Drug information of Tadalafil
Tadalafil relaxes muscles and increases blood flow to particular areas of the body. Tadalafil under the name of Cialis is used to treat erectile dysfunction (impotence) and symptoms of benign prostatic hypertrophy (enlarged prostate).
Another brand of tadalafil is Adcirca, which is used to treat pulmonary arterial hypertension and improve exercise capacity in men and women.
Mechanism of effect
Inhibition of phosphodiesterase type 5 (PDE5) by tadalafil increases the concentrations of cyclic guanosine monophosphate (cGMP).
Tadalafil is used to treat male erectile dysfunction (impotence) and pulmonary arterial hypertension (PAH)
Bioavailability undetermined..Steady state is attained within 5 days of once-daily dosing. Tadalafil is 94% protein bound. Tadalafil is excreted predominantly as metabolites, mainly in the feces (approximately 61%) and to a lesser degree in the urine (approximately 36%).The terminal half-life is 15 h ( Adcirca ) and 17.5 h ( Cialis ).
Drug indicationspulmonary arterial hypertension , Benign Prostatic Hyperplasia , Erectile Dysfunction
Usual Adult Dose for Erectile Dysfunction-Initial dose: 10 mg orally once a day, as needed, prior to sexual activity
-Maintenance dose: 5 to 20 mg orally once a day, as needed, prior to sexual activity based on individual efficacy and tolerability.
Usual Adult Dose for Pulmonary Hypertension Adcirca (R): -40 mg orally once a day
Drug contraindicationshypersensitivity to drug or its components. , with nitrates and nitric oxide donors
Side effectsMigraine , nausea , Headache , insomnia , chest pain , dry mouth , Tachycardia , dizziness , fatigue , Seizures , Blurred vision , rash , flushing , vertigo , Diarrhea , Dyspnea , asthenia , pruritus , Hypertension , hypotension , paresthesia , neuropathy , dyspepsia , Cough , respiratory tract infection , myalgia , somnolence , Arthralgia , pain in the extremities , back pain , Upper respiratory tract infection , syncope , Hypersensitivity , Nasopharyngitis , Angina pectoris , sweating , orthostatic hypotension , Tinnitus , Facial edema , Visual abnormalities
InteractionsAlprostadil , Spironolactone , Imatinib , Bosentan , MG , Aluminium MG+simeticone , Aluminium gel , Amlodipine , Erythromycin , Enalapril , Magnesium hydroxide , Clarithromycin , Contraceptive , Contraceptive DE , Contraceptive HD , Contraceptive LD , Quinidine , Phenytoin phenobarbital , Metoprolol , Miconazole , Nitroglycerin , Voriconazole , Ketoconazole , Itraconazole , isosorbide dinitrate , Posaconazole , Fluvoxamine , Phenobarbital , Phenytoin , Tamsulosin , Carbamazepine , Phentolamine Mesylate , Bisoprolol , Nitroprusside sodium , Doxazosin , ritonavir , nelfinavir , Indinavir , Amyl Nitrite , Sapropterin , Telaprevir , Nicardipine , riociguat , Florbetapir F18 , Nesiritide
1-Monitor patients for response to therapy, any changes in BP or heart rate, and hearing or vision loss.
2-Use with caution in patients with mild to moderate hepatic impairment; Use is not recommended in patients with severe hepatic impairment.
3-Dosage adjustment is needed in patients with mild to moderate renal impairment; avoid use in patients with severe renal impairment
4-Safety of tadalafil is unknown in patients with bleeding disorders or active peptic ulceration
5-Evaluate CV status and left ventricular outflow obstruction (eg, aortic stenosis) before treatment
6-Sudden decrease or loss of hearing, which may be accompanied by tinnitus and dizziness, has been reported.
7-Sudden loss of vision in one or both eyes has been reported
rarely and may be a sign of nonarteritic anterior optic neuropathy.
8-Prolonged erections, exceeding 4 h, may occur and require immediate medical attention.
9-Use with caution in patients with conditions that may predispose them to priapism (eg, sickle cell anemia, multiple myeloma, leukemia) and in patients with anatomical deformation of the penis (eg, angulation, cavernosal fibrosis, Peyronie disease).
Points of recommendation
• May be taken without regard to food. • Cialis tablets should not be split; the entire dose should be taken. • Inform patients that tadalafil is marketed as both Adcirca and Cialis and to not take them together.