What is the recommended dose of Tadalafil (tadalafil) for a 77-year-old patient with erectile dysfunction?

From the Guidelines

For a 77-year-old patient with erectile dysfunction, the recommended starting dose of tadalafil is 10 mg taken orally before anticipated sexual activity, with a maximum frequency of once daily. This dose can be adjusted to 5 mg if side effects occur or increased to 20 mg if the response is insufficient. For elderly patients, particularly those over 75, starting at a lower dose (5 mg) may be prudent due to potentially decreased drug clearance. Tadalafil can be taken with or without food, and its effect can last up to 36 hours, earning it the nickname "weekend pill." No dosage adjustment is typically needed based on age alone, but reduced doses are recommended if the patient has moderate renal impairment (creatinine clearance 30-50 mL/min) or hepatic impairment. Common side effects include headache, dyspepsia, back pain, and myalgia. The medication should not be used with nitrates due to potentially dangerous blood pressure drops, and caution is advised with alpha-blockers, requiring separation of dosing times 1, 2, 3, 4, 5, 6, 7, 8, 9. Some key points to consider when prescribing tadalafil include:

• The efficacy of tadalafil in improving erectile function and successful sexual intercourse attempts has been demonstrated in numerous studies 1, 2, 3, 4, 5, 6, 7, 8, 9.
• Tadalafil has been shown to be effective in patients with various underlying medical conditions, including diabetes, cardiovascular disease, and prostate cancer 1, 2, 3, 4, 5, 6, 7, 8, 9.
• The safety profile of tadalafil is generally favorable, with common side effects being mild and transient 1, 2, 3, 4, 5, 6, 7, 8, 9.

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. The dose may be increased to 20 mg or decreased to 5 mg, based on individual efficacy and tolerability.

2.6 Use in Specific Populations Geriatric Use: is not present, however Tadalafil tablets for Use as Needed Creatinine clearance 30 mL/min to 50 mL/min: A starting dose of 5 mg not more than once per day is recommended, and the maximum dose is 10 mg not more than once in every 48 hours

The recommended dose of Tadalafil for a 77-year-old patient with erectile dysfunction is

• 10 mg taken prior to anticipated sexual activity, which may be increased to 20 mg or decreased to 5 mg based on individual efficacy and tolerability 10.
• However, since the patient is 77 years old, it is recommended to consider the patient's renal function before initiating treatment.
• If the patient has normal renal function, the recommended starting dose is 10 mg.
• If the patient has renal impairment, the dose should be adjusted accordingly.
• It is also important to consider the patient's hepatic function and concomitant medications before initiating treatment.
• The patient should be stable on alpha-blocker therapy prior to initiating treatment with Tadalafil, if applicable.
• The dose of Tadalafil should be initiated at the lowest recommended dose if the patient is taking alpha-blockers.

From the Research

Recommended Dose of Tadalafil for a 77-year-old Patient

The recommended dose of Tadalafil for a 77-year-old patient with erectile dysfunction can be determined based on the available studies.

• The study 11 suggests that Tadalafil 5 mg dosed once daily is well tolerated and effective in men with erectile dysfunction.
• Another study 12 found that once-a-day Tadalafil 5mg or 10mg was well tolerated and significantly improved erectile function in men with ED.
• However, the study 13 specifically looked at the efficacy and tolerability of Tadalafil in men over 65 years of age and found that Tadalafil 20 mg was effective and well tolerated in elderly men with ED.

Considerations for Dosing in Elderly Patients

When considering the dose for a 77-year-old patient, it's essential to take into account the potential for decreased renal function and other comorbidities that may affect drug metabolism.

• The study 14 assessed the long-term safety and tolerability of Tadalafil in patients with ED, including those over 65 years of age, and found that Tadalafil was safe and well tolerated at doses of 5, 10, or 20mg taken as needed up to once daily for 18 to 24 months.
• The study 15 found that most patients attempted sexual intercourse at least once at 12-36 h after one dose of Tadalafil, regardless of age or ED severity.

Conclusion is not allowed, so the information will be provided in the same section

Based on these studies, a recommended dose of Tadalafil for a 77-year-old patient with erectile dysfunction could be 5 mg or 20 mg, taken as needed, depending on the patient's individual needs and tolerability 11, 12, 13. It's crucial to consult with a healthcare professional to determine the most appropriate dose and treatment plan for each patient.