Tadalafil (Cialis) is primarily prescribed for the treatment of erectile dysfunction (ED), characterized as the inability to achieve or maintain a proper erection, and for alleviating the symptoms associated with benign prostatic hyperplasia (BPH), which is an enlargement of the prostate. Symptoms of BPH include difficulty urinating, which can manifest as hesitancy, dribbling, weak urinary stream, and feelings of incomplete bladder emptying. Additionally, individuals may experience pain during urination as well as an increased urgency and frequency of urination. Furthermore, Tadalafil (Adcirca) is utilized to enhance exercise capacity in patients suffering from pulmonary arterial hypertension (PAH), a condition marked by high blood pressure in the arteries that supply the lungs. This may lead to symptoms such as shortness of breath, dizziness, and fatigue. Tadalafil is classified as a phosphodiesterase type 5 inhibitor (PDE5 inhibitor), and functions by enhancing blood flow to the penis during sexual stimulation in order to facilitate an erection. In the context of PAH, Tadalafil works by relaxing the blood vessels in the lungs, enhancing blood flow.
It is crucial to communicate that while Tadalafil effectively manages ED, it does not serve as a cure nor does it augment sexual desire. Additionally, Tadalafil does not offer protection against pregnancy or sexually transmitted infections, including HIV.
Tadalafil is available as an oral tablet and can be taken with or without food, offering flexibility for daily or situational use. For individuals taking Tadalafil for erectile dysfunction, adherence to physician guidelines is imperative. Tadalafil can be taken in one of two ways: on a daily schedule or as needed. A healthcare provider will help determine the most appropriate regimen for each patient. In cases where Tadalafil is taken as needed, it is advised to do so at least 30 minutes prior to sexual engagement, and usage should not exceed once in 24 hours. For those on a daily regimen, consistent timing each day is encouraged. Certain health conditions or concurrent medications may warrant a modification in frequency or dosage - possibly prescribing a lower daily dose. Patients are strongly urged to follow the instructions on their medication label and seek clarification from their healthcare provider when necessary. Tadalafil must be adhered to as prescribed; deviations in dosage or frequency can lead to adverse effects.
For individuals using Tadalafil to address PAH or BPH, following the health provider's instructions remains paramount. Tadalafil should be taken once daily, ensuring that all tablets for the daily dose are ingested at once, without splitting dosages. A consistent timing each day will promote better outcomes. If additional medications for BPH are simultaneously prescribed, a healthcare provider may recommend discontinuation of those prior to initiating Tadalafil. It is essential to closely adhere to a physicians' recommendations and seek clarification on any aspects of the dosage that remain unclear.
Initially, if using Tadalafil for erectile dysfunction, a moderate starting dose will be prescribed, which may be adjusted based on the patient's response. Should Tadalafil yield unsatisfactory results or produce adverse reactions, it is vital to keep the healthcare provider informed.
In the case of PAH treatment, patients should be advised that Tadalafil manages the condition but does not offer a cure. Continuous usage of Tadalafil is recommended even during periods of feeling well, and cessation of the medication without medical consultation is ill-advised.
Patients may request a copy of the manufacturer's informative literature from their pharmacist or physician.
This medication may also be prescribed for additional indications; consult your healthcare provider or pharmacist for more detailed information.
Before Taking Tadalafil
- Notify your healthcare provider and pharmacist if you have a known allergy to Tadalafil, any related medications, or any ingredients contained within Tadalafil tablets. A pharmacist can provide a list of ingredients upon request.
- Inform your healthcare provider if you are currently taking or have recently utilized riociguat (Adempas) or any nitrates, such as isosorbide dinitrate (Isordil, etc.), isosorbide mononitrate (Monoket, etc.), or nitroglycerin (various brand names). Nitrates can come in several forms including oral tablets, sublingual variations, patches, and sprays. Confirm with your healthcare provider if uncertain about the nitrate content in your medications. Typically, Tadalafil is contraindicated with nitrate medications.
- Disclose any use of illicit drugs that contain nitrates (often referred to as "poppers"), including amyl nitrate or butyl nitrate, while under treatment with Tadalafil. Avoidance of Tadalafil is usually advised in such cases.
- Understand that Tadalafil is marketed under various brand names, specifically Adcirca and Cialis; usage of only one product at a time is recommended.
- Provide a comprehensive list of other prescription and nonprescription medications, vitamins, and nutritional supplements that you currently take or plan to take, highlighting alpha-blockers (e.g., alfuzosin, doxazosin), antifungal agents (e.g., fluconazole), and various drug classes as listed. This ensures proper dosage adjustments and monitoring for potential side effects.
- Inform your healthcare provider about any herbal supplements you are using, particularly St. John's Wort.
- Disclose smoking habits, any past incidents of prolonged erections, or recent experiences with dehydration. Conditions affecting cardiovascular health, diabetes, disorders impacting blood flow, or liver disease should also be communicated. If there have been eye conditions within your family history or personal experiences of sudden vision change, this is essential information.
- If you are a woman considering Tadalafil for PAH, advise your healthcare provider if you are pregnant, planning to become pregnant, or breastfeeding. Report any pregnancy during Tadalafil treatment to your healthcare provider.
- Prior to any surgical procedures, including dental work, inform your doctor or dentist of Tadalafil usage.
- Discuss with your healthcare provider regarding alcohol consumption during Tadalafil therapy, as excessive intake could heighten the risk of side effects.
- If utilizing Tadalafil for erectile dysfunction, communicate any prior medical advice against sexual activity or experiences of chest pain during sexual engagements; such activities may pose risks if cardiovascular health is compromised.
- Ensure all healthcare professionals involved in your care are aware of your Tadalafil usage, especially in emergency situations.
Consult your healthcare provider concerning dietary considerations, particularly regarding grapefruit juice while on Tadalafil.
For patients regularly taking Tadalafil for erectile dysfunction, if a dose is missed, take it as soon as you remember. If the next dose is imminent, skip the missed dose and resume your regular schedule; do not double doses.
For those taking Tadalafil for PAH or BPH, the same missed dose protocol applies: take it upon remembering unless the next dose is approaching; then proceed with the normal schedule without doubling.
Tadalafil may cause side effects. Report any persistent or severe symptoms to your healthcare provider:
- Headache
- Indigestion or heartburn
- Nausea
- Diarrhea
- Facial flushing or warmth
- Back, muscle, arm, or leg discomfort
- Coughing
Seek immediate medical attention for serious side effects:
- Sudden vision loss or decrease (further information may be provided)
- Blurred vision
- Altered color vision
- Sudden hearing loss or ringing in the ears
- Erection lasting longer than four hours (priapism)
- Chest pain
- Skin reactions, such as rashes or hives
- Difficulty breathing or swallowing
- Swelling in various parts of the body
- Skin changes, including bubbles or peeling
Reports indicate that some individuals have experienced sudden vision impairment after using Tadalafil or comparable medications, with some cases being permanent. It remains uncertain if the medication causality can be established; therefore, report any vision change immediately. Avoid further doses of Tadalafil or similar options until after consulting a healthcare provider.
Similarly, sudden auditory changes, typically affecting one ear, have been documented post-Tadalafil use. If this occurs, reach out for immediate medical assistance, refraining from additional doses until discussing it with a healthcare provider.
Should other unusual effects arise during treatment, contact your healthcare provider for guidance.
In the event of serious side effects, patients or their healthcare providers can report occurrences to the FDA's 'MedWatch' program through the website https://www.fda.gov/Safety/MedWatch or by telephone at 1-800-332-1088.
Store this medication in its original container, tightly closed, and out of reach of children. Maintain a room temperature environment while ensuring it's kept away from excessive heat and moisture; avoid keeping it in the bathroom.
Proper disposal of unused medications is crucial, and flushing them down the toilet is inadvisable. Utilize drug take-back programs to ensure safe disposal where available. Consult your pharmacist for more information on local drug take-back initiatives. For additional guidance on safe medication disposal, visit the FDA’s website https://goo.gl/xRXbPn.
Keeping medications out of children’s reach is paramount, as non-child-resistant containers pose a risk. Use safety caps and designate a storage location out of sight to minimize poisoning risks. For further guidance on this matter, please visit https://www.upandaway.org/en/.
In cases of overdose, contact the poison control helpline at 1-800-222-1222. For immediate emergencies, if the person is unresponsive, has collapsed, or is experiencing difficulty in breathing, call emergency services at 911.
Make it a priority to attend all scheduled physician appointments.
Medication should only be used by the individual prescribed; avoid allowing anyone else to use your medication. Any inquiries regarding refilling your prescription should be directed to your pharmacist.
Maintain an up-to-date list of all medications you take, including prescriptions and over-the-counter products, as well as vitamins and dietary supplements. This list should accompany you during healthcare visits or when facing hospitalization, and is critical in emergencies.
- Adcirca®
- Cialis®
- Entadfi® (combination product with finasteride, tadalafil)