From the Guidelines
Tadalafil tablets do not cure pulmonary hypertension, but they can help manage the condition by improving symptoms and quality of life. Tadalafil (commonly prescribed as Adcirca for pulmonary hypertension, typically at 40mg once daily) works as a phosphodiesterase type 5 (PDE5) inhibitor that relaxes blood vessels in the lungs, allowing blood to flow more easily and reducing the workload on the heart. This medication helps decrease pulmonary vascular resistance and can improve exercise capacity and delay clinical worsening in patients with pulmonary arterial hypertension (PAH) 1. According to the 2019 Chest guideline, tadalafil is one of the currently approved medications for the treatment of pulmonary arterial hypertension, with a recommended dose of 40mg once daily 1.
Key Points to Consider
- Tadalafil is a selective PDE-5 inhibitor that has shown favorable results on exercise capacity, symptoms, hemodynamics, and time to clinical worsening in patients with PAH 1.
- The medication should be part of a comprehensive treatment plan that may include other medications and lifestyle modifications depending on the type and severity of pulmonary hypertension.
- Treatment with tadalafil must be continuous to maintain its benefits, and patients should be monitored regularly by healthcare providers to assess the medication's effectiveness and adjust treatment as needed.
- The dose of tadalafil for pulmonary hypertension is typically 40mg once daily, as recommended by the 2019 Chest guideline 1.
Important Considerations for Treatment
- Pulmonary hypertension is a chronic, progressive condition that currently has no cure.
- A comprehensive treatment plan should be individualized to each patient's needs and may include multiple medications and lifestyle modifications.
- Regular monitoring by healthcare providers is essential to assess the effectiveness of treatment and make adjustments as needed.
From the FDA Drug Label
Tadalafil tablets are also marketed as ADCIRCA for the treatment of pulmonary arterial hypertension. Tadalafil tablets for the Treatment of ED ED is a condition where the penis does not fill with enough blood to harden and expand when a man is sexually excited, or when he cannot keep an erection Tadalafil tablets helps increase blood flow to the penis and may help men with ED get and keep an erection satisfactory for sexual activity.
Tadalafil tablets do not cure pulmonary hypertension. They are used to treat the symptoms of pulmonary arterial hypertension, but the label does not indicate that they provide a cure for the condition. 2
From the Research
Efficacy of Tadalafil in Pulmonary Hypertension
- Tadalafil is a selective cyclic guanosine monophosphate-specific phosphodiesterase type 5 inhibitor that has been shown to be effective in improving exercise ability and health-related quality of life (HR-QOL) scores in patients with pulmonary arterial hypertension (PAH) 3, 4.
- Studies have demonstrated that tadalafil significantly increases the mean placebo-corrected 6-minute walk distance (6MWD) and reduces the time to clinical worsening in patients with PAH 3, 5.
- Tadalafil has also been shown to improve cardiopulmonary hemodynamics and reduce the incidence of clinical worsening in patients with PAH 5, 6.
Long-Term Safety and Efficacy
- Long-term treatment with tadalafil has been shown to be well tolerated in patients with pulmonary arterial hypertension, with a safety profile similar to that of shorter-term treatment 7.
- The improvements in 6MWD demonstrated in shorter-term studies have been shown to be sustained for up to 52 additional weeks of treatment with tadalafil 7.
- Post hoc analyses have suggested that background bosentan use and higher 6MWD at baseline may be associated with fewer clinical worsening events in patients treated with tadalafil 7.
Clinical Utility
- Tadalafil is recommended as an option for patients with World Health Organization functional class II or III PAH, and has been shown to be a suitable alternative to sildenafil and a beneficial add-on option when used in combination with other treatments for PAH 5, 6.
- Tadalafil is generally safe and well tolerated, with adverse events typically being mild-to-moderate in intensity and discontinuation rates being low 3, 5.
Cure of Pulmonary Hypertension
- There is no evidence to suggest that tadalafil can cure pulmonary hypertension, as PAH is a chronic and disabling condition that remains challenging to treat and ultimately incurable 5.