Tadalafil (Cialis) is primarily utilized for the treatment of erectile dysfunction (ED), which is characterized by the inability to achieve or sustain an erection, as well as for alleviating the symptoms associated with benign prostatic hyperplasia (BPH; the non-cancerous enlargement of the prostate). Common symptoms of BPH include difficulty with urination, such as hesitation, dribbling, weak urine stream, and incomplete bladder emptying. Other symptoms may include painful urination, increased urinary frequency, and the urgency to urinate in adult males. Additionally, tadalafil (Adcirca) is prescribed to enhance exercise capacity for individuals suffering from pulmonary arterial hypertension (PAH; a condition marked by elevated blood pressure in the arteries supplying blood to the lungs, leading to symptoms like breathlessness, dizziness, and extreme fatigue). Tadalafil functions as a member of the phosphodiesterase type 5 (PDE5) inhibitors class of medications. Its therapeutic action in the treatment of ED involves increasing blood flow to the penis during sexual arousal, facilitating the potential for an erection. Furthermore, tadalafil ameliorates PAH by relaxing the blood vessels in the lungs, promoting easier blood flow.
It is crucial for patients using tadalafil for erectile dysfunction to understand that it does not offer a cure for the condition nor does it enhance sexual desire. Furthermore, tadalafil does not act as a contraceptive nor does it protect against sexually transmitted infections (STIs) such as human immunodeficiency virus (HIV).
Tadalafil is dispensed in tablet form for oral administration. It can be consumed with or without food. If you are prescribed tadalafil for erectile dysfunction, adherence to your physician's recommendations and the outlined guidelines is vital. There are two primary methods for consumption: daily or on an as-needed basis. Consult with your healthcare provider to determine the most appropriate dosing schedule tailored to your needs. Tadalafil may be taken as needed, generally at least half an hour prior to engaging in sexual activity, but not exceeding once within a 24-hour period. Your doctor will assist you in identifying the optimal time to take tadalafil before sexual encounters. In certain situations, tadalafil may also be prescribed for once-daily administration independent of sexual activity timing, allowing for attempts at sexual activity at any time between doses. If you follow a regular dosing schedule, strive to take it around the same time each day. In instances where you have specific health conditions or are prescribed other medications, your doctor may recommend a reduced frequency of tadalafil intake or a lower daily dose. Always adhere to the instructions found on your prescription label and seek clarification from your doctor or pharmacist regarding any uncertainties. Take tadalafil precisely as directed by your healthcare provider; do not adjust your dosage or frequency without professional guidance.
If you are prescribed tadalafil for treating PAH or BPH, it is imperative to follow your doctor’s directives closely. Tadalafil must be taken once per day. All tablets for your daily dosage should be ingested at one time; do not divide the tabs into smaller doses. Aim to take tadalafil at approximately the same time daily. If you are currently on medications for BPH, your healthcare provider may advise you to halt these medications at least one day prior to starting tadalafil therapy. Take care to adhere to your physician's instructions and seek clarification on any aspects that are not clear.
Your physician may initiate treatment with a moderate dose of tadalafil for erectile dysfunction, adjusting it based on your responses and feedback. If tadalafil fails to yield desirable effects, inform your doctor promptly regarding your situation, including any side effects you may encounter.
When being treated for PAH, it is crucial to understand that although tadalafil manages the condition, it does not cure it. Continue taking tadalafil even if you feel well and do not discontinue without consulting your doctor first.
Request a copy of the manufacturer’s patient information from your pharmacist or doctor to stay thoroughly informed.
This medication may be prescribed for various other conditions; inquire with your healthcare professional for additional details.
Before Taking Tadalafil
- Notify your healthcare provider and pharmacist if you're allergic to tadalafil, any other medications, or any components of tadalafil tablets. Ask your pharmacist for a complete list of ingredients.
- Inform your doctor if you are currently taking or have recently taken riociguat (Adempas) or nitrates such as isosorbide dinitrate (Isordil), isosorbide mononitrate (Monoket), and nitroglycerin (Minitran, Nitro-Dur, Nitromist, Nitrostat, among others). Nitrates may come in various forms, including oral tablets, sublingual tablets (to be placed under the tongue), sprays, patches, pastes, and ointments. If uncertain about any of your medications containing nitrates, consult your doctor. If you are on nitrates, expect your doctor to likely advise against taking tadalafil.
- Inform your healthcare provider if you are using illegal drugs containing nitrates ('poppers') such as amyl nitrate, butyl nitrate, or nitrites while on tadalafil. Your doctor may advise against tadalafil if you are using such substances.
- It is important to recognize that tadalafil is marketed under the brand names Adcirca and Cialis. You should only be treated with one of these brands at a time.
- Inform your healthcare providers about all medications you are taking or planning to take, including over-the-counter drugs, vitamins, and dietary supplements. It is especially crucial to inform them of any of the following: alpha-blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), dutasteride (Avodart, in Jalyn), prazosin (Minipress), silodosin (Rapaflo), tamsulosin (Flomax, in Jalyn), and terazosin; amiodarone (Cordarone, Pacerone); certain antifungal agents including fluconazole (Diflucan), griseofulvin (Grifulvin, Gris-PEG), itraconazole (Onmel, Sporanox), ketoconazole (Extina, Ketozole, Nizoral, Xolegel), and voriconazole (Vfend); aprepitant (Emend); bosentan (Tracleer); carbamazepine (Carbatrol, Epitol, Tegretol, Teril, and others); clarithromycin (Biaxin, in Prevpac); diltiazem (Cardizem, Cartia, Tiazac and others); efavirenz (Sustiva, in Atripla); erythromycin (E.E.S., E-Mycin, Erythrocin); HIV protease inhibitors such as indinavir (Crixivan), nelfinavir (Viracept), and ritonavir (Norvir, in Kaletra); lovastatin (Altocor, in Advicor), and medications for high blood pressure; nefazodone; nevirapine (Viramune); other treatments for erectile dysfunction; other medications for PAH; phenobarbital; phenytoin (Dilantin, Phenytek); rifabutin (Mycobutin); rifampicin (Rifadin, Rimactane, in Rifamate, or Rifater); sertraline (Zoloft); telithromycin (Ketek); and verapamil (Calan, Covera, Verelan, in Tarka). Your doctor may need to adjust your medication doses or closely monitor you for adverse effects.
- Inform your healthcare provider about any herbal supplements you are currently taking, particularly St. John's Wort.
- Notify your doctor if you smoke; if you've ever experienced an erection lasting more than four hours; or if you've recently had diarrhea, vomiting, dehydration due to insufficient fluid intake, or excessive sweating. Additionally, inform your doctor if you have or have ever had pulmonary veno-occlusive disease (PVOD; veins in the lungs that are blocked), any condition affecting the shape of the penis, diabetes, high cholesterol, irregular heartbeat, heart attack or heart failure, angina (chest pain), stroke, gastric ulcers, bleeding disorders, issues with blood circulation, or blood cell disorders such as sickle cell anemia, multiple myeloma, or leukemia. Also, inform your doctor if you or any family member has ever had any eye conditions such as retinitis pigmentosa or has experienced sudden severe vision loss.
- For women taking tadalafil for PAH, it is essential to notify your doctor if you are pregnant, planning to become pregnant, or breastfeeding. Contact your physician if you become pregnant while on tadalafil.
- Should you need surgery, including dental procedures, inform your healthcare provider or dentist that you are currently taking tadalafil.
- Discuss with your doctor the safe consumption of alcoholic beverages during treatment with tadalafil. Excessive alcohol consumption (more than five glasses of wine or five whiskey drinks) while taking tadalafil may increase the likelihood of experiencing side effects like dizziness, headaches, rapid heartbeat, and low blood pressure.
- If you are taking tadalafil for erectile dysfunction, update your physician if a healthcare professional has ever advised against sexual activity for health reasons, or if you've experienced chest pain during sexual activity. Engaging in sexual activity can strain your heart, particularly if you have pre-existing heart conditions. Should you experience chest pain, dizziness, or nausea during sexual activities, contact your doctor immediately or seek emergency medical assistance, and refrain from sexual activity until your doctor advises otherwise.
- Make sure to inform all your healthcare providers that you are taking tadalafil. If emergency medical treatment is ever required for a heart-related issue, you must inform the treating providers when you last ingested tadalafil.
Consult your healthcare provider regarding the consumption of grapefruit juice while taking this medication as it may affect how the drug works.
If you take tadalafil for erectile dysfunction regularly and miss a dose, take it as soon as you recall. However, if it's near the time for your next dose, skip the missed dose and proceed with your usual schedule. Never double the dose or administer more than once daily to compensate for a missed one.
If you are using tadalafil for PAH or BPH and miss a dose, take it as soon as you remember. Should it be close to the next scheduled dose, skip the missed dose and continue as per your regular regimen. Do not double the dose to make up for the missed one.
Tadalafil may result in side effects. Notify your doctor if any of these symptoms are severe or persist:
- Headaches
- Indigestion or heartburn
- Nausea
- Diarrhea
- Facial flushing
- Pain in the stomach, back, muscles, arms, or legs
- Coughing
Serious side effects may arise. If you encounter any of these symptoms, call your physician immediately or seek emergency medical assistance:
- Sudden decrease or loss of vision (further information below)
- Blurred vision
- Changes in color perception (such as seeing a blue tint on objects or difficulty differentiating blue from green)
- Sudden decrease or loss of hearing (further information below)
- Tinnitus (ringing in the ears)
- Erection lasting more than four hours
- Dizziness
- Chest pain
- Hives
- Rash
- Difficulty in breathing or swallowing
- Swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or calves
- Severe skin reactions, such as blistering or peeling
Some individuals have reported sudden partial or complete vision loss while using tadalafil or similar medications, with some cases leading to permanent vision loss. It remains undetermined whether the medication caused the vision loss. Should you experience sudden visual impairment while taking tadalafil, contact your doctor promptly or seek immediate medical help. Do not take any further doses of tadalafil or related medications like sildenafil (Revatio, Viagra) or vardenafil (Levitra) until you've consulted your doctor.
Likewise, some patients have experienced sudden hearing loss while receiving tadalafil or similar medications. This condition typically affects only one ear and does not always improve upon discontinuation of the medication. It remains undecided whether the medication was responsible for the hearing loss. Should you face sudden auditory impairment, sometimes accompanied by tinnitus or dizziness while using tadalafil, contact your healthcare provider immediately. Refrain from taking additional doses of tadalafil or similar drugs until you've discussed it with your doctor.
Tadalafil might lead to other side effects; reach out to your doctor if you encounter any unusual issues during your treatment.
If you experience a serious adverse reaction, you can report it to the FDA's 'MedWatch' adverse event reporting program either at the internet page (https://www.fda.gov/Safety/MedWatch) or by calling 1-800-332-1088.
Store this medication in its original container, tightly sealed, and out of the reach of children. Maintain it at room temperature, away from excessive heat and humidity (avoid storing in the bathroom).
Unused medications should be disposed of properly to prevent accidental ingestion by pets, children, or others. However, do not dispose of these medications by flushing them down the toilet. Instead, the safest method for disposal is through a drug take-back program. Consult your pharmacist or contact your local waste/recycling authority for information regarding medication take-back options in your area. For further guidance on proper medication disposal, visit the FDA website at (https://goo.gl/xRXbPn).
It is critical to keep all medications out of children's sight and reach, as numerous containers (such as weekly pill organizers, and those containing eye drops, creams, patches, and inhalers) are not child-resistant and can be opened easily by young children. To prevent accidental poisoning, always use safety caps and promptly store medications in a secure location that is out of sight and reach of children. https://www.upandaway.org/en/
In the event of an overdose, contact Poison Control at 1-800-222-1222. Additional information is available online at https://www.poisonhelp.org/help. If the individual has collapsed, experienced a seizure, is having trouble breathing, or cannot be awakened, contact emergency services immediately at 911.
Attend all appointments scheduled with your healthcare provider.
Do not share your medications with others. For any queries on how to refill your prescription, consult your pharmacist.
It is essential to maintain a written list of all medications you are currently taking, including both prescription drugs and over-the-counter products, as well as vitamins and dietary supplements. Carry this list with you for every visit to your doctor or when admitted to a hospital. This information is vital in case of emergencies.
- Adcirca®
- Cialis®
- Entadfi® (as a combination product containing finasteride and tadalafil)