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Tadalafil

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Tadalafil, Cialis

  • See Also
  1. PDE5 Inhibitor
  2. Sildenafil (Viagra)
  3. Vardenafil (Levitra, Staxyn)
  • Indications
  1. Erectile Dysfunction
    1. Psychogenic Impotence
    2. Neurogenic Impotence
    3. Vasculogenic Impotence
  • Contraindications
  1. See Phosphodiesterase Inhibitors (PDE5 Inhibitors)
  2. Men using nitrates (causes profound Hypotension)
  3. Men using alpha blockers (e.g. Hytrin for BPH)
  • Mechanism
  1. See Phosphodiesterase Inhibitors (PDE5 Inhibitor)
  • Dosing
  1. Start 20 mg PO 1 hour before intercourse
    1. Do not take more than once per 2 days
    2. Most insurance limits to 6 per month
  2. Indications to start with half dosing (10 mg)
    1. Age over 65 years
    2. Hepatic Impairment
    3. Renal Impairment
    4. Concurrent use of Cytochrome P3A4 inhibitor below
  • Pharmacokinetics
  1. Onset within 30 to 60 minutes
  2. Duration as long as 36 hours
    1. Contrast with 4 hours with Viagra
    2. Prolonged effect also leads to prolonged side effects
  1. See Phosphodiesterase Inhibitors (PDE5 Inhibitors)
  2. Hypotensive effect for men on Nitrates (Avoid)
  3. Vision effects (color Vision, Vision Loss)
  4. Sensorineural Hearing Loss
  5. Mild Headache (21%)
  • Efficacy
  1. Also appears effective in Benign Prostatic Hyperplasia (BPH)
    1. May be preferred over Tamsulosin in BPH with comorbid Erectile Dysfunction
    2. Rohrbough (2024) Am Fam Physician 109(1): 83-4 [PubMed]
  • Drug Interactions
  1. See Phosphodiesterase Inhibitors (PDE5 Inhibitors)
  2. Profound Vasodilitation and Hypotension with Nitroglycerin and alpha blockers such as Prazosin (Avoid)
    1. Avoid nitrates within 48 hours of Tadalafil (Cialis)
  3. Cytochrome P3A4 related interactions (Cimetidine, systemic Antifungals, Protease Inhibitors and Macrolides
  • References
  1. 2003 Med Lett Drug Ther 45:101-2 [PubMed]