Tadalafil

DEA Class; Rx

Common Brand Names; Adcirca, Cialis, Alyq

• PAH, PDE-5 Inhibitors; 
• Phosphodiesterase-5 Enzyme Inhibitors

Oral, selective phosphodiesterase type 5 (PDE5) inhibitor with longer duration of action
Used for pulmonary arterial hypertension (PAH), erectile dysfunction (ED), benign prostatic hyperplasia (BPH), or a combination of ED and BPH
As with other PDE5 inhibitors, contraindicated for use with nitrates because the combination can cause a sudden drop in blood pressure

Indicated for the treatment of erectile dysfunction (ED).

Hypersensitivity, including Stevens-Johnson syndrome and exfoliative dermatitis

Soluble guanylate cyclase (sGC) stimulators (eg, riociguat); concomitant use can cause hypotension

• Headache (11-42%)
• Myalgia (1-14%)
• Respiratory tract infection (3-13%)
• Nasopharyngitis (2-13%)
• Dyspepsia (1-13%)
• Flushing (1-13%)
• Back pain (2-12%)
• Nausea (10-11%)
• Nasal congestion (≤9%)
• Gastroesophageal reflux disease (1-3%)
• Hypertension (1-3%)
• Bronchitis (≤2%)
• Genitourinary tract infection (≤2%)

Use caution in patients with anatomic deformation of penis, cardiovascular disease, left ventricular outflow obstruction, myocardial infarction in preceding 90 days, unstable angina, angina occurring during sexual intercourse, NYHA class 2 or greater heart failure in preceding 6 months, uncontrolled arrhythmias, hypotension, uncontrolled hypertension, cerebrovascular accident in preceding 6 months, bleeding disorders, active peptic ulcer disease, liver disease, renal impairment, conditions predisposing to priapism, concomitant use of CYP3A4 inhibitors

May cause dose-related impairment of color discrimination; use caution in patients with retinitis pigmentosa

Evaluate underlying causes of erectile dysfunction or BPH before initiating therapy

Do not use nitrates within 48 hours of last dose of tadalafil

Drug has vasodilatory properties that may result in transient decreases in blood pressure; prior to prescribing, carefully consider whether patients with underlying cardiovascular disease could be affected adversely by such vasodilatory effects; patients with preexisting hypotension, with autonomic dysfunction, with left ventricular outflow obstruction, may be particularly sensitive to actions of vasodilators

When used to treat erectile dysfunction, non-arteritic anterior ischemic optic neuropathy (NAION), a cause of decreased vision including permanent loss of vision, reported postmarketing; if vision problems arise, discontinue, and contact physician

Risk of sudden hearing loss

Limited data from case series with use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes

There are no data on presence of drug and/or its metabolites in human milk, effects on breastfed child, or on milk production

Tadalafil 

tablet (Adcirca, Alyq, generic)

• 20mg

tablet (Cialis, generic)

• 2.5mg
• 5mg
• 10mg
• 20mg