What is the recommended dose of Tadalafil (Cialis) for a 60-year-old male patient taking Ramipril (Angiotensin-Converting Enzyme Inhibitor) 2.5mg?

From the Guidelines

For a 60-year-old male taking ramipril 2.5mg, the recommended starting dose of Cialis (tadalafil) is typically 10mg taken as needed before sexual activity, not to exceed once daily. This recommendation is based on the evidence that tadalafil improves erections in men with erectile dysfunction, including those with various medical conditions such as cardiovascular disease 1. The dose of tadalafil can be adjusted to 5mg if side effects occur or increased to 20mg if the response is insufficient. It's essential to consider the potential interaction between ramipril, an ACE inhibitor, and tadalafil, which may have additive blood pressure-lowering effects 1. The patient should be monitored for symptoms of low blood pressure, such as dizziness or lightheadedness.

Some key points to consider when prescribing tadalafil include:

• The patient should take tadalafil at least 30-60 minutes before anticipated sexual activity, and the effect may last up to 36 hours.
• For men who anticipate more frequent use (more than twice weekly), a daily dosing regimen of 2.5-5mg may be more appropriate.
• The patient should inform all healthcare providers about all medications being taken and report any concerning side effects promptly.
• Tadalafil has been shown to be effective in improving erectile function in men with various medical conditions, including diabetes, depression, and cardiovascular disease 1.

It's also important to note that the evidence suggests that tadalafil is generally well-tolerated and effective in improving erectile function, with a response rate of 69% compared to 33% for placebo 1. However, the patient's individual response to the medication and potential side effects should be closely monitored.

From the Research

Cialis Dose for 60yo Male Taking Ramipril 2.5mg

• The provided studies do not directly address the optimal Cialis dose for a 60-year-old male taking ramipril 2.5mg.
• However, it is known that erectile dysfunction (ED) is a common disorder in middle-aged men and is significantly influenced by cardiovascular risk factors (CVRFs) and cardiovascular disease 2.
• The use of ramipril, an angiotensin-converting enzyme (ACE) inhibitor, has been shown to reduce the risk of cardiovascular events in high-risk patients 3, 4.
• There is evidence that ED is predictive of all-cause death and the composite of cardiovascular death, myocardial infarction, stroke, and heart failure in men with cardiovascular disease 5.
• While the studies do not provide guidance on the specific dose of Cialis, they highlight the importance of considering the patient's overall cardiovascular health and risk factors when managing ED.
• Other treatment options for ED, such as penile traction therapy and vacuum erection devices, have shown promise in various studies 6.