Tadalafil (Cialis) is primarily utilized for the treatment of erectile dysfunction (ED), which is characterized by the inability to achieve or maintain an erection necessary for satisfactory sexual activity. In addition to ED, tadalafil also addresses the symptoms associated with benign prostatic hyperplasia (BPH)—largely affecting adult men—such as difficulties in urination, discomfort during urination, as well as frequent and urgent urination. Furthermore, tadalafil (Adcirca) serves to enhance exercise tolerance in individuals coping with pulmonary arterial hypertension (PAH), a condition marked by elevated blood pressure in the blood vessels responsible for transferring blood to the lungs, which can lead to symptoms like breathlessness, dizziness, and exhaustion. As a member of the phosphodiesterase type 5 (PDE5) inhibitors, tadalafil facilitates its effects on erectile dysfunction by amplifying blood circulation to the penis during sexual arousal, which can subsequently result in an erection. In the context of treating PAH, tadalafil operates by relaxing the blood vessels within the lungs, thereby allowing for a smoother flow of blood.
It is critical to understand that while tadalafil is effective in treating erectile dysfunction, it does not offer a cure nor does it enhance sexual desire. Additionally, it is important to note that tadalafil does not serve as a contraceptive or prevent the spread of sexually transmitted diseases, such as HIV.
Tadalafil is encountered in an oral tablet formulation. It can be ingested either with food or on an empty stomach.
For those using tadalafil to manage erectile dysfunction, adherence to your healthcare provider's directions is imperative. Tadalafil can be administered through two distinct regimens: either as a daily dosage or as required. It is advisable to consult with your doctor to determine which dosing schedule is best suited for your needs. When taken as needed, tadalafil is typically consumed at a minimum of 30 minutes prior to sexual activity, but no more than once per 24-hour cycle. Your physician will assist in establishing the optimal timing for ingesting tadalafil before engaging in sexual endeavors. Conversely, if taken daily, tadalafil offers flexibility regarding sexual activity timing between doses. In this scenario, consistency is key; aim to take the medication at roughly the same hour each day. If certain health issues are present or if you are on other medications, your healthcare provider might suggest using tadalafil less frequently or at a lower dosage. It is essential to strictly adhere to the directions provided on your medication's label and to consult your doctor or pharmacist with any uncertainties. Consume tadalafil exactly as prescribed and avoid altering the dosage or frequency without professional guidance.
For patients using tadalafil for PAH or BPH, strict compliance with your healthcare provider's instructions is crucial, with a recommendation for a daily intake of tadalafil. All tablets for your daily dosage should be taken simultaneously; do not divide the tablets into smaller doses. Aim to consume tadalafil around the same time every day. If you are receiving treatment for BPH, your provider may direct you to discontinue any pre-existing medications at least one day prior to initiating tadalafil therapy.
For those treating erectile dysfunction with tadalafil, your doctor might initiate therapy with a standard dosage and subsequently adjust it according to your individual response to the medication. If you find that tadalafil is ineffective, or if you encounter adverse effects, it is important to communicate this with your healthcare provider.
In regard to PAH treatment, while tadalafil manages symptoms effectively, it is essential to recognize that it is not a definitive cure. Remain on your prescribed regimen, even when feeling well, and do not discontinue tadalafil without a prior conversation with your healthcare provider.
For more information, you may request a copy of the manufacturer's patient information regarding your medication.
This medication may sometimes be prescribed for additional uses; please consult your healthcare provider or pharmacist for more details.
Before Taking Tadalafil
- Be sure to inform your healthcare provider and pharmacist of any allergies to tadalafil, other medications, or any components in tadalafil tablets. If needed, ask your pharmacist for a comprehensive list of ingredients.
- Notify your healthcare provider if you are currently taking or have recently consumed riociguat (Adempas) or nitrates, which include medications like isosorbide dinitrate (Isordil), isosorbide mononitrate (Monoket), and nitroglycerin (various brand names). Nitrates can come in various forms, including oral tablets, sublingual tablets, sprays, patches, pastes, and ointments. If unsure, consult your doctor regarding any medications containing nitrates. Generally, your healthcare provider will likely advise against using tadalafil in conjunction with nitrates.
- If you use recreational drugs containing nitrates (often referred to as "poppers") such as amyl nitrate or nitrites, inform your healthcare provider, who may advise against tadalafil use while you are using such substances.
- Tadalafil is marketed under several brand names, including Adcirca and Cialis. You should be treated with one brand at a time to avoid complications.
- Provide your healthcare provider and pharmacist with a comprehensive list of all medications, including prescription, over-the-counter, vitamins, and dietary supplements you are currently taking or plan to take, especially those listed: alpha-blockers (e.g., alfuzosin, doxazosin, etc.), amiodarone, certain antifungals, aprepitant, bosentan, carbamazepine, clarithromycin, diltiazem, efavirenz, erythromycin, HIV protease inhibitors, lovastatin, sedatives, and others. Your doctor may need to adjust your medication regimen or closely monitor for side effects.
- Inform your healthcare provider about any herbal products you are utilizing, particularly St. John's Wort.
- Be open about your smoking habits, any history of prolonged erections lasting more than 4 hours, and any episodes of dehydration resulting from diarrhea or vomiting. These factors could potentially affect your treatment. Additionally, disclose any history of conditions such as pulmonary veno-occlusive disease, diabetes, cardiovascular issues, or any other significant medical histories, and any family history of eye diseases.
- For women, those planning to conceive or currently breastfeeding, it is important to notify your doctor if you become pregnant while taking tadalafil.
- Before any surgical procedure, including dental, it is imperative to inform your healthcare provider or dentist of your tadalafil consumption.
- Discuss with your doctor the implications of alcohol consumption while taking tadalafil. Excessive alcohol intake could heighten the risk of side effects such as dizziness, headaches, and low blood pressure.
- Inform your healthcare provider about any previous recommendations to avoid sexual activity due to medical reasons or any history of experiencing chest pain during sexual activity. If you face chest pain, dizziness, or nausea during sexual activity, seek immediate medical attention.
- Ensure that all healthcare providers are aware that you are on tadalafil. In emergency situations, this information can be crucial for proper medical attention.
Consult your healthcare provider regarding the safety of consuming grapefruit or its juice while on this medication.
If you miss a dose of tadalafil for erectile dysfunction, take it as soon as you remember unless it is close to the time for your next dose; in that case, skip the missed dose and resume your regular schedule without doubling up.
For those using tadalafil for PAH or BPH, follow similar guidelines by taking the missed dose as soon as it's remembered, but skip it if close to the time for your next scheduled dose.
Tadalafil may cause side effects. Seek medical advice if any of these side effects are severe or persist:
- Headaches
- Indigestion or heartburn
- Nausea
- Diarrhea
- Facial flushing
- Discomfort in the stomach, back, muscles, arms, or legs
- Coughing
Serious side effects may occur. If you experience any of the following symptoms, contact your healthcare provider immediately or seek emergency medical assistance:
- Sudden vision loss or decrease (refer to additional information below)
- Blurred vision
- Changes in color vision (difficulty distinguishing blue from green)
- Sudden hearing decrease or loss (refer to additional information below)
- Tinnitus or ringing in the ears
- Erections lasting longer than 4 hours
- Dizziness
- Chest pain
- Allergic reactions such as hives, rash, or itching
- Difficulty breathing or swallowing
- Facial swelling or swelling of the throat, tongue, or lips
- Skin blistering or peeling
Some patients have reported sudden partial or complete vision loss after using tadalafil or similar medications. It is not definitively established whether the medication caused this. If sudden vision loss occurs while taking tadalafil, contact your healthcare provider immediately and avoid taking further doses of tadalafil or similar drugs like sildenafil or vardenafil unless directed by a doctor.
There have also been reports of sudden hearing loss in patients using tadalafil or similar medications, often affecting one ear and sometimes not reversing upon stopping the medication. If sudden hearing loss is experienced, especially alongside ringing ears or dizziness, seek immediate medical attention.
In addition to the previously mentioned effects, monitoring for any unusual problems while on tadalafil is prudent. Report promptly to your healthcare provider.
In the event of a serious adverse effect, reporting to the FDA's MedWatch Adverse Event Reporting program can be done online or by phone at 1-800-332-1088.
This medication should be maintained in its original packaging, tightly sealed, and stored out of children's reach. Keep at standard room temperature, protected from excessive heat and moisture—avoid bathrooms.
Any unneeded medications should be disposed of appropriately to prevent accidental ingestion by pets, children, or others; flushing them down the toilet is not recommended. Ideal disposal methods include drug take-back programs. Consult your pharmacist or local waste/recycling department for more information. Additional guidance on disposing of medications is available on the FDA's website.
Always ensure medications are stored safely away from children, as many packaging types are not childproof and can be easily opened. To prevent poisoning, employ safety caps and place medications in secure, out-of-reach locations.
In case of overdose, contacting the Poison Control Center at 1-800-222-1222 is advised, with resources accessible online. If the individual experiences collapse, seizures, breathing difficulty, or an inability to awaken, call emergency services immediately.
Ensure to attend all scheduled medical appointments.
Refrain from permitting others to take your medication. Direct any queries to your pharmacist regarding prescription refills.
Maintain a comprehensive list of all medications you are taking—which includes prescription and over-the-counter drugs, vitamins, and dietary supplements. This list should be available during doctor visits or hospital admissions and is crucial in emergency situations.
- Adcirca®
- Cialis®
- Entadfi® (a combination product of finasteride and tadalafil)