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Tadalafil: Uses, Dosage, and Side Effects You Should Know
Summary of Key Points
Tadalafil is a prescription medication used to treat erectile dysfunction (ED), benign prostatic hyperplasia (BPH), and pulmonary arterial hypertension (PAH). It works by relaxing blood vessels, which improves blood flow to specific areas of the body. Tadalafil is available in various strengths and should always be taken as prescribed by your healthcare provider. It is important to consult your doctor before making any changes to your dosage. Our telemedicine providers are also available to help manage your treatment.
Names of Medication
US Brand Name: Cialis (Tadalafil)
US Brand Name: Adcirca (Tadalafil)
The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. The generic name is listed in parentheses.
Pharmacologic Category
Tadalafil belongs to a class of medications known as Phosphodiesterase-5 (PDE5) inhibitors.
Tadalafil Dosage
Tadalafil is used to treat a variety of conditions, and the appropriate dosage depends on the condition being treated. Always consult your doctor or one of our telemedicine providers before making any changes to your dose.
Tadalafil for Erectile Dysfunction (ED)
As needed: 10 mg taken at least 30 minutes before sexual activity. The dose may be increased to 20 mg or reduced to 5 mg depending on how well it works and how well it is tolerated. Do not take more than one dose per day.
Daily use: 2.5 mg once daily, taken at the same time each day, regardless of sexual activity. The dose may be increased to 5 mg based on individual response.
Tadalafil for Benign Prostatic Hyperplasia (BPH)
5 mg once daily, taken at the same time each day. The duration of treatment depends on the severity of symptoms and how well the medication is working.
Tadalafil for Pulmonary Arterial Hypertension (PAH)
40 mg once daily (two 20 mg tablets). Do not split the dose or exceed 40 mg per day.
Tadalafil for Raynaud’s Phenomenon
5 mg once daily, with potential adjustments based on individual response. Consult your doctor for specific recommendations.
Tadalafil for Chronic Obstructive Pulmonary Disease (COPD)
Tadalafil is not a standard treatment for COPD but may be used off-label. Consult your healthcare provider for more information.
Tadalafil for Heart Failure
20 mg once daily. This is an off-label use and should only be taken under close medical supervision.
Tadalafil for Hypertension
40 mg once daily for pulmonary hypertension. For other types of hypertension, consult your healthcare provider for specific dosing recommendations.
Tadalafil for Coronary Artery Disease
5 mg once daily. This is an off-label use and should be discussed with your doctor.
Tadalafil for Diabetes-Related Sexual Dysfunction
10 mg taken as needed before sexual activity. The dose may be adjusted based on response and tolerability.
Tadalafil for Prostate Cancer
5 mg once daily. This is an off-label use and should be taken under the guidance of a healthcare provider.
Dosage Forms and Strengths of Tadalafil
Tadalafil tablets are available in the following strengths: 2.5 mg, 5 mg, 10 mg, and 20 mg.
Administration Instructions for Tadalafil
Tadalafil can be taken with or without food. Swallow the tablet whole with water. If you are taking it for erectile dysfunction, take it at least 30 minutes before sexual activity. For daily use, take it at the same time each day. Do not split or crush the tablets. Always follow your healthcare provider’s instructions and consult them if you have any questions or concerns about your treatment.
Tadalafil Side Effects and Adverse Reactions
Like all medications, Tadalafil can cause side effects. Most are mild, but some can be more serious. If you experience any side effects, contact your healthcare provider immediately. Our telemedicine providers are available to assist you.
Common Tadalafil Side Effects (Occurring in more than 1 in 10 people)
Headache: A common side effect that usually resolves within a few hours.
Flushing: Warmth or redness in the face, neck, or chest.
Indigestion: Stomach discomfort or heartburn.
Less Common Tadalafil Side Effects (Occurring in 1 in 100 people)
Back pain: Muscle aches or discomfort, typically mild.
Stuffy or runny nose: Nasal congestion or cold-like symptoms.
Serious Tadalafil Side Effects (Occurring in less than 1 in 1,000 people)
Vision changes: Sudden vision loss or blurred vision. Seek medical attention immediately.
Hearing loss: Sudden decrease or loss of hearing. Contact your doctor right away.
Prolonged erection (priapism): An erection lasting more than 4 hours. This is a medical emergency and requires immediate treatment.
Contraindications for Tadalafil
A contraindication is a specific condition where a medication should not be used due to potential harm. If you have any of the following conditions, you should not take Tadalafil, as it may pose serious health risks. Always consult your healthcare provider before starting any new medication, and if unsure, schedule a telemedicine appointment with one of our providers.
Severe heart conditions: If you’ve had a recent heart attack, stroke, or have severe heart disease, Tadalafil can put additional strain on your heart, which may be dangerous.
Low blood pressure (hypotension): Tadalafil can lower blood pressure further, potentially causing dizziness, fainting, or even shock.
Uncontrolled high blood pressure (hypertension): If your blood pressure is not well-managed, Tadalafil may increase the risk of complications like heart attack or stroke.
Severe liver or kidney disease: Tadalafil is processed by the liver and kidneys. If these organs aren’t functioning properly, the medication may not be cleared effectively, leading to toxic levels.
Allergy to Tadalafil: If you’ve had an allergic reaction to Tadalafil or any of its ingredients, you should not take this medication.
Use of nitrates: Nitrates (often prescribed for chest pain) and Tadalafil both lower blood pressure. Taking them together can cause a dangerous drop in blood pressure.
Drug to Drug Interactions
It is crucial to inform your healthcare provider about all the medications you are currently taking, as some drugs can interact with Tadalafil and lead to serious side effects. Below are some common medications that may interact with Tadalafil:
Nitrates: Medications like nitroglycerin (Nitrostat) or isosorbide mononitrate (Imdur), often prescribed for chest pain, can cause a dangerous drop in blood pressure when combined with Tadalafil.
Alpha-blockers: Drugs such as doxazosin (Cardura) or tamsulosin (Flomax), used to treat high blood pressure or prostate issues, may also cause a significant drop in blood pressure when taken alongside Tadalafil.
Antifungal medications: Medications like ketoconazole (Nizoral) or itraconazole (Sporanox) can increase the levels of Tadalafil in your body, raising the risk of side effects.
HIV medications: Protease inhibitors such as ritonavir (Norvir) or saquinavir (Invirase) can also elevate Tadalafil levels, potentially leading to adverse effects.
Other erectile dysfunction medications: Combining Tadalafil with other erectile dysfunction treatments, such as sildenafil (Viagra) or vardenafil (Levitra), can increase the risk of side effects, including low blood pressure and prolonged erections.
Tadalafil in Pregnancy
Is it Safe to Take Tadalafil During Pregnancy?
Tadalafil is not typically prescribed for women, and there is limited research on its safety during pregnancy. It is generally not recommended unless specifically advised by a healthcare provider. If you are pregnant or planning to become pregnant, discuss your treatment options with your healthcare provider to ensure the safest course of action.
Tadalafil While Breastfeeding
Is it Safe to Take Tadalafil While Breastfeeding?
There is insufficient data on whether Tadalafil passes into breast milk or its effects on a nursing infant. Therefore, it is not recommended while breastfeeding unless your healthcare provider determines that the benefits outweigh the risks. Always consult your provider before taking any medication while breastfeeding.
Estimated Cost of Tadalafil
The cost of a 30-day supply of Tadalafil varies depending on the dosage and the pharmacy. Without insurance, the price for a 30-day supply using a GoodRx coupon typically ranges from $10 to $30 for generic versions. The brand name (Cialis) is significantly more expensive, often exceeding $300 for a 30-day supply. Check with your pharmacy or use a coupon service like GoodRx to find the best available price.
Possible Alternatives to Tadalafil
If Tadalafil is not suitable for you, alternative treatments and lifestyle changes may help manage your condition. Always discuss these options with your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine appointment with one of our providers to explore these alternatives.
- Erectile dysfunction: Alternatives include other medications like sildenafil (Viagra) or vardenafil (Levitra), vacuum erection devices, or lifestyle changes such as improving diet, increasing physical activity, and reducing alcohol intake.
- Pulmonary arterial hypertension: Other medications such as sildenafil (Revatio) or bosentan (Tracleer) may be used. Oxygen therapy and lifestyle changes like quitting smoking can also help.
- Benign prostatic hyperplasia (BPH): Alternatives include medications like tamsulosin (Flomax) or finasteride (Proscar), as well as lifestyle changes such as reducing caffeine and alcohol intake.
- Raynaud’s phenomenon: Calcium channel blockers such as nifedipine (Procardia) or lifestyle changes like keeping warm and managing stress may help alleviate symptoms.
- Chronic obstructive pulmonary disease (COPD): Bronchodilators, inhaled steroids, and lifestyle changes such as quitting smoking and participating in pulmonary rehabilitation are common alternatives.
- Heart failure: Medications like ACE inhibitors, beta-blockers, and lifestyle changes such as reducing sodium intake and engaging in regular exercise can help manage heart failure.
- Hypertension: Other medications such as ACE inhibitors or calcium channel blockers, along with lifestyle changes like reducing salt intake and increasing physical activity, can help control high blood pressure.
- Coronary artery disease: Alternatives include medications like statins or aspirin, along with lifestyle changes such as adopting a heart-healthy diet and engaging in regular exercise.
- Diabetes-related sexual dysfunction: Managing blood sugar levels, using other medications like sildenafil (Viagra), or making lifestyle changes such as weight loss and regular exercise may help.
- Prostate cancer: Treatment options include surgery, radiation therapy, hormone therapy, or active surveillance, depending on the stage and severity of the cancer.
Recent Updates on Tadalafil Research
Recent research on Tadalafil has explored its potential use in treating conditions beyond erectile dysfunction and pulmonary arterial hypertension. For example, studies are investigating its role in managing Raynaud’s phenomenon and heart failure. Additionally, researchers are examining the long-term effects of Tadalafil on cardiovascular health, particularly in patients with coronary artery disease. While these studies are ongoing, early results suggest that Tadalafil may have broader applications in managing vascular conditions. However, more research is needed before these uses become standard practice. Always consult your healthcare provider for the most up-to-date information on Tadalafil and its potential benefits for your condition.
