Tadalafil (Cialis) is prescribed for the treatment of erectile dysfunction (ED), which is the inability to achieve or maintain an erection, as well as the symptoms associated with benign prostatic hyperplasia (BPH), characterized by an enlarged prostate. Symptoms of BPH may include difficulty urinating, which can manifest as hesitancy, dripping, weak urine flow, and incomplete bladder emptying, along with urinary frequency and urgency that are particularly troublesome for adult men. Additionally, tadalafil (Adcirca) is utilized to enhance exercise capacity in individuals suffering from pulmonary arterial hypertension (PAH), a condition marked by elevated blood pressure in the pulmonary arteries leading to the lungs. Common symptoms of PAH include shortness of breath, dizziness, and fatigue. Tadalafil is classified under a category of medications known as phosphodiesterase type 5 inhibitors (PDE5 inhibitors), which work primarily by increasing blood flow in the penis during sexual stimulation to enable an erection. Furthermore, tadalafil aids in the management of PAH by relaxing the pulmonary blood vessels, thus facilitating smoother blood flow.
It is crucial to understand that tadalafil, when used for erectile dysfunction, does not provide a cure for the condition nor does it enhance sexual desire. Moreover, it does not act as a contraceptive nor does it prevent the transmission of sexually transmitted infections, including HIV.
Tadalafil is available in tablet form for oral intake and can be administered with or without food.
When prescribed for erectile dysfunction, it is vital to adhere to your healthcare provider's instructions alongside the dosing recommendations provided here. Tadalafil may be taken in two ways: either on a daily schedule or as needed. Consult with your doctor about which dosing method is the most suitable for your situation. In cases where tadalafil is taken as needed, it is typically recommended to consume it at least 30 minutes prior to engaging in sexual activity, but it should not be taken more than once every 24 hours. Your healthcare provider will guide you on the optimal timing for ingestion. For those on a daily regimen, tadalafil can be consumed regardless of when sexual activity occurs, allowing for sexual engagement at any moment in-between doses. If you choose to follow a scheduled regimen, aim to take it at approximately the same time each day. For patients with specific health conditions or those on certain medications, your doctor may suggest modifying your dosage or reducing the frequency of administration. Always follow the guidance on your medication label closely, and do not hesitate to reach out to your doctor or pharmacist if you have any uncertainties. It is essential to take tadalafil strictly as instructed, avoiding both underdosing and overdosing, as well as taking it more frequently than prescribed by your doctor.
When treating PAH or BPH, your doctor will likely recommend a daily dosage of tadalafil. Ensure that all tablets for your prescribed daily dose are taken simultaneously each day, and refrain from splitting the tablets for staggered intakes. Consistency in timing is important; hence, try to take tadalafil at approximately the same time every day. If you currently take medications for BPH, your doctor may advise discontinuing those medications at least one day before starting tadalafil. Adhere to your healthcare provider's instructions meticulously, and seek clarification from your doctor or pharmacist for any part that is unclear.
For erectile dysfunction management, your healthcare provider will typically commence your treatment with a moderate tadalafil dose, adjusting it based on your responses and tolerance. If you find that tadalafil is not yielding the desired effects or if you encounter side effects, promptly inform your healthcare provider.
Regarding PAH, it is important to recognize that while tadalafil helps manage the condition, it does not cure it. Continue your treatment regimen even if you feel well, and avoid discontinuing tadalafil without consulting your doctor first.
Request a copy of the manufacturer's patient information from your pharmacist or doctor.
Occasionally, this medication may be prescribed for other indications; consult your doctor or pharmacist for more details.
Before Taking Tadalafil
- Notify your healthcare provider and pharmacist if you have allergies to tadalafil, any other medications, or any of the tablet's components. Request a list of ingredients from your pharmacist.
- Inform your doctor if you are currently on or have recently taken riociguat (Adempas) or nitrates, such as isosorbide dinitrate (Isordil), isosorbide mononitrate (Monoket), or nitroglycerin (Minitran, Nitro-Dur, Nitromist, Nitrostat, etc.). Nitrates can be found in oral tablets, sublingual tablets, sprays, patches, pastes, and ointments. Should you have queries regarding whether any of your medications contain nitrates, reach out to your doctor. Generally, if you are using nitrates, your doctor will advise against taking tadalafil.
- If you use recreational drugs containing nitrates, such as amyl nitrite or butyl nitrite (commonly known as 'poppers') while undergoing tadalafil treatment, be sure to inform your doctor, as they may also recommend not using tadalafil.
- Be aware that tadalafil is marketed under the brand names Adcirca and Cialis, and that only one of these products should be used at a time.
- Disclose all other prescription and over-the-counter medications, vitamins, and dietary supplements you currently take or plan to take, especially those such as alpha-blockers (e.g., alfuzosin, doxazosin, and tamsulosin), antifungals, amiodarone, and various others specified in your product literature. Close monitoring of your medications may be necessary if interactions are possible.
- Notify your physician about any herbal products you consume, particularly St. John's wort.
- It’s significant to inform your doctor if you smoke or if you've ever had an erection lasting longer than 4 hours. Also disclose recent episodes of dehydration due to diarrhea, vomiting, excessive sweating, or inadequate fluid intake. Additionally, let your doctor know if you have a history of pulmonary veno-occlusive disease (PVOD) or any medical conditions related to the structure of the penis, diabetes, cholesterol abnormalities, blood pressure issues, arrhythmias, cardiovascular incidents, or other serious health problems.
- For women taking tadalafil for PAH, it’s crucial to inform your healthcare provider if you are pregnant, intend to become pregnant, or are nursing. If you become pregnant while on tadalafil, contact your doctor immediately.
- Before undergoing any surgical procedures, including dental work, notify your medical or dental provider that you are currently prescribed tadalafil.
- Discuss the safe consumption of alcoholic beverages during your tadalafil treatment with your healthcare provider. Drinking large amounts of alcohol can heighten the risk of experiencing side effects such as dizziness or low blood pressure.
- If you are using tadalafil for erectile dysfunction, inform your doctor if a healthcare professional has ever advised you to avoid sexual activity for health reasons, or if you have previously experienced chest pain during sexual interactions. Understand that sexual activity can place extra strain on the heart, particularly in those with heart disease. Should you encounter chest pain, dizziness, or queasiness during sexual activity, immediately inform your doctor or seek emergency care, and refrain from sexual activity until advised otherwise.
- Ensure that all your healthcare providers are aware that you are taking tadalafil. In case of emergency treatment for a heart issue, your medical team will need to know your tadalafil usage history.
Consult with your healthcare provider as to the dietary considerations regarding grapefruit juice while on this medication.
If you regularly take tadalafil for erectile dysfunction and miss a dose, consume it as soon as you recall. If the next scheduled dose is approaching, skip the missed dose and adhere to your regular medication schedule. Never double up on doses or exceed one dose per day.
For those taking tadalafil for PAH or BPH, follow similar instructions for missed doses. Take the missed dose as soon as remembered, and if the next dose is nearing, skip it and continue as prescribed. Do not double the dose to compensate for one missed.
Tadalafil may lead to side effects. Notify your healthcare provider if any of the following symptoms are severe or persist:
- Headache
- Indigestion or heartburn
- Nausea
- Diarrhea
- Flushing
- Pain in the back, stomach, muscles, arms, or legs
- Coughing
Serious side effects may occur. If any of these symptoms arise, seek immediate medical assistance:
- Sudden changes or loss of vision
- Blurred vision
- Color vision alterations (e.g., bluish tint to objects)
- Sudden hearing loss
- Tinnitus
- Erections lasting more than 4 hours
- Dizziness
- Chest pain
- Hives
- Rashes
- Difficulty in breathing or swallowing
- Facial swelling or localized edema in limbs
- Skin irritation or peeling
Reports indicate that some individuals experience sudden partial or total vision loss after tadalafil use. Although the cause remains uncertain, it is essential to contact your healthcare provider immediately if this occurs, and refrain from taking tadalafil or any similar medications until consulting your physician.
Occasional reports of sudden hearing loss, often affecting one ear, have also been noted in patients using tadalafil. Should you experience such loss, particularly if accompanied by dizziness or tinnitus, seek medical attention without delay. Again, do not re-dose until you have spoken with your physician.
Tadalafil could also elicit other side effects. Notify your healthcare provider if you encounter any atypical symptoms while on this medication.
Should you experience a severe side effect, reporting it to the FDA's MedWatch adverse events program is recommended, accessible at (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 children's reach. Keep at room temperature and away from excessive heat and moisture; avoid storage in the bathroom.
Unused medications should be disposed of properly to prevent accidental ingestion by children or pets. Never flush these medications down the toilet. The preferred method is to use drug take-back programs. Consult your pharmacist or local waste/recycling department for available options. For additional disposal guidance, refer to the FDA website at (https://goo.gl/xRXbPn).
Always keep medications out of children's sight and reach. Many containers, such as those for weekly pill organizers and various topical preparations, are not child-resistant. To prevent poisoning, utilize safety caps and ensure medications are stored securely out of sight.
In the event of an overdose, contact the Poison Control Center at 1-800-222-1222. Further information is accessible online at (https://www.poisonhelp.org/help). If someone has collapsed, is unable to breathe, has experienced a seizure, or cannot be awakened, call emergency services immediately.
Ensure you attend all scheduled appointments with your healthcare provider.
Do not share your medication with anyone else. If you have questions regarding refilling your prescription, consult your pharmacist.
Maintain a written list of all medications you take, including over-the-counter drugs, vitamins, and supplements. This list should be available during medical visits or hospital admissions and is critical in emergencies.
- Adcirca®
- Cialis®
- Entadfi® (as a combination product containing finasteride, tadalafil)