Tadalafil Introduction
Tadalafil is a drug used to treat male erectile dysfunction (ED) and benign prostatic hyperplasia (also known as benign enlargement of the prostate gland). It can also be used for pulmonary arterial hypertension (PAH). It is sold by many name brands including Adcirca, Cialis, and many others. It is an effective drug that can be taken as needed or daily, with the duration of effects lasting for up to 36 hours.
Uses for Tadalafil
Tadalafil is most commonly used to treat ED (erectile dysfunction), but it can also be used to treat the following conditions: benign enlargement of the prostate gland (benign prostatic hyperplasia), pulmonary arterial hypertension, and signs and symptoms of both benign prostatic hyperplasia and pulmonary arterial hypertension. In some cases, it can also be used to reduce high blood pressure.
Mechanism of Action
Tadalafil works by increasing blood flow to the penis and relaxing the smooth muscle of the corpus cavernosum, allowing the penis to become engorged with blood. This increased blood flow allows men to achieve and maintain an erection. In addition, tadalafil has been found to help reduce symptoms of benign prostatic hyperplasia and pulmonary arterial hypertension by blocking the enzyme phosphodiesterase (PDE5) and increasing levels of certain hormones, such as nitric oxide.
How Long Does It Take to Work?
Tadalafil typically takes between 30 and 60 minutes to begin working, although it can sometimes take up to 120 minutes.
Absorption
Tadalafil is rapidly and completely absorbed in the gastrointestinal tract.
Route of Elimination
Tadalafil is mainly eliminated through the kidneys and through the liver. The majority of an administered dose is eliminated as metabolites mainly in the feces, with only a small amount eliminated unchanged in the urine.
Dosage
The recommended starting dose for tadalafil is 10 mg, taken as needed before sexual activity. The maximum recommended dose is 20 mg. For the treatment of symptoms of benign prostatic hyperplasia and pulmonary arterial hypertension, the recommended dose is 40 mg daily. For most other conditions, the recommended dose is 10 mg as needed.
Administration
Tadalafil can be taken with or without food and is usually taken 30 minutes to 1 hour before sexual activity. It is important to note that tadalafil should not be taken more than once per day.
Side Effects
Common side effects of tadalafil include headache, dizziness, blurred vision, flushing, nausea, muscle pain, back pain, indigestion, and rash. In rare cases, more serious side effects such as vision loss, hearing loss, or an erection lasting more than 4 hours may occur.
Toxicity
Tadalafil has a low risk of toxicity. The most serious side effects, such as vision loss, are rare and usually occur at much higher doses than those typically used to treat ED.
Precaution
Patients taking tadalafil should use caution when operating machinery or driving a vehicle. It may cause drowsiness, dizziness, blurred vision, or other vision changes. Patients should also avoid drinking alcohol while taking tadalafil, as drinking alcohol can exacerbate these side effects.
Interaction
Tadalafil may interact with certain medications, including but not limited to nitrates, certain antibiotics, alpha-blockers, and antifungals. Patients should discuss any medications they are taking with their doctor before taking tadalafil.
Disease Interaction
Patients with certain medical conditions should not take tadalafil. These conditions include active peptic ulcer, low blood pressure, heart failure, stroke, or inherited retinal disorders.
Drug Interaction
Tadalafil can interact with certain drugs. Patients should discuss any medications they are taking with their doctor before taking tadalafil.
Food Interactions
Tadalafil may interact with certain foods and beverages. Patients should avoid grapefruit and grapefruit juice while taking tadalafil, as these may increase the side effects of the drug.
Pregnancy Use
Tadalafil is not recommended for use during pregnancy or during lactation. Tadalafil can cross the placenta and may harm a developing fetus.
Lactation Use
Tadalafil is not recommended for use during lactation. Tadalafil can be excreted into breast milk and may harm a nursing infant.
Acute Overdose
Symptoms of an overdose may include dizziness, nausea, chest pain, and difficulty breathing. Treatment is typically supportive and may involve activated charcoal, fluids, and other medications.
Contraindications
Patients with certain medical conditions should not take tadalafil. These conditions include active peptic ulcer, low blood pressure, heart failure, stroke, or inherited retinal disorders.
Use Direction
Patients should take tadalafil as directed by their doctor. It is important to note that tadalafil should not be taken more than once per day.
Storage Conditions
Tadalafil should be stored at room temperature in a dry and dark place. It should not be exposed to moisture or extreme changes in temperature.
Volume of Distribution
After oral administration, tadalafil is widely distributed in tissues in the body. It's volume of distribution is approximately 63 L.
Half Life
The elimination half-life of tadalafil is approximately 17.5 hours.
Clearance
The clearance of tadalafil is approximately 4.7 L/hr.
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Some Frequently Asked Questions About Tadalafil
1. What is Tadalafil ?
Tadalafil is a medication used to treat erectile dysfunction (ED), benign prostatic hyperplasia (BPH), and pulmonary arterial hypertension (PAH). It is a phosphodiesterase type 5 (PDE5) inhibitor.
2. How does Tadalafil work?
It relaxes blood vessels and increases blood flow to specific areas, such as the penis for ED, the prostate and bladder for BPH, or the lungs for PAH.
3. What is Tadalafil commonly known as?
It is most commonly known by its brand name, Cialis, though generic versions are widely available.
4. What conditions does Tadalafil treat?
Tadalafil is used for:
- Erectile dysfunction (ED)
- Benign prostatic hyperplasia (BPH)
- Pulmonary arterial hypertension (PAH, under the brand Adcirca)
5. Is Tadalafil safe for everyone?
No, it’s not safe for people with certain conditions (e.g., severe heart disease) or those on nitrates. A doctor’s evaluation is necessary.
6. How long does Tadalafil take to work?
For ED, it typically takes 30 minutes to 2 hours to start working, depending on the individual and food intake.
7. How long does Tadalafil last?
Its effects can last up to 36 hours, earning it the nickname “the weekend pill.”
8. Can women take Tadalafil ?
It’s not approved for women with sexual dysfunction but may be used off-label for PAH. Women should consult a doctor.
9. What is the typical dosage for ED?
The typical dose is 10 mg taken as needed before sexual activity, adjustable to 5 mg or 20 mg based on response.
10. Can I take Tadalafil every day?
Yes, a lower dose (2.5 mg or 5 mg) can be taken daily for ED or BPH, unlike the as-needed higher doses.
11. Does food affect Tadalafil ?
Unlike Sildenafil, Tadalafil ’s effectiveness is not significantly affected by food, including high-fat meals.
12. Can I drink alcohol with Tadalafil ?
Moderate alcohol is usually fine, but excessive drinking may reduce its effectiveness or worsen ED.
13. What are common side effects of Tadalafil ?
Common side effects include:
- Headache
- Back pain
- Muscle aches
- Flushing
- Indigestion
14. Are there serious side effects?
Rare but serious side effects include:
- Prolonged erection (priapism)
- Sudden vision loss
- Sudden hearing loss
- Chest pain
15. What is priapism?
Priapism is an erection lasting over 4 hours, which can cause permanent damage if untreated. It’s a medical emergency.
16. Can Tadalafil cause vision changes?
Yes, some experience temporary blurred vision or color changes, though sudden vision loss is rare.
17. Is Tadalafil addictive?
No, it’s not physically addictive, though psychological dependence for confidence may develop.
18. Can I buy Tadalafil without a prescription?
In most countries, it requires a prescription. Over-the-counter options are not widely available.
19. Is generic Tadalafil as effective as Cialis?
Yes, generic Tadalafil is equally effective as Cialis when produced by reputable manufacturers.
20. How should I store Tadalafil ?
Store it at room temperature (15-30°C or 59-86°F), away from moisture and heat.
21. Can I split Tadalafil tablets?
Only if advised by a doctor and the tablet isn’t film-coated or scored. Consult a pharmacist.
22. What happens if I overdose on Tadalafil ?
An overdose may cause severe side effects like low blood pressure or priapism. Seek emergency care.
23. Can I take Tadalafil with nitrates?
No, combining Tadalafil with nitrates (e.g., nitroglycerin) can cause a dangerous drop in blood pressure.
24. Does Tadalafil increase sexual desire?
No, it doesn’t boost libido. It only aids erections with sexual stimulation.
25. Who should not take Tadalafil ?
People who should avoid it include:
- Those on nitrates
- Those with severe heart or liver disease
- Those with certain eye conditions (e.g., retinitis pigmentosa)
26. Can Tadalafil treat premature ejaculation?
It’s not designed for this, but it may indirectly help by improving erection duration and confidence.
27. Is Tadalafil safe for older adults?
Yes, but older adults may need a lower dose due to slower metabolism. A doctor’s guidance is key.
28. Can I take Tadalafil with other ED drugs?
No, combining it with other PDE5 inhibitors (e.g., Sildenafil, Vardenafil) is unsafe.
29. Does Tadalafil affect fertility?
No evidence shows it impacts sperm count or fertility.
30. Can I take Tadalafil if I have diabetes?
Yes, it’s often safe for diabetics with ED, but consult a doctor to assess your condition.
31. What’s the difference between Tadalafil and Sildenafil?
Tadalafil lasts up to 36 hours, while Sildenafil lasts 4-6 hours. Tadalafil can also be taken daily.
32. Can Tadalafil cause heart problems?
It’s safe for healthy hearts but may strain the heart during sex if you have pre-existing heart issues.
33. How was Tadalafil discovered?
It was developed by Eli Lilly and ICOS as a longer-lasting alternative to Sildenafil for ED.
34. Is Tadalafil approved by the FDA?
Yes, it was approved by the FDA in 2003 for ED and later for BPH and PAH (as Adcirca).
35. What’s Adcirca?
Adcirca is a brand of Tadalafil used to treat PAH, typically in a 40 mg daily dose.
36. Can Tadalafil be used recreationally?
It’s not advised for those without ED, as it won’t enhance normal function and carries risks.
37. Does Tadalafil expire?
Yes, check the expiration date. Expired Tadalafil may lose potency or safety.
38. Can I take Tadalafil with blood pressure medication?
Some are safe, but avoid it with alpha-blockers or nitrates unless a doctor approves.
39. Does Tadalafil affect sleep?
It doesn’t directly affect sleep, though side effects like back pain might interfere.
40. Can Tadalafil be taken long-term?
Yes, it’s safe for long-term use (daily or as needed) if prescribed and monitored.
41. What’s the maximum dose of Tadalafil ?
For ED, the maximum is 20 mg as needed. For daily use, it’s 5 mg. Higher doses increase risks.
42. Can Tadalafil cause allergic reactions?
Rarely, it may cause rash, itching, or swelling. Seek help if this happens.
43. Is Tadalafil safe during pregnancy?
It’s not typically used in pregnant women unless for PAH, and only under medical supervision.
44. Can I drive after taking Tadalafil ?
Yes, unless you feel dizzy or experience vision changes, in which case avoid driving.
45. Does Tadalafil interact with grapefruit?
Yes, grapefruit may increase Tadalafil levels, potentially raising side effect risks.
46. Can teenagers take Tadalafil ?
It’s not approved for those under 18 unless for PAH in rare cases.
47. What’s the cost of Tadalafil ?
Generic Tadalafil ranges from $1 to $15 per pill, depending on dose and location, cheaper than Cialis.
48. Can Tadalafil be crushed?
It’s not recommended unless your doctor or pharmacist confirms it’s safe for your tablet.
49. Does Tadalafil work without stimulation?
No, sexual arousal is required—it doesn’t cause spontaneous erections.
