From the Guidelines
Tadalafil is a recommended treatment for erectile dysfunction (ED) in men, with a typical dose ranging from 2.5 to 20 mg taken before sexual activity, and it should not be taken with nitrate medications due to the risk of a dangerous drop in blood pressure 1.
Key Points
- Tadalafil works by inhibiting the enzyme phosphodiesterase type 5 (PDE5), which increases blood flow to the penis during sexual stimulation.
- The medication has a longer duration of action compared to other ED medications, lasting up to 36 hours.
- Common side effects include headache, indigestion, back pain, muscle aches, flushing, and nasal congestion.
- Patients with cardiovascular disease should consult their doctor before using tadalafil, and the medication should be taken as prescribed without exceeding the recommended dosage.
Dosage and Administration
- The typical dose of tadalafil for ED ranges from 2.5 to 20 mg taken before sexual activity.
- For daily use, lower doses of 2.5 or 5 mg are prescribed.
Contraindications and Precautions
- Concurrent use of nitrates in any form is a contraindication for oral PDE-5 inhibitor therapy, including tadalafil.
- Patients with cardiovascular disease should exercise caution when using tadalafil, and it is recommended to consult a doctor before taking the medication.
Efficacy and Safety
- High-quality evidence indicates that tadalafil improves erections and successful sexual intercourse attempts compared to placebo 1.
- The medication is generally well-tolerated, with mild to moderate adverse events reported in clinical trials.
From the FDA Drug Label
Tadalafil tablets are a prescription medicine taken by mouth for the treatment of: men with erectile dysfunction (ED) men with symptoms of benign prostatic hyperplasia (BPH) men with both ED and BPH Tadalafil tablets helps increase blood flow to the penis and may help men with ED get and keep an erection satisfactory for sexual activity. The main use of Tadalafil is to treat:
- Erectile Dysfunction (ED): by increasing blood flow to the penis, helping men get and keep an erection.
- Benign Prostatic Hyperplasia (BPH): to alleviate symptoms of an enlarged prostate gland.
- Both ED and BPH: in men who experience both conditions simultaneously. 2
From the Research
Tadalafil Overview
- Tadalafil is a selective cyclic guanosine monophosphate-specific phosphodiesterase type 5 inhibitor 3
- It is effective in treating the signs and symptoms of benign prostatic hyperplasia (BPH) and erectile dysfunction (ED) 3, 4, 5
Efficacy in BPH Treatment
- Once-daily tadalafil 5 mg was effective in treating the signs and symptoms of BPH, with significant improvements in total International Prostate Symptom Score (IPSS) and IPSS subscores 3, 5
- Tadalafil also improved the Quality-of-Life Index (IPSS-QoL) and the BPH Impact Index (BII) 5
Efficacy in ED Treatment
- Tadalafil was effective in treating ED, with significant improvements in the International Index of Erectile Function-Erectile Function (IIEF-EF) Domain score 4, 5
- Once-a-day tadalafil 5mg or 10mg was well tolerated and significantly improved erectile function in men with ED 4
Safety and Tolerability
- Tadalafil was generally well tolerated, with adverse events being of mild to moderate intensity 3, 4, 6
- The most common treatment-emergent adverse events were headache, dyspepsia, nasopharyngitis, and back pain 6
- Tadalafil was safe and well tolerated for up to 24 months, with no significant laboratory or electrocardiographic findings or changes in vital signs attributable to tadalafil 6
Treatment of Both BPH and ED
- Tadalafil was efficacious and well tolerated in treating both ED and LUTS/BPH in sexually active men with both conditions 5
- Improvements in both conditions were significant regardless of baseline severity, and the treatment was not associated with improvement in maximum urine flow or post-void residual volume (PVR) 5, 7