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KOKOKSIB

Ask a doctor about a prescription for KOKOKSIB

5.0(38)
Doctor

Yevgen Yakovenko

General surgery11 years of experience

Dr. Yevgen Yakovenko is a licensed surgeon and general practitioner in Spain and Germany. He specialises in general, paediatric, and oncological surgery, internal medicine, and pain management. He offers online consultations for adults and children, combining surgical precision with therapeutic support. Dr Yakovenko works with patients across different countries and provides care in Ukrainian, Russian, English, and Spanish.

Areas of medical expertise:

  • Acute and chronic pain: headaches, muscle and joint pain, back pain, abdominal pain, postoperative pain. Identifying the cause, selecting treatment, and creating a care plan.
  • Internal medicine: heart, lungs, gastrointestinal tract, urinary system. Management of chronic conditions, symptom control, second opinions.
  • Pre- and postoperative care: risk assessment, decision-making support, follow-up after surgery, rehabilitation strategies.
  • General and paediatric surgery: hernias, appendicitis, congenital conditions, both planned and urgent surgeries.
  • Injuries and trauma: bruises, fractures, sprains, soft tissue damage, wound care, dressing, referral when in-person care is required.
  • Oncological surgery: diagnosis review, treatment planning, and long-term follow-up.
  • Obesity treatment and weight management: a medical approach to weight loss, including assessment of underlying causes, evaluation of comorbidities, development of a personalised plan (nutrition, physical activity, pharmacotherapy if needed), and ongoing progress monitoring.
  • Imaging interpretation: analysis of ultrasound, CT, MRI, and X-ray results, surgical planning based on imaging data.
  • Second opinions and medical navigation: clarifying diagnoses, reviewing current treatment plans, helping patients choose the best course of action.

Experience and qualifications:

  • 12+ years of clinical experience in university hospitals in Germany and Spain.
  • International education: Ukraine – Germany – Spain.
  • Member of the German Society of Surgeons (BDC).
  • Certified in radiological diagnostics and robotic surgery.
  • Active participant in international medical conferences and research.

Dr Yakovenko explains complex topics in a clear, accessible way. He works collaboratively with patients to analyse health issues and make evidence-based decisions. His approach is grounded in clinical excellence, scientific accuracy, and respect for each individual.

If you are unsure about a diagnosis, preparing for surgery, or want to discuss your test results – Dr Yakovenko will help you evaluate your options and move forward with confidence.

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This page is for general information. Consult a doctor for personal advice. Call emergency services if symptoms are severe.
About the medicine

How to use KOKOKSIB

INSTRUCTIONS for medical use of the medicinal product TADALAFIL

Composition

The active substance: tadalafil; 1 film-coated tablet contains tadalafil 10 mg (mg) or 20 mg (mg); excipients: lactose monohydrate, sodium croscarmellose, microcrystalline cellulose RH102, hydroxypropylcellulose, sodium lauryl sulfate, magnesium stearate, film coating mixture 03K12429: hypromellose 6mPas, titanium dioxide (E 171), talc, triacetin, yellow iron oxide (E 172).

Pharmaceutical form

Film-coated tablets.

Main physical and chemical properties

10 mg: film-coated tablets, from pale yellow to yellow in color, round in shape, biconvex, with engraving “45” on one side and smooth on the other. 20 mg: film-coated tablets, from pale yellow to yellow in color, round in shape, biconvex, with engraving “47” on one side and smooth on the other.

Pharmacotherapeutic group

Drugs for the treatment of erectile dysfunction. ATC code G04B E08.

Pharmacological properties

Pharmacodynamics
Mechanism of action

Tadalafil is a selective reversible inhibitor of cyclic guanosine monophosphate (cGMP) - specific phosphodiesterase type 5 (PDE 5). When sexual stimulation causes local release of nitric oxide, inhibition of PDE 5 by tadalafil produces increased levels of cGMP in the cavernous body. This leads to relaxation of smooth muscles and increased blood flow to the tissues of the penis, thereby creating an erection. Tadalafil does not act without sexual stimulation.

Pharmacokinetics

Absorption. Tadalafil is well absorbed after oral administration. The mean maximum plasma concentration (Cmax) is reached on average 2 hours after administration. The absolute bioavailability of tadalafil after oral administration has not been established.

Clinical efficacy and safety

Three clinical trials were conducted involving 1054 patients to determine the onset of action of tadalafil, which demonstrated statistically significant improvement in erectile function, as well as efficacy over 36 hours and detection of effect as early as 16 minutes after administration compared to placebo.

Clinical characteristics

Indications

For the treatment of erectile dysfunction in adult men. The drug is effective in the presence of sexual stimulation. Tadalafil is not indicated for use in women.

Contraindications

Hypersensitivity to tadalafil or to any other component of the medicinal product.

Interaction with other medicinal products and other forms of interaction

Studies on interactions, the results of which are presented below, were conducted for doses of 10 mg and 20 mg.

Influence of other medicinal products on tadalafil

CYP450 inhibitors. Tadalafil is metabolized mainly by CYP3A4. The selective inhibitor of CYP3A4 - ketoconazole (200 mg daily) - increases the exposure (AUC) of tadalafil (10 mg) by 2 times, and Cmax by 15%.

Special instructions

Before prescribing the medicinal product Tadalafil

Before administering the drug, the doctor should determine the underlying causes of erectile dysfunction and prescribe the appropriate course of treatment.

Cardiovascular system

In the post-marketing period and/or during clinical trials, serious cardiovascular events have been reported, including myocardial infarction, sudden cardiac death, unstable angina, ventricular arrhythmia, cerebrovascular disorders, transient ischemic attack, chest pain, accelerated heart rate, and tachycardia.

Ability to affect reaction speed when driving vehicles or operating other mechanisms

The effect of Tadalafil on the ability to drive vehicles and other mechanisms is minimal.

Method of administration and dosage

For oral administration. The medicinal product should be taken with the recommended content of the active substance.

Adult men

The recommended dose is 10 mg before predicted sexual activity, regardless of food intake.

Overdose

Symptoms. When administered to healthy volunteers in a single dose of tadalafil up to 500 mg and in multiple doses up to 100 mg per day, undesirable effects were similar to those observed with smaller doses of the drug.

Adverse reactions

Undesirable effects most frequently reported during the treatment of erectile dysfunction were headache, dyspepsia, back pain, myalgia, the frequency of which increased with increasing doses of the drug.

Frequent (≥ 1/100 ≤ 1/10)Uncommon (≥ 1/1000 ≤ 1/100)Rare (≥ 1/10000 ≤ 1/1000)Frequency not known
Disorders of the immune system
Hypersensitivity reactionsAngioedema2
Disorders of the nervous system
HeadacheDizzinessCerebrovascular disorders1(including hemorrhagic events), loss of consciousness, transient ischemic attack1, migraine2, seizures2, transient amnesia

Shelf life

3 years.

Storage conditions

Store in the original packaging in a place inaccessible to children at a temperature not exceeding 25 °C.

Packaging

For 10 mg: 4 or 7 film-coated tablets in a blister pack. 1 blister pack in a cardboard box.

Release category

By prescription.

Manufacturer

Chilu Pharmaceutical (Hainan) Co., Ltd.

Location of the manufacturer and address of the place of business

No. 273-A, Nanhai Avenue, Neshinl Hi-Tech Zone, Haikou, Hainan 570 314, China.

Alternatives to KOKOKSIB in other countries

The best alternatives with the same active ingredient and therapeutic effect.

Alternative to KOKOKSIB in Spain

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Prescription required
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Manufacturer: Genthon B.V.
Prescription required
Dosage form: TABLET, 90 mg
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Alternative to KOKOKSIB in Poland

Dosage form: Tablets, 120 mg
Active substance: etoricoxib
Prescription required
Dosage form: Tablets, 90 mg
Active substance: etoricoxib
Prescription required
Dosage form: Tablets, 60 mg
Active substance: etoricoxib
Prescription required
Dosage form: Tablets, 30 mg
Active substance: etoricoxib
Prescription required
Dosage form: Tablets, 120 mg
Active substance: etoricoxib
Prescription required
Dosage form: Tablets, 90 mg
Active substance: etoricoxib

Online doctors for KOKOKSIB

Discuss dosage, side effects, interactions, contraindications, and prescription renewal for KOKOKSIB – subject to medical assessment and local rules.

5.0(38)
Doctor

Yevgen Yakovenko

General surgery11 years of experience

Dr. Yevgen Yakovenko is a licensed surgeon and general practitioner in Spain and Germany. He specialises in general, paediatric, and oncological surgery, internal medicine, and pain management. He offers online consultations for adults and children, combining surgical precision with therapeutic support. Dr Yakovenko works with patients across different countries and provides care in Ukrainian, Russian, English, and Spanish.

Areas of medical expertise:

  • Acute and chronic pain: headaches, muscle and joint pain, back pain, abdominal pain, postoperative pain. Identifying the cause, selecting treatment, and creating a care plan.
  • Internal medicine: heart, lungs, gastrointestinal tract, urinary system. Management of chronic conditions, symptom control, second opinions.
  • Pre- and postoperative care: risk assessment, decision-making support, follow-up after surgery, rehabilitation strategies.
  • General and paediatric surgery: hernias, appendicitis, congenital conditions, both planned and urgent surgeries.
  • Injuries and trauma: bruises, fractures, sprains, soft tissue damage, wound care, dressing, referral when in-person care is required.
  • Oncological surgery: diagnosis review, treatment planning, and long-term follow-up.
  • Obesity treatment and weight management: a medical approach to weight loss, including assessment of underlying causes, evaluation of comorbidities, development of a personalised plan (nutrition, physical activity, pharmacotherapy if needed), and ongoing progress monitoring.
  • Imaging interpretation: analysis of ultrasound, CT, MRI, and X-ray results, surgical planning based on imaging data.
  • Second opinions and medical navigation: clarifying diagnoses, reviewing current treatment plans, helping patients choose the best course of action.

Experience and qualifications:

  • 12+ years of clinical experience in university hospitals in Germany and Spain.
  • International education: Ukraine – Germany – Spain.
  • Member of the German Society of Surgeons (BDC).
  • Certified in radiological diagnostics and robotic surgery.
  • Active participant in international medical conferences and research.

Dr Yakovenko explains complex topics in a clear, accessible way. He works collaboratively with patients to analyse health issues and make evidence-based decisions. His approach is grounded in clinical excellence, scientific accuracy, and respect for each individual.

If you are unsure about a diagnosis, preparing for surgery, or want to discuss your test results – Dr Yakovenko will help you evaluate your options and move forward with confidence.

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Doctor

Tetiana Fedoryshyn

General medicine29 years of experience

Dr Tetiana Fedoryshyn is a senior general practitioner, certified nutritionist, and psychologist with over 29 years of clinical experience. She combines classical internal medicine with modern approaches in lifestyle medicine, functional nutrition, and emotional health support.

Her focus is on helping patients regain health through deep understanding of symptoms, personalised nutrition plans, and evidence-based correction of deficiencies, stress-related conditions, and metabolic imbalances. Dr Fedoryshyn works with adults experiencing chronic conditions, fatigue, hormonal disruption, and post-stress exhaustion.

She integrates medical analysis, psychological insight, and real-life behaviour change tools to offer treatment plans tailored to each patient’s biochemistry, mental state, and lifestyle.

Main areas of practice:

  • Chronic condition management and medical counselling
  • Weight loss programmes based on metabolic profiling
  • Diagnosis and treatment of micronutrient deficiencies
  • Recovery from stress, burnout, and hormonal imbalances
  • Emotional support and psychosomatic symptom care
Her approach is never one-size-fits-all – each consultation begins with a deep dive into your unique health history, test results, and emotional landscape. Consultations are available in Ukrainian, Polish, and Russian.
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5.0(5)
Doctor

Mar Tabeshadze

Endocrinology10 years of experience

Dr. Mar Tabeshadze is a licensed endocrinologist and general practitioner in Spain. She provides online consultations for adults, offering medical support for a wide range of endocrine conditions and related health concerns.

  • Diagnostic consultations for suspected endocrine disorders
  • Management of thyroid conditions, including in pregnant women
  • Early detection and treatment of type 1 and type 2 diabetes, with personalised therapy plans
  • Obesity treatment: identifying underlying causes of weight gain, combining medication and non-pharmacological strategies, and long-term support
  • Diagnosis and treatment of endocrine-related skin, hair, and nail issues
  • Ongoing care for patients with osteoporosis, pituitary, and adrenal gland disorders
Dr. Tabeshadze takes a patient-centred approach based on evidence-based medicine. Her goal is to help patients achieve hormonal balance, manage chronic conditions effectively, and improve overall well-being through targeted, personalised care.
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Doctor

Anna Biriukova

General medicine5 years of experience

Dr Anna Biriukova is an internal medicine doctor with clinical experience in cardiology, endocrinology, and gastroenterology. She provides online consultations for adults, offering expert medical support for heart health, hormonal balance, digestive issues, and general internal medicine.

Cardiology – Diagnosis and treatment of:

  • High blood pressure, blood pressure fluctuations, and cardiovascular risk prevention.
  • Chest pain, shortness of breath, arrhythmias (tachycardia, bradycardia, palpitations).
  • Leg swelling, chronic fatigue, reduced exercise tolerance.
  • EKG interpretation, lipid profile evaluation, cardiovascular risk assessment (heart attack, stroke).
  • Post-COVID-19 cardiac monitoring and care.
Endocrinology – Diabetes, thyroid, metabolism:
  • Diagnosis and management of type 1 and type 2 diabetes, and prediabetes.
  • Individual treatment plans including oral medications and insulin therapy.
  • GLP-1 therapy– modern pharmacological treatment for weight management and diabetes control, including drug selection, monitoring, and safety follow-up.
  • Thyroid disorders – hypothyroidism, hyperthyroidism, autoimmune thyroid diseases (Hashimoto’s, Graves’ disease).
  • Metabolic syndrome – obesity, lipid disorders, insulin resistance.
Gastroenterology – Digestive health:
  • Abdominal pain, nausea, heartburn, gastroesophageal reflux (GERD).
  • Stomach and intestinal conditions: gastritis, irritable bowel syndrome (IBS), indigestion.
  • Management of chronic digestive disorders and interpretation of tests (endoscopy, ultrasound, labs).
General internal medicine and preventive care:
  • Respiratory infections – cough, colds, bronchitis.
  • Lab test analysis, therapy adjustments, medication management.
  • Adult vaccinations – planning, contraindications assessment.
  • Cancer prevention – screening strategies and risk assessment.
  • Holistic approach – symptom relief, complication prevention, and quality of life improvement.
Dr Biriukova combines internal medicine with specialist insight, offering clear explanations, personalised treatment plans, and comprehensive care tailored to each patient.
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Doctor

Maryna Kuznetsova

Cardiology16 years of experience

Dr Marina Kuznetsova is an internal medicine doctor and cardiologist with a PhD in medicine. She provides online consultations for adults with chronic and acute conditions, with a strong focus on cardiovascular health. Her approach is based on current clinical guidelines and evidence-based treatment strategies.

Areas of expertise:

  • dyslipidaemia and lipid metabolism disorders
  • prevention and management of atherosclerosis
  • blood pressure monitoring and antihypertensive therapy
  • arrhythmias: diagnosis, follow-up, and treatment adjustment
  • cardiovascular care and recovery support after Covid-19
Dr Kuznetsova helps patients manage cardiovascular risk factors, optimise long-term treatment, and gain clarity in complex health situations – all through accessible and structured online care.
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Antonio Cayatte

General medicine43 years of experience

Dr Antonio Cayatte is a physician in General and Acute Medicine with over 30 years of experience across clinical care, medical research, and education. He offers online consultations for adults with a wide range of symptoms, both acute and chronic.

His clinical background includes:

  • assessment of sudden or unclear symptoms
  • ongoing care for chronic conditions
  • follow-up after hospital discharge
  • interpretation of test results
  • medical support while abroad
Dr Cayatte earned his degree from the University of Lisbon and taught internal medicine at Boston University School of Medicine. He holds active medical registrations in both Portugal and the UK and is a Fellow of the American Heart Association.

Consultations are available in English and Portuguese. Patients value his clarity, professionalism, and balanced approach to evidence-based care.

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Karim BenHarbi

General medicine8 years of experience

Dr. Karim Ben Harbi is a licensed general practitioner based in Italy. He provides online consultations for adults and children, combining international clinical experience with evidence-based medicine. His care approach is focused on accurate diagnosis, preventive care, and personalised health guidance.

Dr. Ben Harbi received his medical degree from Sapienza University in Rome. His training included hands-on experience in diverse settings — tropical medicine, rural healthcare, and urban outpatient practice. He also conducted clinical research in microbiology, exploring the role of the gut microbiome in chronic gastrointestinal issues.

You can consult Dr. Ben Harbi for:

  • General health concerns, prevention, and primary care.
  • Hypertension, type 1 and type 2 diabetes, metabolic issues.
  • Cold, cough, flu, respiratory infections, sore throat, fever.
  • Chronic digestive issues: bloating, gastritis, IBS, microbiome imbalance.
  • Skin rashes, mild allergic reactions, basic dermatological complaints.
  • Medication guidance, treatment adjustments, prescription review.
  • Paediatric concerns — fever, infections, general well-being.
  • Lifestyle optimisation: stress, sleep, weight, and diet counselling.

Dr. Ben Harbi offers reliable, accessible medical support through online consultations, helping patients make informed decisions about their health with a clear, structured, and compassionate approach.

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Svetlana Kolomeeva

Cardiology17 years of experience

Dr. Svetlana Kolomeeva is a general practitioner and internal medicine doctor providing online consultations for adults. She helps patients manage acute symptoms, chronic conditions, and preventive care. Her clinical focus includes cardiovascular health, hypertension control, and managing symptoms like fatigue, weakness, sleep issues, and overall low energy.

Patients commonly seek her help for:

  • High blood pressure, headaches, dizziness, swelling, palpitations.
  • Diagnosis and management of hypertension, arrhythmias, and tachycardia.
  • Metabolic syndrome, excess weight, high cholesterol.
  • Chronic fatigue, insomnia, poor concentration, anxiety.
  • Respiratory symptoms: colds, flu, sore throat, cough, fever.
  • Digestive issues: heartburn, bloating, constipation, IBS symptoms.
  • Chronic conditions: diabetes, thyroid disorders.
  • Interpretation of lab tests and medical reports, therapy adjustment.
  • Second opinion and decision-making support.
  • Cardiovascular disease prevention and metabolic risk reduction.
  • Long-term follow-up and dynamic health monitoring.

Dr Kolomeeva combines clinical expertise with personalised care. She clearly explains diagnoses, guides patients through symptoms and treatment options, and provides actionable plans. Her consultations are designed not only to address current complaints but also to stabilise chronic conditions and prevent future complications. She supports patients through every stage of care – from first symptoms to ongoing health management.

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Jonathan Marshall Ben Ami

Family medicine8 years of experience

Dr. Jonathan Marshall Ben Ami is a licensed family medicine doctor in Spain. He provides comprehensive care for adults and children, combining general medicine with emergency care expertise to address both acute and chronic health concerns.

Dr. Ben Ami offers expert diagnosis, treatment, and follow-up for:

  • Respiratory infections (cold, flu, bronchitis, pneumonia).
  • ENT conditions such as sinusitis, ear infections, and tonsillitis.
  • Digestive issues including gastritis, acid reflux, and irritable bowel syndrome (IBS).
  • Urinary tract infections and other common infections.
  • Management of chronic diseases: high blood pressure, diabetes, thyroid disorders.
  • Acute conditions requiring urgent medical attention.
  • Headaches, migraines, and minor injuries.
  • Wound care, health check-ups, and ongoing prescriptions.

With a patient-focused and evidence-based approach, Dr. Ben Ami supports individuals at all stages of life — offering clear medical guidance, timely interventions, and continuity of care.

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Nataliia Bessolitsyna

Rheumatology25 years of experience

Dr. Nataliia Bessolitsyna is a rheumatologist with extensive clinical experience. She provides online consultations focused on the diagnosis, treatment, and long-term management of joint diseases and systemic autoimmune disorders, following international clinical guidelines and evidence-based medicine.

You can consult Dr. Bessolitsyna about:

  • Joint pain — acute, chronic, or recurring pain.
  • Inflammatory arthritis: rheumatoid arthritis, psoriatic arthritis, polyarthritis, gouty arthritis.
  • Degenerative joint conditions: osteoarthritis, knee and hip arthritis (gonarthrosis, coxarthrosis), nodal polyosteoarthritis.
  • Periarthritis and spondyloarthritis.
  • Spinal inflammation: ankylosing spondylitis (Bechterew’s disease).
  • Systemic autoimmune diseases: lupus, scleroderma, systemic vasculitis.
  • Osteoporosis and bone fragility.

Dr. Bessolitsyna offers a personalised and structured approach — helping patients identify causes of joint pain, interpret test results, and follow tailored treatment plans. Her consultations focus on early diagnosis, symptom control, complication prevention, and improving long-term quality of life.

With remote access to specialist care, patients can receive expert rheumatology support wherever they are.

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