From the FDA Drug Label
The recommended starting dose of tadalafil tablets for use as needed in most patients is 10 mg, taken prior to anticipated sexual activity. Tadalafil tablets for use as needed were shown to improve erectile function compared to placebo up to 36 hours following dosing.
The recommended starting dose of tadalafil for a 73-year-old patient is 10 mg, taken prior to anticipated sexual activity.
- The dose may be increased to 20 mg or decreased to 5 mg, based on individual efficacy and tolerability.
- The maximum recommended dosing frequency is once per day in most patients 1.
From the Research
For a 73-year-old patient, the recommended starting dose of tadalafil is 5 mg once daily, taken at approximately the same time each day. This lower starting dose is particularly appropriate for elderly patients who may be more sensitive to medications and have a higher risk of side effects, as supported by the study published in 2012 2. The daily dosing regimen maintains steady blood levels of the medication and allows for spontaneity in sexual activity. If this dose proves ineffective, it can be increased to 10 mg and eventually to a maximum of 20 mg, but dose adjustments should be made cautiously in older adults. For patients with renal impairment (creatinine clearance 30-50 mL/min), the dose should remain at 5 mg daily and not exceed 10 mg every 48 hours. Tadalafil should be used with caution in elderly patients taking antihypertensives, as the combination can cause significant blood pressure drops, as noted in the study published in 2006 3. The medication works by inhibiting phosphodiesterase type 5, increasing blood flow to the penis during sexual stimulation, but requires sexual arousal to be effective.
Some key points to consider when prescribing tadalafil to elderly patients include:
- The potential for increased sensitivity to the medication and a higher risk of side effects
- The importance of cautious dose adjustments in older adults
- The need for careful monitoring of patients with renal impairment
- The potential for significant blood pressure drops when combined with antihypertensives
- The importance of patient education on the proper use of the medication and the potential for side effects, as supported by the study published in 2008 4.
Overall, the use of tadalafil in elderly patients requires careful consideration of the potential benefits and risks, as well as close monitoring of the patient's response to the medication, as noted in the study published in 2004 5.