Tadalafil – Uses, Dosage and Side Effects
Tadalafil is a prescription medication used to treat erectile dysfunction, benign prostatic hyperplasia, and pulmonary arterial hypertension.
Things worth knowing about "tadalafil"
Tadalafil is a prescription medication used to treat erectile dysfunction, benign prostatic hyperplasia, and pulmonary arterial hypertension.
What is Tadalafil?
Tadalafil is a phosphodiesterase type 5 (PDE-5) inhibitor used medically to treat erectile dysfunction, benign prostatic hyperplasia (enlarged prostate), and pulmonary arterial hypertension (high blood pressure in the arteries of the lungs). It belongs to the same drug class as sildenafil but is distinguished by its significantly longer duration of action of up to 36 hours, earning it the nickname the weekend pill.
Mechanism of Action
Tadalafil selectively inhibits the enzyme phosphodiesterase type 5 (PDE-5), which is responsible for breaking down cyclic guanosine monophosphate (cGMP). By inhibiting PDE-5, cGMP remains active longer, leading to relaxation of smooth muscle in blood vessel walls. This increases blood flow to the erectile tissue of the penis, supporting the ability to achieve and maintain an erection. In the lungs, the same mechanism causes dilation of pulmonary blood vessels, thereby reducing pulmonary arterial pressure.
Indications
Erectile Dysfunction
For erectile dysfunction, tadalafil is used either as an as-needed medication (e.g., 10 mg or 20 mg) or as a low-dose daily therapy (e.g., 2.5 mg or 5 mg per day). The effect begins approximately 30 minutes after intake and can last up to 36 hours.
Benign Prostatic Hyperplasia
In benign prostatic hyperplasia, tadalafil relieves lower urinary tract symptoms such as frequent urination, weak urine flow, and a feeling of incomplete bladder emptying. The recommended dose is typically 5 mg daily.
Pulmonary Arterial Hypertension
For pulmonary arterial hypertension, tadalafil is used at a higher dose (40 mg daily). It improves exercise capacity and slows disease progression.
Dosage and Administration
The dosage depends on the indication and the individual response of the patient. Tadalafil can be taken with or without food. When used on demand for erectile dysfunction, the tablet should be taken at least 30 minutes before anticipated sexual activity. Sexual stimulation is required for the medication to work.
Side Effects
Like all medications, tadalafil can cause side effects. Commonly reported side effects include:
- Headache
- Indigestion (dyspepsia)
- Back pain
- Muscle pain (myalgia)
- Facial flushing
- Nasal congestion
- Dizziness
Less common but serious side effects include visual disturbances, sudden hearing loss, or a prolonged and painful erection (priapism). These require immediate medical attention.
Contraindications and Drug Interactions
Tadalafil must not be taken together with nitrates (e.g., glyceryl trinitrate, commonly used for heart conditions), as this combination can cause a dangerous drop in blood pressure. Other contraindications include:
- Severe cardiovascular disease or a recent heart attack or stroke
- Severe liver impairment
- Known hypersensitivity to tadalafil
- Low blood pressure (hypotension)
Interactions with alpha-blockers, certain antibiotics, antifungal agents, and HIV protease inhibitors are also possible and should be discussed with a healthcare provider before use.
References
- European Medicines Agency (EMA): Cialis (tadalafil) - Summary of Product Characteristics. URL: https://www.ema.europa.eu
- Brock GB et al. - Efficacy and safety of tadalafil for the treatment of erectile dysfunction: results of integrated analyses. J Urol. 2002;168(4):1332-1336.
- Ghofrani HA et al. - Tadalafil therapy for pulmonary arterial hypertension. N Engl J Med. 2009;361:1731-1740.
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