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