What is tadalafil used for?

Tadalafil is a medication that serves several therapeutic purposes. It is primarily utilized for treating conditions related to erectile dysfunction, pulmonary arterial hypertension, and benign prostatic hyperplasia.

  • Erectile dysfunction (ED), which is a medical condition characterized by the inability to achieve or maintain an erection sufficient for sexual performance
  • Pulmonary arterial hypertension (PAH), a severe condition that involves increased blood pressure in the arteries that lead to the lungs
  • Benign prostatic hyperplasia (BPH), an enlargement of the prostate gland that often presents urinary symptoms

Additionally, tadalafil may be employed to manage other conditions as deemed appropriate by your healthcare provider, expanding its utility in various clinical scenarios.

How does tadalafil work (mechanism of action)?

Tadalafil operates by inhibiting an enzyme known as phosphodiesterase type 5 (PDE5). Normally, PDE5 restricts the relaxation of certain muscle types, particularly in the walls of blood vessels. By inhibiting this enzyme, tadalafil promotes relaxation of smooth muscle tissue, allowing for increased blood flow. In cases of erectile dysfunction, this enhanced blood flow to the penis facilitates the achievement and maintenance of an erection during sexual arousal. In pulmonary arterial hypertension, tadalafil aids in dilating the blood vessels within the lungs, which helps to lower blood pressure and alleviate cardiac stress. Moreover, in benign prostatic hyperplasia, it serves to relax the muscles surrounding the bladder and prostate, thereby improving urinary flow and decreasing associated symptoms.

How is tadalafil supplied (dosage forms)?

Brands and other names

  • Adcirca
  • Alyq
  • Cialis 
  • Tadliq 

Dosage forms and strengths

  • 20 mg/5 mL oral suspension
  • 2.5 mg oral tablets
  • 5 mg oral tablets
  • 10 mg oral tablets
  • 20 mg oral tablets

How should I store tadalafil?

For optimal efficacy, tadalafil should be stored under controlled conditions, specifically at room temperature within the range of 68°F to 77°F (20°C to 25°C). It is acceptable for tadalafil to be briefly exposed to temperatures ranging from 59°F to 86°F (15°C to 30°C) for transportation purposes. Ensure it is kept in a cool, dry environment to maintain its stability and effectiveness.

Side Effects

What are the most common side effects of tadalafil?

The most common adverse effects associated with tadalafil are enumerated below. These side effects may vary based on individual circumstances, as well as the specific condition being treated. It is imperative to inform your healthcare provider should any of these effects become bothersome or persistent.

  • Headache
  • Flushing
  • Upset stomach 
  • Nasal congestion
  • Muscle pain, including discomfort in the back, arms, or legs
  • Nausea
  • Dizziness

There may be other side effects related to tadalafil that are not listed here. Should you suspect you are experiencing side effects, prompt communication with your healthcare provider is essential. In the United States, adverse effects can be reported to the FDA through www.fda.gov/medwatch or by calling 800-FDA-1088. For Canadian patients, side effects can be reported to Health Canada at www.health.gc.ca/medeffect or by contacting 866-234-2345.

What are the serious side effects of tadalafil?

While serious side effects are comparatively rare, the following significant adverse effects associated with tadalafil are important to acknowledge, along with recommendations for action if they occur.

Severe Allergic Reactions. Tadalafil has the potential to provoke allergic reactions, which may be serious. Should you experience any symptoms indicative of a severe allergic reaction, it is crucial to cease tadalafil and seek immediate medical assistance.

  • Breathing difficulties or wheezing
  • Rapid heartbeat
  • Fever or a general sense of unwellness
  • Swollen lymph nodes
  • Swelling in the face, lips, mouth, tongue, or throat
  • Difficulty swallowing or tightness in the throat
  • Itching, skin rashes, or raised red bumps on the skin known as hives
  • Nausea or vomiting
  • Dizzyness, lightheadedness, or fainting
  • Abdominal cramps
  • Joint discomfort

Painful, Prolonged Erection (Priapism). Tadalafil may occasionally induce an erection that is not only persistent and unwanted but also painful, which can occur independently of sexual arousal. Failure to treat priapism urgently can lead to irreversible damage to the penis. If you experience an erection that lasts more than four hours, or one that is unrelated to sexual stimulation, seek emergency medical help immediately, especially if you feel pain or tenderness.

  • Erection that persists for more than four hours
  • Erection not associated with sexual arousal
  • Penile pain or tenderness

Low Blood Pressure (Hypotension). Tadalafil can lead to a significant reduction in blood pressure levels. If you start feeling faint or dizzy, it is recommended to lie down until assistance can be sought. Inform your healthcare provider immediately if you experience signs of low blood pressure.

  • Dizziness or faintness
  • Confusion
  • Feeling unusually weak or fatigued

Vision Changes. One of the potential side effects of tadalafil includes mild, temporary changes in vision, such as seeing a blue tint, unusual color perceptions, blurred vision, or increased sensitivity to light. Although rare, some individuals have reported cases of permanent vision loss. Should you notice sudden vision loss in either one or both eyes, immediate medical intervention is essential.

Hearing Loss. Tadalafil may lead to a sudden decrease or loss of hearing capabilities. If you experience hearing loss or any associated symptoms, promptly cease taking tadalafil and consult your healthcare provider.

  • Ringing in the ears (tinnitus)
  • Dizziness

Warnings & Precautions

Who should not use tadalafil?

Allergies to Ingredients. Individuals who are hypersensitive to any of the components listed below should refrain from using tadalafil.

  • Tadalafil
  • Cialis
  • Alyq
  • Adcirca
  • Tadliq
  • Any other ingredients specific to the formulation you have received

Your pharmacist is a valuable resource for providing detailed ingredient information for the specific tadalafil products available.

Drug Interactions. It is critical to avoid concurrent use of tadalafil with certain medications. Prior to commencing tadalafil, inform your healthcare provider regarding any prescription or over-the-counter (OTC) medications, vitamins, herbal products, and supplements you are currently taking. Refer to the Interactions section for comprehensive details.

What should I know about tadalafil before using it?

Only take tadalafil if it has been specifically prescribed for you by a qualified healthcare provider. Follow your prescription guidelines precisely.

Do not share your tadalafil prescription with others, even if they exhibit similar conditions; it could be harmful to them.

Store tadalafil securely, ensuring it remains out of the reach of children.

Engaging in sexual activity introduces potential strain on the heart, which could be hazardous for individuals with specific health issues, particularly if there has been a recent heart attack. Discuss with your healthcare provider if your cardiovascular health permits sexual activity. Should you experience chest pain, dizziness, or nausea during sexual activity, cease immediately and contact your healthcare provider without delay.

Tadalafil does not confer protection against sexually transmitted infections, including HIV.

Tadalafil is classified as a member of the phosphodiesterase-5 (PDE-5) inhibitors, which are prescribed for erectile dysfunction and pulmonary arterial hypertension. It is inadvisable to use multiple PDE-5 inhibitors simultaneously. This category comprises avanafil (Stendra), sildenafil (Viagra, Revatio, and others), tadalafil (Cialis and others), and vardenafil (Levitra, Staxyn).

If you are utilizing liquid tadalafil, it is imperative to shake the bottle vigorously for 30 seconds before each use. Employ an accurate measuring instrument to ascertain your dose. Household spoons lack precision and risk inaccurate dosing; consult your pharmacist for recommendations on suitable measuring tools.

What should I tell my healthcare provider before using tadalafil?

Inform your healthcare provider about any and all health conditions you have, alongside any prescription or OTC medications, vitamins, herbal products, and other supplements you are currently taking. This information is crucial for determining the appropriateness of tadalafil for your situation.

Specifically, ensure that you discuss any of the following health concerns with your healthcare provider:

Current and Past Health Conditions. Disclose any relevant health issues to your healthcare provider, including:

  • Cardiovascular problems, including arrhythmias, angina, or congestive heart failure
  • Recent history of heart attack, stroke, or heart surgery within the past six months
  • Low blood pressure
  • Uncontrolled high blood pressure
  • Peyronie’s disease, characterized by abnormal curvature of the penis
  • An episode of erection lasting beyond four hours
  • Blood disorders, including sickle cell anemia, multiple myeloma, or leukemia
  • Inherited eye disorders such as retinitis pigmentosa
  • History of vision impairment or optic nerve issues
  • Conditions increasing the risk of optic nerve damage, including diabetes, hyperlipidemia, smoking, age over 50, or having a “crowded optic disc” as might be noted in an eye examination
  • Auditory issues
  • Blood clotting disorders
  • Gastrointestinal ulcers
  • Renal impairment
  • Severe liver dysfunction
  • Pulmonary veno-occlusive disease, characterized by obstruction in pulmonary blood vessels

Pregnancy. The effects of tadalafil on pregnancy and fetal safety remain uncertain. You should inform your healthcare provider if you are pregnant or contemplating pregnancy to receive guidance on the appropriateness of tadalafil's use in such cases.

Breastfeeding.  The transference of tadalafil into breast milk is not well understood. It is wise to inform your healthcare provider of your breastfeeding status or if you plan to breastfeed.

Interactions

Does tadalafil interact with foods or drinks?

Your healthcare provider may recommend minimizing or avoiding grapefruit consumption while taking tadalafil. This is due to grapefruit and its juice having the potential to elevate tadalafil concentrations within your system, thus increasing the likelihood of experiencing adverse effects.

While the implications of alcohol on tadalafil are not entirely established, consuming alcohol may heighten the risk of encountering low blood pressure and dizziness. Therefore, it is advisable to moderate alcohol intake while undergoing treatment with tadalafil.

Does tadalafil interact with other medicines (drug interactions)?

Ensure that you always disclose any prescription or OTC medications, vitamins, herbal products, and other supplements to your healthcare provider before starting tadalafil.

In particular, discuss any of the following substances you are currently using before initiating tadalafil:

  • Nitrates, such as nitroglycerin (Nitro-Dur, Nitrostat, and others) or isosorbide, typically utilized for managing chest pain resulting from heart conditions, or recreational drugs like amyl nitrite (“poppers”)
  • Guanylate cyclase stimulators, including riociguat (Adempas) for pulmonary arterial hypertension or vericiguat (Verquvo) for heart failure
  • Alpha-blockers, such as alfuzosin (Uroxatral), doxazosin (Cardura), dutasteride, prazosin (Minipress), silodosin (Rapaflo), tamsulosin (Flomax), or terazosin (Hytrin), commonly prescribed for elevated blood pressure or urinary issues due to prostate enlargement
  • Antihypertensives, like amlodipine (Norvasc) or enalapril (Vasotec)
  • Bosentan (Tracleer), indicated for pulmonary arterial hypertension
  • Protease inhibitors, such as ritonavir (Norvir) utilized for HIV treatment
  • Rifampin (Rifadin), used to treat tuberculosis
  • Antifungal medications, including ketoconazole or itraconazole (Sporanox, Tolsura)
  • Macrolide antibiotics like erythromycin (Ery-Tab and others) or clarithromycin (Biaxin)
  • Any other medications prescribed for erectile dysfunction or pulmonary arterial hypertension

Other medicines may also modify the serum concentrations of tadalafil. Always consult your healthcare provider regarding any medications you are taking or have recently completed.

This may not represent an exhaustive list of all medications that could interact with tadalafil. Always verify with your healthcare provider for comprehensive guidance.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much tadalafil?

If you or someone else has consumed an excessive amount of tadalafil, seek immediate medical attention by calling 911 or contacting a Poison Control center at 800-222-1222. Prompt action is crucial in managing any potential overdose effects.

What should I do if I miss a dose of tadalafil?

If you realize that you have missed a scheduled dose, take it as soon as you remember. However, if it is nearing the time for your next dose, skip the missed dose and proceed with the next dose. Under no circumstances should you take a double or extra dose.

Some formulations of tadalafil are designed to be taken only on an as-needed basis. Adhere to your healthcare provider's recommendations regarding dosage. Never take more than the prescribed dose.

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