Tadalafil (Cialis) is a prescription medication primarily used to treat erectile dysfunction (ED), which is defined as the inability to obtain or maintain an erection satisfactory for sexual performance. In addition to its use for erectile dysfunction, tadalafil is also indicated for the treatment of benign prostatic hyperplasia (BPH), which refers to the non-cancerous enlargement of the prostate gland. Symptoms of BPH may include difficulty urinating, such as hesitancy, dribbling, weak urinary stream, and sensation of incomplete bladder emptying. Moreover, tadalafil is employed in the management of pulmonary arterial hypertension (PAH), a condition characterized by high blood pressure in the arteries that supply the lungs, leading to symptoms like shortness of breath, dizziness, and fatigue.
It is critical to understand that tadalafil does not provide a cure for erectile dysfunction and does not increase sexual desire. Furthermore, tadalafil does not act as a contraceptive and does not prevent the transmission of sexually transmitted infections, including the human immunodeficiency virus (HIV).
Tadalafil is available in tablet form for oral administration and can be taken with or without food. There are two main dosage regimens for tadalafil: it can be taken as needed or on a daily basis. Patients should consult with their healthcare provider to determine which dosing schedule is most appropriate for their needs.
For those taking tadalafil on an as-needed basis, it is generally recommended to take the medication at least 30 minutes before engaging in sexual activity, with the understanding that it should not be taken more often than once every 24 hours. Alternatively, tadalafil can be taken daily, allowing for sexual activity at any time between doses. To optimize the effectiveness of the medication, patients should aim to take it at approximately the same time each day if following a daily regimen.
In the case of treating BPH or PAH, patients are typically advised to take tadalafil once daily. It is essential that all tablets be taken together as part of the daily dose, and they should not be divided into smaller doses. It's also advisable to take tadalafil at a consistent time each day. If a patient is already on other medications for BPH, their healthcare provider might suggest discontinuing those medications at least one day prior to starting tadalafil.
When initiating treatment for erectile dysfunction, healthcare providers often start patients on a moderate dose of tadalafil, which may then be adjusted based on individual response and tolerance. Patients should inform their doctor if tadalafil does not yield desired results or if side effects are experienced.
While tadalafil effectively manages PAH, it is essential to note that it does not cure the condition. Patients are advised to continue taking tadalafil even if they feel well, and cessation of the medication should only be done under medical guidance.
Patients should request a copy of the manufacturer's patient information leaflet from their pharmacist or healthcare provider to further understand the medication.
Occasionally, tadalafil may be prescribed for other medical conditions; patients should consult their doctor or pharmacist for additional information regarding these uses.
Before Taking Tadalafil
- Disclose any allergies to tadalafil or any other medications to your healthcare provider. Review the list of ingredients in tadalafil tablets with your pharmacist.
- Inform your doctor if you are taking or have taken medications such as riociguat (Adempas) or nitrates (e.g., isosorbide dinitrate, nitroglycerin), as the combination can lead to serious complications.
- Let your doctor know if you are using illegal drugs that contain nitrates, as they may pose additional risks when taken with tadalafil.
- Be aware that tadalafil is marketed under different brand names, and patients should use only one of these medications at a time.
- Include all medications, supplements, and herbal products you are taking with your healthcare provider. Special attention should be given to alpha-blockers and certain antifungal agents, as well as any medications that may affect blood pressure.
- Notify your doctor if you smoke, have had prolonged erections, or have any medical conditions such as pulmonary issues, cardiovascular diseases, diabetes, or blood disorders.
- Pregnant or breastfeeding women should consult their doctor before using tadalafil, and those considering surgery should inform their surgeon or dentist of their tadalafil usage.
- Discuss your alcohol consumption with your doctor, as excessive drinking may aggravate tadalafil's side effects.
- Consult your healthcare provider if you have been advised to avoid sexual activity for medical reasons, especially if you experience chest pain during sexual engagement.
- Inform all healthcare providers about your tadalafil use, especially in emergencies.
Consult your doctor regarding the consumption of grapefruit juice while using tadalafil, as it may affect the medication's efficacy.
If a dose of tadalafil for erectile dysfunction is missed, take it as soon as you remember unless it is nearly time for your next dose; in such cases, skip the missed dose and resume the regular schedule. Do not take two doses at once.
If you forget a dose of tadalafil for PAH or BPH, take it as soon as possible, following the same rule as above regarding timing of the next dose.
Tadalafil may cause side effects. Contact your healthcare provider if any of these symptoms are severe or persistent:
- Headache
- Indigestion or heartburn
- Nausea
- Diarrhea
- Hot flashes
- Pain in the back, stomach, muscles, arms, or legs
- Coughing
Serious side effects warrant immediate medical attention:
- Sudden loss of vision or blurred vision
- Changes in color vision and sudden loss of hearing
- Prolonged erection exceeding 4 hours (seeking immediate help is essential)
- Dizziness, chest pain, hives, rashes
- Difficulty breathing or swallowing and facial swelling
- Skin blistering or peeling
Patients have reported sudden vision loss which may occur after taking tadalafil or similar medications. This has resulted in permanent loss in some cases. Should you experience sudden vision changes, contact your healthcare provider immediately.
Sudden hearing loss has also been reported, typically affecting one ear; therefore, if you experience this symptom, seek medical attention promptly.
If unusual or serious side effects occur while on tadalafil, reach out to your doctor for further guidance.
To report severe side effects, the FDA's MedWatch Adverse Event Reporting program can be accessed online or via a dedicated phone line.
Store this medication in its original container, well-sealed and out of children’s reach. Keep at room temperature, avoiding excessive heat and moisture.
Proper disposal of unused medications is crucial to prevent accidental ingestion by children or pets. Consult local disposal programs or use designated drug take-back options to eliminate medications safely.
Always store medications securely, out of children's sight and reach. Utilize child-proof caps and ensure a safe storage location.
In case of overdose, contact the poison control center or seek immediate medical intervention if serious symptoms such as fainting, seizures, or difficulty breathing occur.
Attend all follow-up appointments with your healthcare provider to ensure proper management of your treatment.
Do not share your medication with others, and ask your pharmacist if you have questions regarding prescription refills.
Maintain a list of all medications you are taking, including over-the-counter drugs and supplements, to share with your healthcare provider during visits or emergencies.
- Adcirca®
- Cialis®
- Entadfi® (as combination products containing finasteride and tadalafil)