Tadalafil (Cialis) is widely prescribed to manage erectile dysfunction (ED), which is characterized by the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. Additionally, it is effective in alleviating symptoms of benign prostatic hyperplasia (BPH), such as difficulty urinating (which may present as hesitancy, dribbling, a weak urinary stream, or incomplete bladder emptying), painful urination, and increased urgency and frequency of urination among adult males. The formulation also includes tadalafil (Adcirca), which enhances exercise capacity in individuals with pulmonary arterial hypertension (PAH), a condition marked by elevated blood pressure in the arteries supplying the lungs, often leading to symptoms like breathlessness, dizziness, and heightened fatigue. Tadalafil acts as a phosphodiesterase type 5 (PDE5) inhibitor, facilitating improved blood flow to the penis during sexual stimulation, thus enabling an erection. For managing PAH, tadalafil works by relaxing the pulmonary blood vessels, promoting smoother blood flow and lowering pulmonary artery pressure, contributing to symptom relief.
It is crucial to note that tadalafil does not serve as a cure for erectile dysfunction, nor does it enhance sexual desire. Furthermore, it does not provide protection against sexually transmitted infections, including HIV, or prevent pregnancy.
Tadalafil is available as an oral tablet, which can be ingested with or without food, offering versatility in administration.
For erectile dysfunction treatment, it can be taken either on a daily basis or as required, depending on individual preferences and medical advice. Typically, when used as needed, it should be consumed at least 30 minutes prior to sexual activity, ensuring that it is not taken more than once every 24 hours. Consult your healthcare provider to determine the optimal timing of the dose for your specific needs. When taken daily, it allows for flexibility regarding sexual activity timing, although it is advisable to take it at a consistent time each day. Some patients may be required to adjust the frequency or dosage based on existing health conditions or concurrent medications, thus necessitating close consultation with their healthcare professionals.
When tadalafil is prescribed for PAH or BPH, a once-daily regimen is typically recommended. Patients should take their entire prescribed dosage at once daily, without splitting tablets for separate doses. Regular monitoring and adherence to the prescribed schedule are essential for optimal treatment outcomes.
For those being treated for erectile dysfunction, healthcare providers usually initiate therapy with a moderate dose, adjusting up or down based on therapeutic response and side effects. If tadalafil proves ineffective or adverse reactions occur, it is vital to communicate these issues to your healthcare provider promptly.
In the case of PAH, while tadalafil manages symptoms effectively, it is important to understand that it does not provide a cure for the condition. Continuation of the medication is necessary, even if symptomatic relief occurs. Discontinuing treatment without medical guidance is not advisable.
A copy of the manufacturer’s patient information should be requested from your pharmacist or healthcare professional.
Tadalafil may be utilized for various off-label indications; consult your healthcare provider for more detailed information regarding any additional uses.
Considerations Prior to Taking Tadalafil
- Notify your healthcare provider and pharmacist of any known allergies to tadalafil or any other medications, including the ingredients found in tadalafil tablets.
- Inform your physician if you are currently or have recently used riociguat (Adempas) or any nitrate medications, such as isosorbide mononitrate (Monoket) or nitroglycerin (Minitran, Nitro-Dur), as the combination can lead to potentially serious adverse effects.
- Any illicit drugs containing nitrates, including those known as "poppers," should also be disclosed to your doctor, as this drug interaction is significant.
- It is crucial to remember that tadalafil is marketed under the names Adcirca and Cialis, and thus, treatment should not involve both simultaneously.
- Advise your healthcare team regarding all medications, vitamins, and supplements you are currently taking or plan to start, especially certain antihypertensive agents, antifungals, and other medications that could interact with tadalafil, as dose adjustments may be necessary.
- Communicate any herbal products in use, notably St. John’s Wort, with your healthcare provider.
- Report any history of prolonged erections exceeding 4 hours, and notify your doctor regarding any episodes of dehydration, recent illnesses, or other relevant health issues.
- Women considering tadalafil for PAH should discuss pregnancy intentions or breastfeeding status with their healthcare provider, as the risks associated with tadalafil during these periods require careful consideration.
- Inform your healthcare providers about your tadalafil use prior to any surgery, including dental procedures.
- Discuss alcohol consumption with your doctor, as excessive intake may heighten the risk of side effects including dizziness or hypotension.
- Report any episodes of chest pain, dizziness, or nausea during sexual activity to your physician immediately, as they may indicate serious cardiovascular complications.
- Ensure that all healthcare professionals involved in your care are aware of your tadalafil regimen, especially in emergency situations.
Consult your healthcare provider about the intake of grapefruit juice while using tadalafil, as dietary interactions may affect medication efficacy.
If you miss a dose of tadalafil for erectile dysfunction, take it immediately upon remembering; however, if it is nearly time for your next scheduled dose, skip the missed dose and resume your normal dosing schedule without doubling up.
For PAH or BPH, similar guidelines apply—take the missed dose promptly, or skip it if close to the next dose time, but never take two doses at once.
Potential Side Effects of Tadalafil: Report Severe or Persistent Symptoms
- Headaches
- Gastrointestinal discomfort or heartburn
- Nausea or vomiting
- Diarrhea
- Facial flushing
- Muscle or back pain
- Coughing or respiratory distress
Serious Side Effects: Seek Immediate Medical Attention If You Experience:
- Sudden vision loss or decrease
- Blurred vision
- Visual disturbances, such as a blue tint or trouble differentiating colors
- Sudden hearing loss or ringing in the ears
- Prolonged erection lasting over 4 hours
- Severe dizziness
- Chest pain or discomfort
- Severe skin reactions such as hives or rash
- Breathing difficulties
- Swelling in various parts of the body
- Skin changes such as peeling or bumps
A small fraction of patients have reported sudden visual impairment post-tadalafil use, with some cases being irreversible. Should sudden vision loss occur, seek medical help immediately and refrain from using tadalafil or similar agents until consulting your healthcare provider.
Additionally, sudden hearing loss, which may occur alongside tinnitus, has been documented in some cases; immediate medical evaluation is necessary if these symptoms arise.
Other unusual side effects may develop; if you notice atypical symptoms while taking tadalafil, it is advisable to consult your doctor for further evaluation.
If a serious adverse effect occurs, reports may be submitted to the FDA's ‘MedWatch’ adverse event reporting program, accessible at https://www.fda.gov/Safety/MedWatch or by calling 1-800-332-1088.
Store this medication in its original container, ensuring it is tightly sealed and kept out of reach of children. Maintain storage at room temperature, shielded from excessive heat and moisture, and refrain from keeping it in the bathroom.
Unused medications should be disposed of properly to prevent accidental ingestion by children or pets. Avoid flushing medications down the toilet. Consult your local pharmacist or waste management department for guidance on proper disposal methods and available drug take-back programs. For further details on safe medication disposal, refer to the FDA website at https://www.fda.gov/DrugDisposal.
It is imperative to ensure all medications are stored securely, preventing access to children and reducing the risk of accidental poisoning. Use child-resistant packaging diligently and place medications in a designated secure location, out of sight and reach.
In the event of an overdose, contact the Poison Control Center at 1-800-222-1222, or seek information online at https://www.poisonhelp.org/help. If the person affected is unconscious, having seizures, experiencing trouble breathing, or unresponsive, call emergency services immediately at 911.
Ensure attendance at all scheduled appointments with your healthcare provider.
Never share your medication with others. Should you have any inquiries regarding prescription refills, your pharmacist is available to assist.
Keeping an updated list of all medications—including prescriptions and over-the-counter drugs, as well as vitamins or supplements—can be beneficial. Bring this list to each healthcare appointment or hospital visit, as it is essential for providing complete medical history in emergencies.
- Adcirca®
- Cialis®
- Entadfi® (combination product containing finasteride and tadalafil)