Tadalafil (Cialis) is utilized in the treatment of erectile dysfunction (ED; impotence; the inability to attain or maintain an erection) as well as benign prostatic hyperplasia (BPH; enlarged prostate) symptoms, which encompass difficulty urinating (hesitancy, dribbling, weak stream, and incomplete bladder emptying), discomfort during urination, and frequent urinary urgency in adult males. Furthermore, Tadalafil (Adcirca) serves to enhance exercise capacity in individuals suffering from pulmonary arterial hypertension (PAH; elevated blood pressure in the vessels delivering blood to the lungs, causing shortness of breath, dizziness, and fatigue). Tadalafil is categorized under phosphodiesterase type 5 (PDE5) inhibitors. This medication functions by amplifying blood flow to the penis during sexual excitement to assist in achieving an erection. Additionally, Tadalafil addresses PAH by dilating the pulmonary blood vessels, facilitating blood flow more efficiently.
It's crucial to understand that tadalafil does not offer a cure for erectile dysfunction nor does it enhance sexual desire. Moreover, tadalafil does not act as a preventive measure for pregnancy nor does it inhibit the transmission of sexually transmitted infections, including the human immunodeficiency virus (HIV).
Tadalafil is available in an oral tablet formulation. It can be consumed with or without food.
For those taking tadalafil for erectile dysfunction, adhering to your physician’s directives is essential. There exist two primary methods of administration: daily use or usage as needed. It is advisable to engage in a conversation with your healthcare provider regarding the most suitable dosing regimen for your specific circumstances. Tadalafil can be consumed on an as-needed basis, typically at least 30 minutes prior to sexual activity, and should not exceed once a day within a 24-hour span. Your doctor will guide you on the most appropriate timing for ingestion before sexual engagement. Alternatively, tadalafil can also be ingested daily, irrespective of sexual activity timing; sexual activity may be attempted at any point between doses. If you are adhering to a daily schedule, aim to take tadalafil consistently at the same time each day. In certain medical contexts, such as underlying health conditions or concurrent medication usage, your healthcare provider might recommend a reduced frequency of tadalafil intake or prescribe a lower daily dosage. It is imperative to follow the instructions on your prescription label with meticulous attention, and seek clarification from your healthcare professional regarding any uncertainties you may encounter. Always take tadalafil precisely as prescribed and avoid deviating from the recommended dosage.
If you are using tadalafil for PAH or BPH, adhering to your physician's guidelines is of utmost importance. Typically, tadalafil is administered once daily. Take your entire daily dose in one sitting; do not divide the tablets across different times of the day. It is advisable to consume tadalafil around the same time every day. Should you be on medications for BPH, your healthcare provider may instruct you to cease those medications for at least one day prior to initiating tadalafil treatment. Rigorously follow your doctor’s advice and ask questions to ensure you completely understand the treatment plan.
In cases where tadalafil is prescribed for erectile dysfunction, a standard initial dose will likely be prescribed, which may be adjusted based on your body's reaction to the medication. It’s vital to communicate with your healthcare provider if you find that tadalafil is ineffective, or if you encounter any adverse effects.
For those utilizing tadalafil for PAH, it is imperative to grasp that while this medication can manage the condition, it does not present a cure. Always continue with your prescribed dosage, even if you experience an improvement; consult your doctor before considering any discontinuation of the medication.
Do not hesitate to request a copy of the patient information from your healthcare provider or pharmacist.
At times, this medication may be prescribed for alternative purposes; consult your healthcare provider or pharmacist for further details.
Precautions Prior to Tadalafil Use
- Inform your healthcare provider and pharmacist if you have a known allergy to tadalafil or anything else contained within the tablets. Request a detailed ingredient list from your pharmacist.
- Notify your physician if you are currently taking or have recently consumed riociguat (Adempas) or nitrate medications, such as isosorbide dinitrate (Isordil), isosorbide mononitrate (Monoket), and nitroglycerin (Minitran, Nitro-Dur, Nitromist, Nitrostat, and others). These nitrates are available in forms such as oral tablets, sublingual tablets, sprays, patches, pastes, and ointments. If uncertain about whether your medications include nitrates, consult your healthcare professional. Generally, tadalafil should not be co-administered with nitrates.
- Advise your doctor if you consume illicit drugs with nitrate properties, often termed as 'poppers,' such as amyl nitrate, butyl nitrate, or nitrite during your tadalafil therapy; your healthcare provider will likely caution you against the concurrent use of tadalafil with these substances.
- Be cognizant that tadalafil is marketed under the brand names Adcirca and Cialis. Treatment should only be conducted with one of these formulations at any given time.
- Inform your healthcare provider and pharmacist about all medications (prescription and over-the-counter), vitamins, and dietary supplements you are currently taking or intend to take. Special attention should be given to alpha-blockers (e.g., alfuzosin, doxazosin, dutasteride, prazosin, silodosin, tamsulosin, terazosin), amiodarone, various antifungal agents, aprepitant, bosentan, carbamazepine, clarithromycin, diltiazem, and other specified agents. Your doctor may need to alter your medication dosages or monitor you closely for potential adverse effects.
- Disclose any herbal products you are using, particularly St. John’s Wort, to your healthcare provider.
- Notify your doctor if you engage in smoking, have previously experienced an erection lasting beyond 4 hours, or if you’ve encountered dehydration due to diarrhea, vomiting, or excessive perspiration. Additionally, if you have or have previously had pulmonary veno-occlusive disease (PVOD), penile deformities, diabetes, high cholesterol levels, fluctuating blood pressure, irregular heartbeat, heart disease, stroke, stomach ulcers, bleeding disorders, or any severe kidney, liver, or heart conditions, inform your doctor. Lastly, alert your healthcare provider if you or any family member has a history of eye diseases, particularly retinitis pigmentosa, or if you have previously suffered sudden, significant vision loss.
- If you are a woman utilizing tadalafil for PAH, make sure to notify your doctor if you are pregnant, planning to conceive, or currently breastfeeding. Contact your physician if you become pregnant during treatment.
- Informed your healthcare provider or dentist if you are scheduled for surgery, including dental procedures, while being treated with tadalafil.
- Discuss with your healthcare provider the safe consumption of alcohol during your tadalafil treatment. Excessive drinking (more than five glasses of wine or five shots of whiskey) can lead to an increased risk of side effects such as dizziness, headaches, and changes in blood pressure.
- If you are using tadalafil for erectile dysfunction, inform your healthcare provider if you have ever been advised to refrain from sexual activity for medical reasons or if you have experienced chest pain during sexual activities.
- It is imperative to keep your healthcare providers informed that you are on tadalafil. In the event of an emergency relating to heart problems, ensure they are aware of your last dose.
Consult your healthcare provider regarding dietary restrictions, especially concerning food and grapefruit juice while on this medication.
If a dose of tadalafil for erectile dysfunction is missed, take it as soon as it comes to mind. However, if the next dose is nearing, skip the missed one and continue with your regular schedule. Do not double the dosage or take more than once a day.
In cases of missed doses for PAH or BPH, take the missed dose promptly upon remembering it. Nonetheless, if the next dose is approaching, skip the missed dose and stick with your standard regimen. Avoid doubling the dose to compensate for a missed one.
Potential Side Effects of Tadalafil
Tadalafil may elicit side effects. Seek medical assistance if you encounter any severe or persistent symptoms including:
- Headaches
- Indigestion or heartburn
- Nausea
- Diarrhea
- Flushing of the skin
- Pain in the back, stomach, muscles, arms, or legs
- Persistent cough
Some side effects may warrant immediate medical attention:
- Sudden alterations in vision, including decrease or loss
- Blurred vision quality
- Changes in color vision, particularly blue hues
- Sudden changes to hearing capability
- Tinnitus or ringing sensations in ears
- Prolonged erection (lasting more than 4 hours)
- Dizziness
- Angina or chest pain
- Visible skin reactions, such as rashes or hives
- Breathing or swallowing difficulties
- Facial, throat, tongue, or limb swelling
- Skin blistering or peeling
Reports indicate that some individuals experienced sudden partial or complete vision loss post-tadalafil ingestion. In certain instances, this loss was irreversible. The correlation between the medication and vision impairment remains ambiguous. If you experience sudden visual disturbances, seek immediate medical help and refrain from taking further tadalafil or similar medications like sildenafil or vardenafil until consulting your healthcare provider.
Similar reports have surfaced concerning sudden auditory losses linked to tadalafil. This condition often affects one ear and does not consistently improve upon medication cessation. The relationship between this side effect and the medication remains unclear. In the event of hearing loss paired with ringing or dizziness, contact your healthcare provider immediately and avoid further doses until an assessment is made.
Tadalafil may induce other unusual side effects. If any atypical symptoms arise during treatment, reach out to your healthcare professional.
Should you develop severe adverse effects, either you or your physician should report them to the FDA’s MedWatch program through their online portal or by contacting 1-800-332-1088.
Keep tadalafil in its original container, securely closed, and out of children's reach. Store at room temperature, away from excessive heat and moisture. Avoid keeping it in bathrooms.
Disposal of unused medications should be conducted carefully to prevent accidental ingestion by children or pets. Do not discard medications by flushing them. The optimal disposal method is through a drug take-back program. Contact your pharmacist or local waste management for information on available drug disposal initiatives. For more guidance on safe medication disposal, refer to the FDA’s website.
It is vital to secure all medications from children, as many containers (like weekly pill organizers, creams, patches, and inhalers) are not child-proof. To avert poisoning risks, always use child-resistant caps and store medications in a safe, out-of-sight place.
In the event of an overdose, contact the Poison Control Center or your local emergency services immediately. If the individual presents with serious symptoms such as unconsciousness, seizures, or trouble breathing, call emergency services without delay.
Ensure that you attend all scheduled appointments with your healthcare provider.
Do not share your medication with anyone else. If you have questions about your refill or prescription, consult your pharmacist.
It is essential to maintain a written log of all medications you are on, encompassing prescribed, over-the-counter, and supplement types. Bring this list to each doctor's appointment and keep it accessible in emergencies.
- Adcirca®
- Cialis®
- Entadfi® (as a combination product containing finasteride and tadalafil)