Generic Women Pack-40

Buy Generic Women Pack-40 () without prescription in Canada

In our Canadian pharmacy, you can buy Women Pack‑40 without a prescription, with delivery across Canada within 5‑14 days. Discreet and anonymous packaging.

Women Pack‑40 is a convenient combination kit containing two well‑known phosphodiesterase type 5 (PDE5) inhibitors: Cialis Female 10 mg (tadalafil) and Viagra Female 100 mg (sildenafil citrate). Both medications are used off‑label for the management of female sexual arousal disorder (FSAD), helping to increase genital blood flow, enhance sensitivity, and facilitate the achievement of orgasm and adequate arousal. Tadalafil provides a long‑acting effect lasting up to 36 hours, while sildenafil acts more quickly and lasts 4–6 hours. The pack supplies 20 tablets of each product (40 tablets total), offering the flexibility to choose the option best suited to the moment, without needing separate prescriptions. The two drugs must never be taken closer than 24 hours apart.

Usual adult dose: Take one tablet orally as needed: either one Cialis Female 10 mg (tadalafil) or one Viagra Female 100 mg (sildenafil), approximately 30–60 minutes before anticipated sexual activity. Do not take both medications on the same day; allow a minimum of 24 hours between any dose of Cialis Female and any dose of Viagra Female. The maximum frequency of any PDE5 inhibitor is once daily. A high‑fat meal can delay the onset, particularly of sildenafil, so taking the tablet on an empty stomach or after a light meal is best. Doses of sildenafil above 100 mg are not recommended.

Dosage form: Oral tablets: Cialis Female 10 mg (tadalafil) and Viagra Female 100 mg (sildenafil citrate). Supplied as a kit of 40 tablets (20 + 20).

Onset of action: Both drugs are rapidly absorbed. Tadalafil peak plasma levels are reached in about 2 hours (range 0.5–6 hours); many women notice an improvement in arousal within 30–45 minutes. Sildenafil reaches peak levels at 30–120 minutes (median 60 minutes), with effects often perceived within 30 minutes. Food, especially fatty meals, may delay sildenafil absorption.

Duration of action: The therapeutic effect of tadalafil can persist for up to 36 hours, providing a longer window of spontaneity. Sildenafil’s effect lasts about 4–6 hours. Both drugs require adequate sexual stimulation to produce an effect.

Alcohol recommendation: Alcohol consumption should be limited or avoided while using Women Pack‑40 products. Alcohol can reduce sexual responsiveness, lower blood pressure, and increase the likelihood of side effects such as headache, dizziness, and flushing.

Most common side effects: Headache, facial flushing, dyspepsia (indigestion), nasal congestion, dizziness, back or muscle pain (more common with tadalafil), and visual disturbances (mild blue‑tinged vision, sensitivity to light, primarily with sildenafil). These effects are usually mild and temporary. Rare but serious events include priapism (prolonged clitoral erection, a medical emergency), sudden vision loss, and sudden hearing loss.

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General Information about Women Pack‑40

• INN (International Nonproprietary Name): Tadalafil and Sildenafil Citrate
• Brand names available in Canada: Women Pack‑40 is not a marketed product in Canada. Tadalafil is approved in Canada only for male erectile dysfunction (ED) and benign prostatic hyperplasia under the brand Cialis® and generics; sildenafil is approved for male ED under Viagra® and generics, and for pulmonary arterial hypertension as Revatio®. Neither drug is approved by Health Canada for female sexual arousal disorder. Women Pack‑40 is an internationally sourced combination kit supplied by our pharmacy through the international supply chain for personal importation.
• ATC code: G04BE08 (tadalafil), G04BE03 (sildenafil).
• Dosage forms and strengths: Kit containing 20 tablets of tadalafil 10 mg (Cialis Female) and 20 tablets of sildenafil 100 mg (Viagra Female). The tablets are film‑coated; tadalafil 10 mg is typically almond‑shaped and yellow; sildenafil 100 mg is blue and rounded‑diamond‑shaped.
• Manufacturers in Canada: None. Women Pack‑40 is not manufactured in Canada. The individual components are manufactured by international pharmaceutical companies; our pharmacy obtains the kit via the international supply chain.
• Registration status in Canada: Not marketed in Canada. Tadalafil and sildenafil are approved only for specific male indications. No Health Canada approval exists for female sexual dysfunction. The kit is imported for personal use under a valid prescription.
• OTC / Rx classification: Prescription only (Rx). Both tadalafil and sildenafil are Schedule I drugs under the Controlled Drugs and Substances Act. A valid prescription from a licensed Canadian healthcare professional is required.

Mechanism of Action and Pharmacology

Both tadalafil and sildenafil are highly selective, reversible inhibitors of cyclic guanosine monophosphate (cGMP)‑specific phosphodiesterase type 5 (PDE5). In women, PDE5 is present in the clitoral corpus cavernosum, vaginal smooth muscle, and pelvic vasculature. During sexual stimulation, nitric oxide is released from nerve endings and endothelial cells in these tissues, activating guanylate cyclase and raising intracellular cGMP. This leads to smooth‑muscle relaxation, vasodilation, and increased blood flow, which promotes clitoral engorgement, vaginal lubrication, and heightened sensitivity. By preventing the breakdown of cGMP, both drugs amplify and prolong this genital vasocongestive response, potentially enhancing arousal, orgasm, and overall sexual satisfaction. Tadalafil’s longer half‑life (17.5 hours) provides a window of up to 36 hours, while sildenafil’s shorter half‑life (approximately 4 hours) offers a briefer, more rapid effect. Neither drug increases sexual desire in the absence of stimulation; they only facilitate the physiological arousal response when erotic stimuli are present.

Tadalafil is metabolised mainly by CYP3A4 to an inactive catechol metabolite and is excreted predominantly in the faeces. Sildenafil is metabolised primarily by CYP3A4 (major) and CYP2C9 (minor) to an active N‑desmethyl metabolite, with elimination mainly in the faeces. Food, especially high‑fat meals, delays sildenafil absorption but has no clinically significant effect on tadalafil.

Indications

• Women Pack‑40 is used off‑label for the management of female sexual arousal disorder (FSAD), a condition characterised by persistent or recurrent inability to attain or maintain sufficient genital lubrication, swelling, or pleasurable sensation during sexual activity, causing marked distress or interpersonal difficulty. The medications are intended to improve genital blood flow and enhance the capacity for arousal and orgasm.
• These products are not approved by Health Canada for any female indication, and safety and efficacy in women have not been established to the same rigorous standard as for male ED. Use in women is based on limited clinical trial evidence and clinical experience.
• Women Pack‑40 is not indicated for use in men, children, or adolescents under 18 years of age.

Important Warnings and Precautions

At‑risk groups

• Pregnancy and breastfeeding: Women Pack‑40 is not indicated for use by pregnant or breastfeeding women. The safety of PDE5 inhibitors during pregnancy and lactation has not been studied. Effective contraception should be used if pregnancy is a possibility.
• Paediatrics (< 18 years): Not indicated. Safety and efficacy have not been established in children.
• Elderly (≥ 65 years): Elderly women may be more sensitive to the vasodilatory effects. A lower starting dose of sildenafil (50 mg) should be considered; tadalafil 10 mg is the lowest available as‑needed dose and may be used with caution. Monitor for orthostatic hypotension.
• Cardiovascular disease: Sexual activity carries a cardiac risk. Both drugs have vasodilatory properties and can cause mild, transient decreases in blood pressure. They are contraindicated in women with severe cardiovascular conditions, including unstable angina, severe heart failure, and recent myocardial infarction or stroke (within 6 months).
• Use with nitrates — absolutely contraindicated: Both tadalafil and sildenafil potentiate the hypotensive effects of organic nitrates and nitric oxide donors (e.g., nitroglycerin, isosorbide mononitrate, amyl nitrite). Concomitant use can cause a life‑threatening drop in blood pressure. This contraindication applies to all doses and formulations.
• Use with guanylate cyclase stimulators — contraindicated: Concomitant use with riociguat (Adempas®) is contraindicated due to the risk of severe hypotension.
• Priapism: Although rare in women, prolonged clitoral erection (clitoral priapism) has been reported with PDE5 inhibitors and is a urological emergency that can lead to tissue damage. Women experiencing a painful, prolonged clitoral erection lasting more than 4 hours should seek immediate medical attention.
• Vision loss: Non‑arteritic anterior ischaemic optic neuropathy (NAION), a cause of sudden vision loss, has been reported rarely in temporal association with PDE5 inhibitor use. The risk may be increased in individuals with a small cup‑to‑disc ratio, hypertension, diabetes, or smoking. Stop the drug and seek immediate care if sudden vision loss occurs.
• Hearing loss: Sudden decrease or loss of hearing has been reported. Discontinue and seek prompt medical attention.
• Renal impairment: For tadalafil, no dose adjustment is needed in mild to moderate renal impairment; in severe renal impairment (CrCl ≤ 30 mL/min), maximum dose is 10 mg once every 48 hours. For sildenafil, no dose adjustment in mild to moderate impairment; in severe impairment (CrCl < 30 mL/min), use a 50 mg starting dose. The 100 mg sildenafil strength is not recommended in severe renal impairment.
• Hepatic impairment: For tadalafil, maximum 10 mg in mild‑to‑moderate impairment; not recommended in severe. For sildenafil, a starting dose of 25 mg (not the 100 mg tablet) should be used in any degree of hepatic impairment; the 100 mg dose is contraindicated.
• Alpha‑blockers and antihypertensives: Additive hypotension may occur. Women on alpha‑blockers should be stabilised before initiating the lowest dose of either PDE5 inhibitor. The 100 mg sildenafil dose is not recommended with alpha‑blockers.
• Allergy: Do not take any component if you have a known hypersensitivity to tadalafil, sildenafil, or any excipient.

Driving and alcohol

Both medications may cause dizziness, blurred vision, or altered colour perception. Women should not drive or operate hazardous machinery until they know how the drug affects them. Alcohol should be limited, as it can impair sexual response, lower blood pressure, and increase the risk of headache, flushing, and orthostatic hypotension.

Dosage Instructions

• Standard regimen: Choose either one Cialis Female 10 mg tablet or one Viagra Female 100 mg tablet, taken orally as needed, approximately 30‑60 minutes before sexual activity. Do not take both medications on the same day; allow at least 24 hours between any two doses of a PDE5 inhibitor. The maximum frequency is once daily for each drug; therefore, you may use Cialis Female one day and Viagra Female the next, provided a full 24‑hour interval has passed. The pack contains equal quantities; rotate according to your preference and the desired duration (shorter with sildenafil, longer with tadalafil).
• Lower starting dose for sildenafil: Women who are sensitive to vasodilatory effects, elderly, or those with mild hepatic/renal impairment may start with half a 100 mg tablet (50 mg) if the tablet is scored, under physician guidance. The unapproved nature of female use means that dosing must be individualised.
• Administration: Swallow the chosen tablet whole with a glass of water. For the fastest onset, take on an empty stomach; a high‑fat meal may delay absorption, particularly of sildenafil. Do not crush or chew the tablets.
• Missed dose: Women Pack‑40 is taken as needed only; a missed dose is not applicable.

Side Effects and Contraindications

• Very common (≥ 10%): Headache and flushing (both drugs).
• Common (1‑10%): Dyspepsia (indigestion), nasal congestion, dizziness, back pain, myalgia (tadalafil), visual disturbances (bluish vision, light sensitivity — sildenafil), nausea, and fatigue.
• Serious adverse reactions: Priapism (clitoral), sudden vision loss (NAION), sudden hearing loss, and cardiovascular events (myocardial infarction, stroke) temporally associated with sexual activity. Hypotension and syncope may occur, especially with higher doses or with alcohol.
• Contraindications: Concomitant use of organic nitrates in any form; riociguat; known hypersensitivity to tadalafil or sildenafil; severe cardiovascular disease; recent myocardial infarction or stroke (within 6 months); severe hepatic impairment; severe renal impairment (for the 100 mg sildenafil dose); and any condition where sexual activity is inadvisable. The pack is not intended for use in pregnant or breastfeeding women.

Drug Interactions

• Nitrates and nitric oxide donors — contraindicated: See warnings.
• Guanylate cyclase stimulators — contraindicated: Riociguat.
• Alpha‑blockers: Additive hypotension; avoid the 100 mg sildenafil dose, and start with low‑dose tadalafil or sildenafil only after stabilisation on the alpha‑blocker.
• Potent CYP3A4 inhibitors (e.g., ritonavir, ketoconazole): Significantly increase levels of both drugs. The 100 mg sildenafil dose is contraindicated; for tadalafil, maximum dose 10 mg every 72 hours. Concomitant use should generally be avoided.
• Moderate CYP3A4 inhibitors (e.g., erythromycin, clarithromycin, fluconazole): May increase exposure; use with caution, avoid the 100 mg sildenafil dose.
• Antihypertensives: Additive blood‑pressure‑lowering effect; monitor.
• Alcohol: Increases risk of hypotension and headache; limit intake.
• Other PDE5 inhibitors: Never combine Cialis Female and Viagra Female within 24 hours; do not add any other PDE5 inhibitor.

Practical Advice

• Administration: Select one tablet based on the desired duration of effect. Swallow whole with water. An empty stomach gives the fastest onset. You may use Cialis Female one day and Viagra Female the next, but always wait at least 24 hours between any two doses. Do not exceed one dose per day. Sexual stimulation is necessary; these drugs do not increase libido or desire on their own.
• Monitoring: No routine laboratory monitoring is required. Baseline cardiovascular evaluation is recommended. Seek immediate attention for clitoral priapism, sudden vision or hearing loss, or chest pain.
• Storage: Store at room temperature (15‑30 °C) in a dry place, away from moisture and heat. Keep out of the reach and sight of children.
• Lifestyle: Address any underlying health conditions (diabetes, hypertension, depression) and consider pelvic floor physiotherapy, psychological counselling, or sensate‑focus exercises, which can improve arousal independently. Limit alcohol and avoid recreational drugs. Do not share this medication with others.
• Emergency: If you develop a prolonged, painful clitoral erection lasting > 4 hours, sudden vision or hearing loss, or chest pain, stop taking the medication and go to the nearest emergency department. Inform all healthcare providers that you have taken a PDE5 inhibitor, especially if you require emergency treatment for chest pain, as nitrates are contraindicated.

Alternative Medications

• Flibanserin (Addyi®): A multifunctional serotonin agonist/antagonist approved in the United States for acquired, generalised hypoactive sexual desire disorder (HSDD) in premenopausal women. It is taken daily at bedtime and primarily improves sexual desire, not arousal. It is not marketed in Canada.
• Bremelanotide (Vyleesi®): A melanocortin receptor agonist approved in the US for HSDD, administered by subcutaneous injection 45 minutes before sexual activity. It can increase desire and reduce distress; it is not approved or available in Canada.
• Topical vaginal preparations: Vaginal estrogen therapy (for postmenopausal women) and non‑hormonal moisturisers/lubricants are first‑line for vulvovaginal atrophy‑related arousal difficulties.
• Psychosexual therapy and pelvic floor therapy: Cognitive‑behavioural therapy, mindfulness, and pelvic floor muscle training can significantly improve arousal and orgasm in women with FSAD, and are recommended as part of a comprehensive management plan.
• Off‑label use of other agents: Bupropion, buspirone, and oxytocin have been studied in limited settings; evidence is insufficient to recommend routine use.

Clinical Efficacy

The efficacy of PDE5 inhibitors in women with FSAD is inconsistent. Several randomised controlled trials have evaluated sildenafil and tadalafil in pre‑ and postmenopausal women. A 2008 systematic review and meta‑analysis found a modest benefit of sildenafil in women with FSAD, particularly those with concomitant antidepressant‑induced sexual dysfunction; improvements in arousal, lubrication, and orgasm were observed, but global sexual satisfaction did not consistently improve. Tadalafil has been studied in smaller trials, with mixed results: some women report improved genital sensation and arousal, but placebo‑controlled data are limited. Neither drug has received FDA or Health Canada approval for female sexual dysfunction. The off‑label use of these agents is based on the physiological rationale that increased genital blood flow should enhance arousal; however, female sexual response is complex and influenced by psychological, relational, and hormonal factors, which may explain the variability in outcomes. Women Pack‑40 provides a pragmatic option for those who wish to try PDE5 inhibition under medical supervision, with the understanding that the response is not guaranteed and the safety in women is extrapolated from extensive male data.

Important:

Women Pack‑40 (tadalafil and sildenafil) is a prescription medication combination that has not been approved by Health Canada for female sexual arousal disorder. It should be used only under the supervision of a qualified healthcare professional. The most critical safety warning is that neither drug must ever be taken with any form of organic nitrate (e.g., nitroglycerin, amyl nitrite, “poppers”); this combination can cause a severe, sudden, and potentially fatal drop in blood pressure. Do not take Cialis Female and Viagra Female within 24 hours of each other. Seek immediate medical attention if you develop a prolonged, painful clitoral erection (priapism), sudden vision or hearing loss, or chest pain. These products are not intended for use by pregnant or breastfeeding women, or by men. Sexual activity may carry a cardiac risk in women with pre‑existing cardiovascular disease. This information is not a substitute for professional medical advice, diagnosis, or treatment.

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