From the Guidelines
Tadalafil is a recommended treatment for erectile dysfunction (ED) in men, with a typical starting dose of 10mg taken before sexual activity, which can be adjusted to 5mg or 20mg based on effectiveness and tolerability 1.
Key Points
- Tadalafil works by inhibiting phosphodiesterase type 5 (PDE5), increasing blood flow to the penis during sexual stimulation by relaxing smooth muscles and blood vessels.
- The medication has a longer duration of action (up to 36 hours) compared to other ED medications, earning it the nickname "weekend pill" 1.
- Common side effects include headache, indigestion, back pain, muscle aches, flushing, and nasal congestion.
- Tadalafil should not be taken with nitrates or certain other medications due to potentially dangerous interactions that could cause severe drops in blood pressure.
- Patients with cardiovascular conditions should consult their doctor before using tadalafil 1.
Dosage and Administration
- For ED, the typical starting dose is 10mg taken before sexual activity, which can be adjusted to 5mg or 20mg based on effectiveness and tolerability.
- Alternatively, a daily dose of 2.5mg to 5mg can be taken regardless of sexual activity timing.
- For BPH, the recommended dose is 5mg once daily.
Efficacy and Safety
- High-quality evidence indicates that tadalafil improves successful sexual intercourse and erections in men with ED 1.
- The medication has been shown to be effective in men with specific medical conditions, such as diabetes, depression, and cardiovascular disease 1.
- Tadalafil is generally well-tolerated, with common side effects being mild to moderate in severity 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Tadalafil Overview
- Tadalafil is a phosphodiesterase-5 (PDE5) inhibitor used to treat erectile dysfunction (ED) and lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) 2, 3, 4, 5.
- The drug has a half-life of 17.5 hours, allowing for once-daily dosing 2.
Efficacy in Treating ED
- Tadalafil has been shown to be effective in treating ED in multiple studies, with significant improvements in erectile function (EF) and successful penetration and completion of intercourse 2, 3, 6.
- In a 12-week study, tadalafil 5mg and 10mg once daily significantly improved EF, with 84.5% and 84.6% of patients reporting improved erections, respectively 2.
Efficacy in Treating LUTS/BPH
- Tadalafil has also been shown to be effective in treating LUTS/BPH, with significant improvements in International Prostate Symptom Score (IPSS) and Quality-of-Life Index (IPSS-QoL) 3, 4, 5.
- In a pooled analysis of four randomized studies, tadalafil 5mg once daily significantly improved IPSS and IIEF-EF Domain score, with mean changes from baseline of -6.0 and 6.4, respectively 3.
Safety and Tolerability
- Tadalafil has been shown to be safe and well-tolerated in multiple studies, with common adverse events including headache, dyspepsia, back pain, and nasopharyngitis 2, 3, 6, 4.
- In a 24-month extension trial, tadalafil was safe and well-tolerated, with a discontinuation rate due to adverse events of 6.3% 6.