Tadalafil
Tadalafil is a phosphodiesterase type 5 inhibitor. Its label indicates it for erectile dysfunction, for the signs and symptoms of benign prostatic hyperplasia, and for both together. The same document states that tadalafil is also marketed as ADCIRCA for the treatment of pulmonary arterial hypertension, and that a patient should not take both.
Cialis Daily
Erectile Dysfunction, Benign Prostatic Hyperplasia
2.5mg · 5mg
Utilised to manage everyday erectile capability to alleviate performance pressure and support spontaneous physical activity.
Cialis Super Active
Erectile Dysfunction
20mg · 40mg
Indicated to address severe erectile dysfunction to relieve performance issues and support rapid vascular dilation.
Tadalis Sx
Erectile Dysfunction
20mg
Indicated to address penile vascular tone to manage erectile performance and alleviate clinical physical dysfunction.
Tastylia Strips
Erectile Dysfunction
10mg · 20mg
Developed to mitigate penile vascular restriction to support convenient performance and target rapid physical absorption.
Extra Super Tadarise
Erectile Dysfunction, Premature Ejaculation
40mg + 60mg
Utilised to manage male sexual performance to alleviate physical distress and support extended intimate duration.
Endobloc T Kit
Pulmonary Arterial Hypertension
5mg + 20mg
Lower pulmonary artery pressure and improve exercise capacity in pulmonary arterial hypertension
Key points
- Tadalafil’s mean terminal half-life is 17.5 hours in healthy subjects, and steady-state plasma concentrations are attained within 5 days of once-daily dosing.
- It is predominantly metabolised by CYP3A4 to a catechol metabolite, so drugs that inhibit CYP3A4 increase tadalafil exposure.
- Back pain and myalgia are its characteristic musculoskeletal reactions: in a one-year open-label extension study they were reported in 5.5% and 1.3% of patients respectively.
- Tadalafil is excreted predominantly as metabolites, mainly in the faeces at approximately 61% of the dose, and to a lesser extent in the urine at approximately 36%.
How it works
The UK summary of product characteristics describes tadalafil as a selective, reversible inhibitor of cyclic guanosine monophosphate-specific phosphodiesterase type 5. When sexual stimulation causes the local release of nitric oxide, inhibiting PDE5 raises cGMP levels in the corpus cavernosum, which relaxes smooth muscle and lets blood flow into the penile tissues. The same document states plainly that tadalafil has no effect in the absence of sexual stimulation.
Safety specific to tadalafil
Nitrates. Giving tadalafil to anyone using any form of organic nitrate, regularly or intermittently, is contraindicated, because clinical pharmacology studies showed it potentiates the hypotensive effect of nitrates. The label also says not to use tadalafil in patients taking a guanylate cyclase stimulator such as riociguat, since PDE5 inhibitors may potentiate the hypotensive effects of those medicines.
Sudden vision loss. Patients should stop tadalafil and seek medical care if a sudden loss of vision occurs in one or both eyes. That may be a sign of non-arteritic anterior ischaemic optic neuropathy, which the label describes as a rare condition and a cause of decreased vision, including permanent loss of vision. It puts the annual incidence of NAION at 2.5 to 11.8 cases per 100,000 in males aged 50 and over, and notes that a “crowded” optic disc may raise the risk.
Sudden hearing loss. Patients should stop taking PDE5 inhibitors including tadalafil and seek prompt medical attention in the event of sudden decrease or loss of hearing, which may be accompanied by tinnitus and dizziness. The label is careful to say it is not possible to determine whether these events relate directly to the medicine or to other factors.
Priapism. There have been rare reports of prolonged erections greater than 4 hours and priapism, meaning painful erections greater than 6 hours. Priapism, if not treated promptly, can result in irreversible damage to the erectile tissue, and an erection lasting more than 4 hours, whether painful or not, calls for emergency medical attention.
Hypersensitivity. Tadalafil is contraindicated in anyone with a known serious hypersensitivity to it, and hypersensitivity reactions including Stevens-Johnson syndrome and exfoliative dermatitis have been reported.
Alpha-blockers and antihypertensives. Tadalafil can augment the blood-pressure-lowering effect of alpha-blockers and antihypertensive medications. Because once-daily use provides continuous plasma tadalafil levels, the label asks prescribers to take that continuous exposure into account when judging the potential for interactions.
Where tadalafil is taken for benign prostatic hyperplasia, the label asks that other urological conditions capable of causing similar symptoms be considered before treatment begins.
When to seek urgent care
An erection lasting more than 4 hours, a sudden loss of vision in one or both eyes, and a sudden decrease or loss of hearing all call for stopping the medicine and seeking care rather than waiting. A spreading rash with blistering or peeling skin needs the same urgency.
Tadalafil brand names in the UAE
The Emirates Drug Establishment’s drug directory records Cialis 5mg as a tablet whose ingredient is tadalafil, which is the name many readers in the region will recognise.
Further reading
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