What patient education is required for Tadalafil (Cialis) therapy?

From the Guidelines

Tadalafil should be taken exactly as prescribed, typically 5mg daily for the treatment of male lower urinary tract symptoms (MLUTS), and patients should be aware of its potential side effects and contraindications, as outlined in the most recent guidelines 1. When taking tadalafil, patients should understand it works by relaxing blood vessels to increase blood flow to specific areas of the body.

Key Points to Consider

• The typical dose for MLUTS is 5mg daily, as recommended by the 2023 European Association of Urology guidelines 1.
• Tadalafil can be taken with or without food, but avoid grapefruit products as they may increase side effects.
• Common side effects include headache, indigestion, back pain, muscle aches, flushing, and nasal congestion, which usually resolve on their own.
• Seek immediate medical attention if you experience an erection lasting more than 4 hours, sudden vision or hearing loss, chest pain, or allergic reactions.
• Tadalafil should not be taken with nitrate medications (like nitroglycerin) as this combination can cause a dangerous drop in blood pressure, and is also contraindicated in patients with cardiac disease, hypotension, poorly controlled blood pressure, recent stroke (<6 mo), or significant hepatic or renal insufficiency 1.

Important Considerations

• Patients should inform their healthcare provider about all medications they're taking, including over-the-counter drugs and supplements, to avoid potentially harmful interactions.
• Tadalafil is a reasonable option to trial in selected men, ideally those with concomitant erectile dysfunction, as suggested by the 2021 AUA guideline 1.
• The majority of studies that address the impact of PDE5s on LUTS/BPH used tadalafil, and the mechanism of action of this PDE5 effect is only partially understood 1.

From the FDA Drug Label

1. 11 Recommended Administration Physicians should instruct patients on the appropriate administration of tadalafil to allow optimal use. For tadalafil for use as needed in men with ED, patients should be instructed to take one tablet at least 30 minutes before anticipated sexual activity. In most patients, the ability to have sexual intercourse is improved for up to 36 hours For tadalafil for once daily use in men with ED or ED/BPH, patients should be instructed to take one tablet at approximately the same time every day without regard for the timing of sexual activity. Tadalafil is effective at improving erectile function over the course of therapy For tadalafil for once daily use in men with BPH, patients should be instructed to take one tablet at approximately the same time every day.

Patient Education for Tadalafil:

• Take tadalafil at least 30 minutes before anticipated sexual activity for use as needed.
• Take one tablet daily at the same time every day for once daily use.
• Tadalafil is effective for up to 36 hours for use as needed and improves erectile function over the course of therapy for once daily use.
• Patients should be instructed to follow the recommended administration to allow optimal use 2.

From the Research

Tadalafil Patient Education

• Tadalafil is a phosphodiesterase type 5 (PDE5) inhibitor used to treat erectile dysfunction (ED) and benign prostatic hyperplasia (BPH) 3, 4.
• The medication is available in different dosages, including a once-daily, low-dose option, which provides therapeutic concentrations throughout the 24-hour dosing interval 3.
• Tadalafil can be used as a monotherapy or add-on therapy for patients with lower urinary tract symptoms (LUTS) secondary to BPH, with or without ED 4.

Drug Interactions

• Tadalafil is contraindicated in patients taking nitrates due to the risk of severe hypotension and syncope 5, 6, 7.
• Caution is advised when using tadalafil with alpha-blockers, as it may cause orthostatic hypotension 5, 6, 7.
• Tadalafil can be used with most antihypertensive agents, but may cause additive decreases in blood pressure 6.
• The medication is metabolized mainly via the CYP3A4 pathway, and its plasma concentrations may be influenced by CYP3A inhibitors or inducers 5, 7.

Safety and Efficacy

• Tadalafil has been shown to be safe and effective in clinical trials for the treatment of ED and BPH 3, 4.
• The medication has a favorable side-effect profile, and its use is not associated with an increased risk of myocardial infarction or death 6.
• Tadalafil may have therapeutic potential for cardiovascular diseases, and its use is recommended as first-line therapy for patients with pulmonary hypertension 7.