What is the optimal daily dosing of Tadalafil (Cialis)?

From the Guidelines

The optimal daily dosing of Tadalafil (Cialis) is 40mg daily orally. This recommendation is based on the most recent and highest quality study available, which provides state-of-the-art evidence in the treatment of systemic sclerosis 1. The study outlines the dosing for various therapies, including phosphodiesterase 5 inhibitors like Tadalafil, which is specifically listed as 40mg daily orally.

Key Considerations

• The dosing of Tadalafil is crucial for its effectiveness in treating conditions like pulmonary hypertension, which is associated with systemic sclerosis.
• Phosphodiesterase 5 inhibitors, including Tadalafil, work by enhancing the nitric oxide–cyclic GMP pathway, leading to pulmonary vasodilatory and anti-proliferative effects.
• It's essential to note that the dosing may vary depending on the specific condition being treated and individual patient response.

Important Details

• The study provides a comprehensive overview of therapies for systemic sclerosis, including endothelin receptor antagonists, phosphodiesterase 5 inhibitors, prostacyclin analogues, and soluble guanylate cyclase stimulators.
• Tadalafil is one of the phosphodiesterase 5 inhibitors listed, with a specified daily dosing of 40mg orally 1.
• Other phosphodiesterase 5 inhibitors, like Sildenafil, have different dosing regimens, such as 20mg three times per day orally.

Clinical Implications

• Healthcare providers should consult the latest guidelines and studies, such as the one referenced here 1, to ensure they are prescribing the optimal dose of Tadalafil for their patients.
• Patients should be closely monitored for response and tolerability, and the dose may need to be adjusted accordingly.
• As with any medication, it's crucial to be aware of potential side effects and interactions with other medications.

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. The recommended starting dose of tadalafil tablets for once daily use is 2.5 mg, taken at approximately the same time every day, without regard to timing of sexual activity. The tadalafil tablets dose for once daily use may be increased to 5 mg, based on individual efficacy and tolerability.

The optimal daily dosing of Tadalafil (Cialis) is:

• For use as needed: 10 mg, taken prior to anticipated sexual activity, with a maximum frequency of once per day. The dose may be adjusted to 5 mg or 20 mg based on individual efficacy and tolerability.
• For once daily use: 2.5 mg, taken at approximately the same time every day, which may be increased to 5 mg based on individual efficacy and tolerability 2.

From the Research

Optimal Daily Dosing of Tadalafil

• The optimal daily dosing of Tadalafil (Cialis) can vary depending on the individual and their specific needs, but studies have shown that doses of 2.5mg and 5mg once daily are effective and well-tolerated for the treatment of erectile dysfunction (ED) 3, 4.
• A study published in 2008 found that once-daily tadalafil 2.5 and 5 mg was efficacious and well tolerated in men with diabetes and ED, suggesting this may be an alternative to on-demand treatment for some men 3.
• Another study published in 2008 found that tadalafil 5 mg dosed once daily for 1 or 2 years was well tolerated and effective in men with ED, making it a viable alternative to the current on-demand dosing of tadalafil 4.
• A long-term study published in 2004 found that tadalafil at doses of 5,10, or 20mg taken as needed up to once daily for 18 to 24 months was safe and well tolerated, supporting the long-term use of tadalafil in the clinical management of ED 5.
• A comparative study published in 2015 found that tadalafil once daily provided similar efficacy in men with ED who had previously demonstrated a partial response to as-needed sildenafil, tadalafil, or vardenafil 6.
• A study published in 2018 compared the differences between daily 5mg and on-demand 20mg tadalafil use in diabetic patients with ED, and found that daily use of 5mg of tadalafil significantly improved the quality of ejaculation and LUTS more than the on-demand use of 20mg of tadalafil 7.

Dosage Considerations

• The dosage of tadalafil can be adjusted based on individual needs and response to treatment, with common dosages ranging from 2.5mg to 20mg once daily 3, 4, 5, 6, 7.
• Patients with diabetes and ED may benefit from once-daily tadalafil 2.5 or 5 mg, as this dosage has been shown to be efficacious and well tolerated in this population 3.
• Patients who have previously demonstrated a partial response to as-needed PDE5I therapy may benefit from tadalafil once daily, as this dosage has been shown to provide similar efficacy to as-needed therapy 6.
• Daily use of 5mg of tadalafil may be beneficial for patients over 65 years old who do not benefit from treatment with 20mg of tadalafil, or in patients who have LUTS over 65 years old 7.