Ceebis 20 Mg Tablets

Description

What are Ceebis 20 Mg Tablets?

Ceebis 20 Mg Tablets are oral tablets manufactured by Cooper Pharma, an established Indian pharmaceutical company. Each tablet contains 20 mg of Tadalafil as the active ingredient — a phosphodiesterase type 5 (PDE5) inhibitor used in the management of erectile dysfunction (ED) in adult men, as well as in the treatment of pulmonary arterial hypertension (PAH).

Tadalafil at the 20 mg strength is the standard on-demand dose for erectile dysfunction. It is taken before anticipated sexual activity and provides a significantly longer window of effectiveness — up to 36 hours — compared to other PDE5 inhibitors. This extended duration has earned tadalafil the informal description of “the weekend pill” among patients. Ceebis 20 Mg allows men experiencing ED to plan sexual activity more naturally without the time pressure associated with shorter-acting medications. Each pack contains 10 tablets (1 strip).

Ceebis 20 Mg is a prescription-only medicine. It must be prescribed by a qualified physician following a clinical assessment of suitability, including cardiovascular status and any concurrent medications that may interact with tadalafil.

Composition and Product Details

Brand Name	Ceebis 20
Generic Name	Tadalafil
Strength	20 mg per tablet
Dosage Form	Oral tablet
Pack Size	10 tablets (1 strip)
Manufacturer	Cooper Pharma, India
Therapeutic Class	PDE5 Inhibitor / Erectile Dysfunction / Men’s Health
Prescription Required	Yes

About Cooper Pharma and the Ceebis Brand

Cooper Pharma is an Indian pharmaceutical company engaged in the manufacture and distribution of generic medicines across multiple therapeutic areas including men’s health, cardiology, and general medicine. Operating under WHO-GMP guidelines, Cooper Pharma supplies affordable generic medicines to domestic and international markets.

The Ceebis brand represents Cooper Pharma’s tadalafil product range, offering a clinically equivalent alternative to the originator brand at a significantly lower cost. As a generic product, Ceebis 20 Mg contains the same active ingredient (tadalafil) at the same dose as the innovator product and must demonstrate pharmaceutical equivalence under regulatory standards.

Understanding Erectile Dysfunction

Erectile dysfunction (ED) is the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual activity. It is a common medical condition affecting men across all age groups, with prevalence increasing with age — studies indicate that approximately 40% of men in their 40s experience some degree of ED, rising to over 50% by their 60s.

ED can have physical and psychological causes, and often both contribute simultaneously:

• Vascular causes: Reduced blood flow to the penis due to atherosclerosis, hypertension, or diabetes is the most common underlying physical mechanism. The same vascular risk factors that contribute to cardiovascular disease also impair penile blood flow.
• Neurological causes: Damage to the nerves supplying the penis (from diabetes, multiple sclerosis, spinal cord injury, or pelvic surgery) can impair the signals required for an erection.
• Hormonal causes: Low testosterone or thyroid dysfunction may contribute.
• Psychological causes: Anxiety, depression, relationship problems, and stress can all contribute to or compound ED — even when there is no underlying physical cause.

Erectile dysfunction can significantly impact quality of life, self-confidence, and intimate relationships. Treatment with PDE5 inhibitors such as tadalafil is effective for most men with ED and is associated with high patient satisfaction.

How Tadalafil (Ceebis 20 Mg) Works

Tadalafil works by selectively inhibiting phosphodiesterase type 5 (PDE5) — an enzyme found in high concentrations in the smooth muscle of the corpus cavernosum (the erectile tissue of the penis) and in vascular smooth muscle, including the pulmonary vasculature.

The mechanism of erection involves the following pathway:

1. Sexual stimulation activates parasympathetic nerve fibres that release nitric oxide (NO) into the smooth muscle of the corpus cavernosum.
2. Nitric oxide activates soluble guanylate cyclase, which converts GTP into cyclic guanosine monophosphate (cGMP).
3. cGMP causes smooth muscle relaxation in the corpus cavernosum and the helicine arteries, allowing blood to flow into the erectile tissue and producing an erection.
4. Normally, PDE5 breaks down cGMP, limiting the duration and quality of the erection.
5. Tadalafil inhibits PDE5 — preventing cGMP breakdown, prolonging smooth muscle relaxation, and sustaining the increased blood flow that supports the erection.

Importantly, tadalafil does not independently cause erections — it only enhances the natural erectile response to sexual stimulation. Without sexual arousal, the cascade of NO release is not initiated and tadalafil has no erectile effect.

Why tadalafil lasts longer than other PDE5 inhibitors: Tadalafil has a plasma half-life of approximately 17.5 hours, compared to 3–5 hours for sildenafil and vardenafil. This extended half-life means that a single 20 mg dose maintains therapeutic PDE5 inhibition for up to 36 hours — allowing multiple attempts at sexual activity within this window without requiring a second dose.

Indications and Uses

Ceebis 20 Mg Tablets are indicated for:

• Erectile dysfunction (ED) in adult men: The primary indication. Treatment of the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. Used as on-demand therapy — taken as needed before sexual activity.
• Pulmonary arterial hypertension (PAH): Tadalafil at 40 mg once daily (Adcirca brand internationally) is approved for improving exercise capacity in PAH. The 20 mg tablets are sometimes prescribed for PAH under specialist supervision; patients should follow their prescriber’s specific instructions.

Note: Tadalafil 5 mg once daily (not this product) is also prescribed for daily ED management and for benign prostatic hyperplasia (BPH) or combined ED/BPH. Ceebis 20 Mg is specifically formulated and indicated for the on-demand 20 mg dosing regimen.

Dosage and Administration

Dosing must be prescribed and directed by a qualified physician. Individual dose requirements may vary based on response, tolerability, and concurrent medical conditions.

Erectile Dysfunction — On-Demand Use (20 mg)

• Standard dose: One tablet (20 mg) taken orally as needed, at least 30 minutes before anticipated sexual activity. Up to 36 hours may elapse between taking the tablet and attempting intercourse within the window of effect — giving considerably more flexibility than shorter-acting PDE5 inhibitors.
• Frequency: Maximum one dose per 24-hour period. Tadalafil 20 mg should not be taken more often than once daily.
• Food and alcohol: Ceebis 20 Mg may be taken with or without food — unlike sildenafil, a high-fat meal does not meaningfully affect tadalafil absorption. However, excessive alcohol consumption (more than 5 units) should be avoided as alcohol can independently impair erectile function and compound the blood-pressure-lowering effects of tadalafil.
• Swallowing: Tablets should be swallowed whole with water. Do not crush or chew.

Dose Adjustment

• If the 20 mg dose produces inadequate response and is well tolerated, consult your physician — some patients may benefit from dose optimisation rather than moving to a different agent.
• If side effects are troublesome, your physician may consider a lower dose (10 mg).

Special Populations

Elderly (≥65 years)

No dose adjustment is required for elderly patients based on age alone. However, older patients frequently have cardiovascular conditions or take medications (particularly nitrates or alpha-blockers) that may affect tadalafil safety. A thorough clinical assessment is essential before prescribing in this age group.

Renal Impairment

Tadalafil clearance is reduced in renal impairment. In mild to moderate renal impairment (creatinine clearance 31–80 mL/min), no specific dose adjustment is required, but increased exposure means greater potential for side effects. In severe renal impairment (creatinine clearance <30 mL/min), the maximum recommended dose is 10 mg; tadalafil should be used with caution and not more than once every 48 hours. Dialysis does not significantly clear tadalafil.

Hepatic Impairment

In mild to moderate hepatic impairment (Child-Pugh class A or B), the dose should not exceed 10 mg. Tadalafil is not recommended in severe hepatic impairment (Child-Pugh class C) due to insufficient safety data.

Paediatric and Adolescent Use

Tadalafil is not indicated for use in individuals under 18 years of age.

Women

Ceebis 20 Mg is indicated for adult men only and is not intended for use by women or children. Tadalafil is separately studied for PAH treatment in women, but under different clinical guidance.

Precautions and Warnings

• Cardiovascular status — essential pre-treatment assessment: Sexual activity itself carries cardiac risk. Before prescribing tadalafil, physicians assess cardiovascular fitness for sexual activity. Tadalafil should not be prescribed if the patient is not fit for sexual activity due to cardiovascular disease. Men with active or unstable angina, a recent heart attack (within 90 days), a recent stroke (within 6 months), uncontrolled arrhythmias, or uncontrolled hypertension should not take tadalafil without cardiological clearance.
• Nitrates — absolute contraindication: The combination of tadalafil and any nitrate preparation (including glyceryl trinitrate tablets, sprays or patches, isosorbide mononitrate or dinitrate, and nitric oxide donors such as amyl nitrite/”poppers”) causes a clinically significant and potentially life-threatening fall in blood pressure. This combination is absolutely contraindicated under all circumstances.
• Priapism: Tadalafil has been associated with priapism — a prolonged, painful erection lasting more than 4 hours, unrelated to sexual stimulation. This is a medical emergency requiring immediate treatment. Patients with sickle cell anaemia, multiple myeloma, leukaemia, or penile anatomical deformities (such as Peyronie’s disease) are at increased risk. Patients must seek emergency medical attention without delay if an erection persists beyond 4 hours.
• Visual and hearing disturbances: Rare post-marketing cases of non-arteritic anterior ischaemic optic neuropathy (NAION) — a sudden decrease or loss of vision — have been reported with PDE5 inhibitors. If sudden visual or hearing loss occurs after taking tadalafil, discontinue immediately and seek urgent medical assessment.
• Hypotension: Tadalafil has mild systemic vasodilatory effects. In patients with pre-existing hypotension, dehydration, or on antihypertensive medications, the blood-pressure-lowering effect can be amplified. This risk is significantly increased with concurrent alpha-blocker use.
• Underlying cause of ED: ED may be a symptom of an underlying condition requiring treatment (such as diabetes, hypertension, or cardiovascular disease). PDE5 inhibitors treat the symptom; the underlying cause should also be addressed.

Contraindications

• Concomitant use of nitrates (any form) or nitric oxide donors — absolute contraindication due to risk of severe hypotension
• Severe cardiovascular disease where sexual activity is inadvisable — including unstable angina, recent myocardial infarction (<90 days), recent stroke (<6 months), uncontrolled hypertension, uncontrolled arrhythmias, or heart failure with hypotension
• Severe hepatic impairment (Child-Pugh class C)
• Previous episode of NAION (non-arteritic anterior ischaemic optic neuropathy)
• Hereditary degenerative retinal disorders (including retinitis pigmentosa)
• Hypersensitivity to tadalafil or any excipient in the formulation
• Patients under 18 years of age
• Concurrent use of ritonavir at doses >200 mg twice daily

Possible Side Effects

Very Common (affecting more than 1 in 10 users)

• Headache

Common (affecting up to 1 in 10 users)

• Flushing (facial warmth and redness)
• Nasal congestion or stuffy nose
• Back pain
• Myalgia (muscle aches)
• Dyspepsia (indigestion)
• Limb pain

These are the most frequently reported side effects and are generally mild to moderate, and transient. They tend to be dose-related and typically resolve within a few hours.

Uncommon

• Dizziness
• Blurred vision
• Palpitations
• Hypotension
• Nausea
• Rash

Rare but Serious

• Priapism (persistent painful erection >4 hours) — seek emergency medical attention immediately
• Sudden decrease or loss of vision (NAION) — discontinue and seek urgent medical review
• Sudden hearing decrease or loss with or without tinnitus — discontinue and seek medical attention
• Severe hypotension (particularly if nitrates have been taken) — emergency services
• Hypersensitivity reactions including angioedema — seek immediate medical attention

Drug Interactions

• Nitrates and nitric oxide donors (glyceryl trinitrate, isosorbide mononitrate/dinitrate, amyl nitrite/”poppers”): Absolutely contraindicated. Combined use causes potentially fatal hypotension. Even if the last dose of tadalafil was taken more than 48 hours ago, this interaction may still be clinically significant; inform any physician or emergency medic that you have taken tadalafil.
• Alpha-blockers (tamsulosin, doxazosin, alfuzosin, terazosin, prazosin — used for BPH or hypertension): May cause significant additional blood-pressure reduction. If alpha-blockers are prescribed, tadalafil should be initiated at the lowest appropriate dose with clinical monitoring; the combination can cause symptomatic hypotension.
• Potent CYP3A4 inhibitors (ritonavir, ketoconazole, itraconazole, clarithromycin): Significantly increase tadalafil exposure. Concurrent use with ritonavir >200 mg twice daily is contraindicated; reduce dose and monitor carefully with other potent inhibitors.
• CYP3A4 inducers (rifampicin, phenytoin, carbamazepine, phenobarbital, St John’s Wort): May reduce tadalafil plasma levels and decrease efficacy. Discuss with your physician.
• Antihypertensive medications: Tadalafil may cause additional blood-pressure lowering; clinical monitoring is advised, particularly when initiating treatment.
• Alcohol: Substantial alcohol intake (more than 5 units) potentiates blood-pressure-lowering effects and may independently impair erectile function. Moderate alcohol consumption is generally acceptable.
• Grapefruit juice: Inhibits CYP3A4-mediated metabolism of tadalafil; should be avoided around the time of dosing.

Other Tadalafil Products on IndoGenMed

IndoGenMed stocks a range of tadalafil-based products across different brands and strengths. Your physician will advise on the most appropriate tadalafil product, dose, and dosing schedule based on your individual clinical needs. For patients using tadalafil primarily for erectile dysfunction with sexual activity less than twice weekly, on-demand dosing (such as Ceebis 20 Mg) is typically preferred; for patients requiring more frequent use, a daily low-dose tadalafil regimen may be more appropriate — speak with your prescribing physician to determine the right option.

Storage Instructions

• Store below 30°C in a cool, dry place away from direct sunlight and moisture
• Keep tablets in the original blister strip until required
• Store out of reach of children and pets
• Do not use after the printed expiry date
• Do not store in a bathroom or near a sink where humidity may be high

Frequently Asked Questions

Q: How long before sexual activity should I take Ceebis 20 Mg?

A: You should take Ceebis 20 Mg at least 30 minutes before anticipated sexual activity. Unlike sildenafil (which should be taken 30–60 minutes before intercourse on an empty or low-fat stomach), tadalafil’s onset of action may occur as soon as 30 minutes for some patients, and the effect lasts up to 36 hours. This means that once you have taken the tablet, you have a 36-hour window within which sexual activity — with appropriate arousal — may result in a satisfactory erection. You do not need to plan the timing as precisely as with shorter-acting PDE5 inhibitors.

Q: Can I take Ceebis 20 Mg every day?

A: Ceebis 20 Mg should not be taken more than once in a 24-hour period. Because tadalafil has a long half-life (~17.5 hours), the drug remains active in your body for an extended time. Daily dosing at 20 mg is not the approved regimen for this tablet — daily tadalafil therapy uses a much lower dose (typically 5 mg). If you have been prescribed daily tadalafil, a separate prescription specifically for daily low-dose use will be issued by your physician. Do not use Ceebis 20 Mg as a daily-use medicine without specific medical direction.

Q: Why must I not use nitrates with Ceebis 20 Mg?

A: Nitrates (including glyceryl trinitrate, isosorbide mononitrate, isosorbide dinitrate) and nitric oxide donors (including amyl nitrite/poppers) act on the same blood-pressure pathway as tadalafil. Both drug classes cause blood vessels to dilate. When taken together, the combined effect on blood pressure can be severe and potentially fatal — causing a dramatic drop in blood pressure (hypotension) that may result in loss of consciousness, heart attack, or stroke. This is an absolute contraindication: never take tadalafil if you use any nitrate medication for angina or any form of amyl nitrite. Always inform any doctor treating you in an emergency that you have taken tadalafil, so nitrates are not administered to you.

Q: What should I do if I get an erection that won’t go away?

A: A persistent erection lasting more than 4 hours — even if not painful initially — is a medical emergency called priapism. If untreated, priapism can cause permanent damage to the erectile tissue of the penis, potentially resulting in irreversible erectile dysfunction. If your erection lasts longer than 4 hours, do not wait: seek emergency medical attention immediately. Tell the medical team that you have taken tadalafil.

Q: Will Ceebis 20 Mg work the first time I try it?

A: Tadalafil is effective in most men with ED, but responses can vary between individuals. Some men experience full benefit from the first dose; others may find that the first or second attempt produces a partial response. Clinical guidance recommends giving tadalafil a fair trial of at least 6 attempts at the recommended dose before concluding it is not working — ensuring each attempt is made after adequate sexual stimulation. If after a reasonable number of attempts the response is still unsatisfactory, speak to your physician: they may adjust the dose, investigate underlying contributory factors, or discuss alternative treatment options.

References

1. NHS. Tadalafil. NHS.uk. Available at: https://www.nhs.uk/medicines/tadalafil/
2. MedlinePlus. Tadalafil. U.S. National Library of Medicine. Available at: https://medlineplus.gov/druginfo/meds/a604008.html
3. U.S. Food and Drug Administration (FDA). Tadalafil (Cialis) — Full Prescribing Information. Available at: FDA.gov
4. European Medicines Agency (EMA). Cialis (tadalafil) — European Public Assessment Report (EPAR). Available at: EMA.europa.eu
5. Porst H, Buvat J (eds). Standard Practice in Sexual Medicine. Blackwell Publishing, 2006.