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Tadalafil
Tadalafil, commonly known by its brand name Cialis, is a prescription medication used to treat erectile dysfunction (ED), benign prostatic hyperplasia (BPH), and pulmonary arterial hypertension (PAH). It belongs to a class of drugs known as phosphodiesterase-5 (PDE5) inhibitors, which work by relaxing the blood vessels and improving blood flow. In the case of ED, tadalafil helps men achieve and maintain an erection sufficient for sexual activity. It is also prescribed for daily use or as needed to treat urinary symptoms associated with an enlarged prostate (BPH) and to manage pulmonary hypertension.
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Frequently Asked Questions
How long does tadalafil last?
Tadalafil can last up to 36 hours, which is why it is often called the "weekend pill." This long duration allows for greater flexibility in timing sexual activity compared to other ED medications.
Can I take tadalafil every day?
Yes, tadalafil can be taken daily at lower doses (2.5 mg or 5 mg) for the treatment of both ED and BPH. This allows for spontaneous sexual activity without needing to plan around a dose.
Can tadalafil cure erectile dysfunction?
No, tadalafil does not cure ED but helps manage the symptoms. It temporarily improves blood flow to the penis during sexual arousal, allowing men with ED to achieve and maintain an erection.
How long does it take for tadalafil to work?
Tadalafil usually starts working within 30 to 60 minutes after taking the pill. However, sexual stimulation is still required for it to be effective.
Can I take tadalafil with other medications?
You should always check with your healthcare provider before combining tadalafil with other medications, especially nitrates or alpha-blockers, as these combinations can cause dangerous drops in blood pressure.
Comprehensive Drug Guide
How Does Tadalafil Work?
Tadalafil works by inhibiting the enzyme phosphodiesterase type 5 (PDE5), which regulates blood flow in the penis. During sexual stimulation, tadalafil enhances the effects of nitric oxide by relaxing smooth muscles in the blood vessels of the penis, allowing increased blood flow and leading to an erection. For BPH, tadalafil relaxes muscles in the prostate and bladder, easing symptoms such as difficulty in starting urination and the need to urinate frequently. For PAH, tadalafil relaxes blood vessels in the lungs, reducing the workload on the heart and improving exercise ability.
What is Tadalafil Used For?
Common Dosages
- 2.5 mg, 5 mg, 10 mg, and 20 mg tablets
Typical Dosing
- For erectile dysfunction (ED):
- As needed: The typical dose is 10 mg taken at least 30 minutes before sexual activity. The dose may be adjusted to 20 mg or reduced to 5 mg based on effectiveness and tolerance.
- Daily use: The usual dose is 2.5 mg to 5 mg once daily, allowing for spontaneous sexual activity without the need to plan around a dose.
- For benign prostatic hyperplasia (BPH):
- The recommended dose is 5 mg once daily.
- For pulmonary arterial hypertension (PAH):
- The typical dose is 40 mg (two 20 mg tablets) taken once daily.
Typical Dosing
FDA Approved Indications
- Erectile dysfunction (ED)
- Benign prostatic hyperplasia (BPH)
- Pulmonary arterial hypertension (PAH)
Off-Label Uses
Who Shouldn't Take Tadalafil?
- Use of nitrates (such as nitroglycerin) for chest pain or heart problems, as this combination can cause a dangerous drop in blood pressure
- Severe heart or liver problems
- Recent history of stroke or heart attack
- Severe hypotension (low blood pressure)
- Known hypersensitivity or allergic reaction to tadalafil or any component of the formulation
Advice From The Pharmacist
- Take tadalafil exactly as prescribed by your healthcare provider. If you are taking it as needed for ED, avoid taking more than one dose in a 24-hour period.
- Avoid consuming large amounts of alcohol while taking tadalafil, as this can increase the risk of side effects such as dizziness or fainting.
- Tadalafil can be taken with or without food, but be mindful that a heavy or high-fat meal may delay the time it takes for the medication to take effect.
- If you experience sudden vision loss or an erection lasting more than 4 hours, seek medical attention immediately, as these are medical emergencies.
Side Effects of Tadalafil
Common Side Effects
- Headache
- Flushing (redness of the face)
- Indigestion
- Back pain
- Muscle aches
- Nasal congestion
Uncommon/Severe Side Effects
- Priapism (an erection lasting longer than 4 hours)
- Sudden vision loss or hearing loss
- Severe allergic reactions (rash, difficulty breathing, swelling of the face or throat)
- Severe hypotension (especially when taken with nitrates or certain blood pressure medications)
Risks and Warnings of Tadalafil
- Nitrate Interaction: Tadalafil must never be used in combination with nitrates (commonly prescribed for heart conditions), as this can cause a dangerous drop in blood pressure, leading to fainting, heart attack, or stroke.
- Cardiovascular Risk: Patients with heart conditions should use tadalafil cautiously, as sexual activity can place additional strain on the heart. Consult your doctor to ensure it is safe for you.
- Priapism: Prolonged erections (lasting more than 4 hours) can cause permanent damage to the penis if not treated promptly. Seek immediate medical help if this occurs.
Interactions with Tadalafil
Common Drug Interactions
- Nitrates (e.g., nitroglycerin): The combination with tadalafil is contraindicated, as it can cause life-threatening low blood pressure.
- Alpha-blockers: These medications, used for high blood pressure or BPH (e.g., tamsulosin), can also lower blood pressure, and combining them with tadalafil can increase the risk of dizziness or fainting.
- CYP3A4 inhibitors: Drugs like ketoconazole and ritonavir can increase the levels of tadalafil in the blood, leading to a higher risk of side effects.
- Alcohol: Excessive alcohol consumption can lower blood pressure and increase the risk of side effects such as dizziness or fainting.
Alternatives to Tadalafil
- Sildenafil (Viagra): Another PDE5 inhibitor commonly used to treat erectile dysfunction. It is typically taken 30 to 60 minutes before sexual activity.
- Vardenafil (Levitra): A PDE5 inhibitor used to treat ED, with effects similar to sildenafil.
- Avanafil (Stendra): A newer PDE5 inhibitor that works quickly, often within 15 minutes, and is used for ED.
- Alprostadil: A different class of medication that can be injected or inserted into the urethra to treat erectile dysfunction, typically for patients who do not respond to oral PDE5 inhibitors.
