.
I score mine with a razor blade before cutting. I have not tried cutting the 5mg only the 20mg. Sometimes
they will crumble some. I agree, start with ED meds asap and get it up and running again. yeah
    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". 11/10/09: Full naturals without meds. I will sometimes take 5mg of Cialis if my wife and I have a big weekend or evening planned, but spontanous erections are fine even without.
    1.  


      hb2006
      Regular Member


      Date Joined Nov 2008
      Total Posts : 299
         Posted 12/30/2009 10:50 AM (GMT -6)   
      Cialis used to work fine for me prior to the RRP. My PCP always prescribed the largest dosage because I was on Medco and got only 5 pills a month. Anyway, I would cut them into thirds and every third would last for 24 hours. But you always need that "sexual stimulation" aspect.
       
      I continued using it after the RRP but with not much luck, so my urologist switched me to Levitra. It works like Cialis did before and I use both pills from CVS and from India via ADC.  I can't tell any difference between the pills.
       
      Btw, I have two pill cutters 
      Age 60, PSA 2007 4.1, PSA 2008 10.0
      Diagnosed April 2008, Biopsy: 6 of 12 cores positive, Gleason 4 + 5 = 9
      CT and Bone Scan negative, Open surgery at Shawnee Mission Medical Center May 21, 2008
      Right side nerves spared, Radical prostatectomy and lymph node dissection
      Cather removed on June 3rd, totally dry on July 9th, pT2c, lymph nodes negative
      PSA Sept 28, 2008 0.00, PSA Jan 22, 2009 0.00, PSA June 29, 2009 0.00
      ED Status- Currently using Trimix, Levitra daily for increased blood flow.
      Noctural Erections have completely returned on a nightly basis, same hardness as before.


      Skip53
      New Member


      Date Joined Dec 2009
      Total Posts : 1
         Posted 12/31/2009 4:12 PM (GMT -6)   
      First post here and it seems like a great place to compare notes. After reading other experiences about ED after DaVinci, I requested that my surgeon put me on Cialis as a rehabilitative measure about 3 weeks ago. He prescribed six 20mg pills that I split and take one (10 mg) every three days. At this point I'm only six weeks past my surgery date, but do feel like life will eventually be restored to that part of my anatomy. I feel a bit more of a resurgence on that third day but still have the dreaded ED to contend with that was not an issue at all previously. Trying to be patient here and I'm really counting my blessings that 1) the cancer did not spread and my prostate is no longer 2) the recovery hasn't been too bad and 3) my incontinence is not an issue unless I sneeze or watch the Daily Show (insert smiley face here). Happy New Year to all!
      Stats:
      Age: 56 as of 1/2010
      PSA went from 2.9 to 3.6 in 2008 - 2009
      Biopsy on 9/11/09
      Two out of twelve cores positive with one suspicious
      Gleason Score = 4+3
      Surgery (Da Vinci, robotic prostatectomy): 11/19/09
      Removed Catheter: 11/30/09
      100% bladder control - Pad free 12/17/09

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