Tadalafil (Cialis)

Comprehensive information about Tadalafil, its uses, dosages, and important safety considerations.

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Medical Disclaimer: This information is for educational purposes only. Always consult your healthcare provider before starting any medication.

What is Tadalafil?

Tadalafil is a prescription medication belonging to a class of drugs called phosphodiesterase type 5 (PDE5) inhibitors. It was approved by the FDA in 2003 and is marketed under the brand names Cialis (for erectile dysfunction and benign prostatic hyperplasia) and Adcirca (for pulmonary arterial hypertension).

Key Facts

  • Generic Name: Tadalafil
  • Brand Names: Cialis, Adcirca
  • Drug Class: PDE5 Inhibitor
  • FDA Approval: 2003
  • Duration: Up to 36 hours

Uses

Tadalafil is FDA-approved for several conditions:

1. Erectile Dysfunction (ED)

The primary use of Tadalafil is to treat erectile dysfunction in men. It helps achieve and maintain an erection sufficient for sexual activity when sexually stimulated.

2. Benign Prostatic Hyperplasia (BPH)

Tadalafil is also approved to treat symptoms of an enlarged prostate, including difficulty urinating, weak stream, and frequent urination.

3. ED and BPH Combined

Tadalafil can be prescribed to treat both conditions simultaneously.

4. Pulmonary Arterial Hypertension (PAH)

Under the brand name Adcirca, Tadalafil is used to treat pulmonary arterial hypertension to improve exercise capacity.

How It Works

Tadalafil works by inhibiting the enzyme phosphodiesterase type 5 (PDE5). Here's how the process works:

  1. Sexual Stimulation: When sexually aroused, your body releases nitric oxide.
  2. Increased cGMP: Nitric oxide triggers the production of cyclic guanosine monophosphate (cGMP).
  3. Muscle Relaxation: cGMP relaxes smooth muscle tissue and dilates blood vessels.
  4. Increased Blood Flow: This allows increased blood flow to the penis.
  5. PDE5 Inhibition: Tadalafil prevents PDE5 from breaking down cGMP, maintaining the erection.
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Important: Tadalafil only works in the presence of sexual stimulation. It does not cause automatic erections or increase sexual desire.

Onset and Duration

  • Onset Time: Typically begins working within 30-60 minutes
  • Peak Effect: Reaches maximum concentration in 2 hours
  • Duration: Can remain effective for up to 36 hours
  • Food Interaction: Can be taken with or without food

Dosage Information

Condition Dosing Schedule Typical Doses
ED (As-Needed) Take before sexual activity 5mg, 10mg, or 20mg
ED (Daily) Once daily, same time 2.5mg or 5mg
BPH Once daily 5mg
ED + BPH Once daily 5mg
PAH Once daily 40mg (Adcirca)

Important Dosage Guidelines

  • Do not take more than one dose per day
  • For as-needed use, take at least 30 minutes before sexual activity
  • Daily dosing provides the flexibility for spontaneous sexual activity
  • Your doctor may adjust your dose based on effectiveness and tolerability
  • Lower doses may be recommended for those with kidney or liver problems
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Warning: Never exceed the prescribed dose. Taking more than recommended does not improve effectiveness and increases the risk of serious side effects.

Side Effects

Common Side Effects

These side effects are generally mild and may decrease over time:

  • Headache
  • Indigestion or heartburn
  • Back pain
  • Muscle aches
  • Flushing (warmth, redness)
  • Stuffy or runny nose

Serious Side Effects

Seek immediate medical attention if you experience:

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Seek Emergency Care:
  • Erection lasting more than 4 hours (priapism)
  • Sudden vision loss in one or both eyes
  • Sudden hearing decrease or loss
  • Chest pain or irregular heartbeat
  • Severe dizziness or fainting
  • Shortness of breath

Warnings & Precautions

Do Not Take Tadalafil If:

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  • You take nitrates for chest pain (nitroglycerin, isosorbide)
  • You take riociguat (Adempas) for pulmonary hypertension
  • You are allergic to tadalafil or any ingredients
  • Your doctor has advised against sexual activity

Tell Your Doctor If You Have:

  • Heart problems or history of heart attack/stroke
  • High or low blood pressure
  • Liver or kidney disease
  • Blood cell disorders (sickle cell anemia, leukemia)
  • Bleeding disorders
  • Stomach ulcers
  • Peyronie's disease or penile deformity
  • Retinitis pigmentosa or vision problems

Drug Interactions

Tadalafil can interact with many medications. Always inform your healthcare provider about all medications you're taking, including:

  • Alpha-blockers for prostate or blood pressure
  • Other blood pressure medications
  • Antifungal medications (ketoconazole, itraconazole)
  • Antibiotics (clarithromycin, erythromycin)
  • HIV protease inhibitors
  • Other ED medications