From the Guidelines
Tadalafil does not prevent or reverse the aging process, though it may help address certain age-related conditions, such as erectile dysfunction (ED) and benign prostatic hyperplasia (BPH), as evidenced by high-quality studies 1.
Tadalafil Mechanism and Usage
Tadalafil, commonly sold as Cialis, is primarily prescribed for ED, which becomes more common as men age, and for BPH. The typical dose ranges from 2.5-20mg, with 5-10mg being common for ED treatment taken before sexual activity or as a daily 2.5-5mg dose. For BPH, a daily 5mg dose is standard.
Key Considerations
- Tadalafil effectively improves blood flow by inhibiting phosphodiesterase type 5 (PDE5), allowing blood vessels to relax and increasing circulation to the penis and prostate.
- It does not affect the fundamental biological processes of aging.
- Some research suggests PDE5 inhibitors may have other benefits like improved exercise capacity and potentially positive effects on cardiovascular health, but these are not anti-aging effects.
- Patients should be aware that tadalafil requires sexual stimulation to work for ED, can cause side effects like headaches and muscle aches, and should not be taken with nitrate medications due to dangerous blood pressure drops.
Evidence Summary
High-quality evidence from studies 1 indicates that PDE-5 inhibitors, including tadalafil, improve successful sexual intercourse and erections in men with ED, including those with various underlying medical conditions such as diabetes, depression, cardiovascular disease, and prostate cancer.
Recommendation
Given the evidence, tadalafil is recommended for the treatment of ED and BPH in aging men, with careful consideration of potential side effects and interactions, particularly with nitrate medications 1.
From the Research
Tadalafil and Aging
- The studies provided do not directly address the relationship between tadalafil and aging 2, 3, 4, 5, 6.
- However, the studies do mention the age range of men affected by erectile dysfunction (ED), which includes men between 40 and 70 years of age 2, 6.
- Tadalafil has been shown to be effective in men with ED of various ages, including older men 3, 4.
- The efficacy and safety of tadalafil have been demonstrated in clinical trials involving men with a mean age of 56 years 3.
- There is no conclusive evidence to suggest that tadalafil has any specific advantages or disadvantages in older men compared to younger men 2, 3, 4, 5, 6.
Efficacy and Safety of Tadalafil
- Tadalafil has been shown to be effective in the treatment of ED, with significant improvements in erectile function and success rates for intercourse attempts 3, 4.
- The safety profile of tadalafil is similar to that of other phosphodiesterase-5 inhibitors, with common adverse events including headache, dyspepsia, and back pain 3, 4.
- Tadalafil has a longer duration of action than sildenafil and vardenafil, which may be preferred by some men 2, 6.
Comparison with Other Phosphodiesterase-5 Inhibitors
- Tadalafil has been compared to sildenafil and vardenafil in several studies, with similar efficacy and safety profiles 2, 5, 6.
- The choice of phosphodiesterase-5 inhibitor may depend on individual patient preferences and needs, with some men preferring the longer duration of action of tadalafil 2, 6.