Intimate

Indications

Tadalafil is used to treat erectile dysfunction (difficulty getting or keeping an erection firm enough for sex) in adult men, and urinary symptoms caused by an enlarged prostate (benign prostatic hyperplasia), either separately or together. Under a specialist, it is also used for pulmonary arterial hypertension (high blood pressure in the arteries of the lungs).

How It Works

Tadalafil blocks an enzyme called PDE5. This relaxes the blood vessels of the penis so more blood can flow in during sexual arousal, and relaxes muscle in the prostate and bladder to ease passing urine. It does not cause an erection without sexual stimulation. Its effect can last up to 36 hours.

Dosage and Administration

• Erectile dysfunction, as needed: usually 10 mg taken at least 30 minutes before sexual activity. The doctor may change it to 5 mg or 20 mg. Do not take more than one dose a day.
• Erectile dysfunction, daily use: 2.5 to 5 mg once a day at about the same time, as prescribed.
• Enlarged prostate: usually 5 mg once a day.
• Pulmonary arterial hypertension: as prescribed by the specialist.

Can be taken with or without food. People with kidney or liver problems may need a lower dose.

Interactions

Never take it with nitrates such as Glyceryl trinitrate or Isosorbide mononitrate, or with Riociguat, because blood pressure can drop dangerously; nitrates should not be given within 48 hours of the last dose. Alpha-blockers such as Doxazosin or Tamsulosin can cause dizziness. Ritonavir, Ketoconazole, Itraconazole and Clarithromycin raise Tadalafil levels, while Rifampicin lowers them. Heavy drinking increases the chance of dizziness and low blood pressure.

Contraindications

• Use of any nitrate medicine or Riociguat.
• Heart attack within the last 90 days, recent stroke, unstable chest pain, severe heart failure, uncontrolled high or very low blood pressure, or heart disease where sexual activity is not advised.
• Previous sudden loss of vision from reduced blood flow to the optic nerve (NAION).
• Allergy to Tadalafil.

Side Effects

Common: headache, indigestion, back pain, muscle aches, flushing and a blocked nose. These usually ease within a few days of regular use.

Get urgent medical help if an erection lasts more than 4 hours, or if you have chest pain, fainting, sudden loss or reduction of vision, sudden hearing loss, or swelling of the face or throat.

Pregnancy and Lactation

Tadalafil for erectile dysfunction or prostate symptoms is not meant for women. Use for pulmonary hypertension during pregnancy or breastfeeding is only under specialist advice.

Precautions and Warnings

Check with a doctor first if you have heart disease, as sex puts extra strain on the heart. Use with care if you have a curved or scarred penis, sickle cell disease, leukaemia or multiple myeloma, bleeding problems, or kidney or liver disease. A doctor should check for prostate cancer before treating urinary symptoms. Do not combine with other medicines for erectile dysfunction.

Overdose

Too much increases side effects such as headache, back pain, dizziness and low blood pressure. Seek medical help.

Therapeutic Class

Phosphodiesterase type 5 (PDE5) inhibitor.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.