(Including Branded and Generic Options)
What is Tadalafil?
Tadalafil is a phosphodiesterase-5 (PDE5) inhibitor approved for the treatment of erectile dysfunction (ED). It helps increase blood flow to the penis during sexual stimulation, resulting in improved erectile function.
Who Should NOT Use Tadalafil?
Do not use tadalafil if:
- You take nitrates or nitric oxide donors (e.g., nitroglycerin, isosorbide dinitrate, isosorbide mononitrate) in any form, including recreational drugs known as “poppers.” Combining tadalafil with these medications can cause a severe drop in blood pressure.
- You are allergic to tadalafil or any ingredients in the product.
- You take guanylate cyclase (GC) stimulators like riociguat, as tadalafil may amplify the blood pressure-lowering effects of these medications.
How to Use Tadalafil
As-Needed Use:
- Take 1 tablet approximately 30 minutes before sexual activity.
- Do not exceed 1 dose in a 24-hour period.
Daily Use:
- Take 1 tablet at the same time daily, regardless of planned sexual activity.
- Follow your prescribed dosage exactly.
- Important Notes:
- Tadalafil can be taken with or without food.
- Avoid consuming large amounts of alcohol (more than 5 drinks) as it may increase the risk of side effects.
- Never mix tadalafil with other ED medications or PDE5 inhibitors.
What Should You Tell Your Healthcare Provider?
Before starting tadalafil, provide a complete medical history to your healthcare provider, including:
- All current medications, including over-the-counter drugs, supplements, and herbal remedies.
- Medical conditions, especially if you have a history of:
- Heart problems, including angina, heart failure, irregular heartbeat, or recent heart attack.
- Low or high blood pressure or conditions affecting blood pressure regulation.
- Stroke or life-threatening arrhythmia in the last 6 months.
- Kidney or liver disease, which may require dosage adjustments.
- Vision problems such as non-arteritic anterior ischemic optic neuropathy (NAION) or retinitis pigmentosa.
- Hearing issues, such as sudden hearing loss or tinnitus.
- Bleeding disorders or stomach ulcers.
- Priapism, a condition causing painful, prolonged erections.
Possible Drug Interactions
Tadalafil may interact with certain medications or substances, increasing the risk of side effects or altering drug efficacy:
- Nitrates and Alpha-Blockers: May cause severe drops in blood pressure.
- CYP3A4 Inhibitors: Medications like ritonavir, ketoconazole, and erythromycin may increase tadalafil levels, leading to adverse effects.
- Alcohol: Consuming large quantities may amplify blood pressure-lowering effects and increase dizziness.
Always consult your healthcare provider for guidance before combining tadalafil with any other medications.
Serious Risks and Side Effects
If you experience the following, stop taking tadalafil and seek immediate medical attention:
- Prolonged Erection (Priapism): Erections lasting more than 4 hours can cause permanent damage to the penis.
- Vision Changes: Sudden loss of vision may indicate non-arteritic anterior ischemic optic neuropathy (NAION).
- Hearing Changes: Sudden hearing loss, often with ringing in the ears, requires urgent medical attention.
- Severe Allergic Reactions: Symptoms include rash, swelling, or difficulty breathing.
Most Common Side Effects
Tadalafil is generally well-tolerated. Common side effects include:
- Headache
- Back pain
- Muscle pain
- Nasal congestion
- Flushing (warmth or redness in the face, neck, or chest)
- Indigestion
- Pain in the limbs
Important Precautions
- Sexual Activity: Patients with heart conditions should discuss whether it is safe to engage in sexual activity.
- Not for Protection Against STDs: Tadalafil does not prevent sexually transmitted infections. Practice safe sex.
- Missed Dose: For daily use, take the missed dose as soon as you remember unless it’s close to the time for your next dose. Never double the dose.
Reporting Side Effects
If you experience side effects, report them to the FDA at www.fda.gov/medwatch or call 1-800-FDA-1088.
For additional information, consult the full prescribing information or contact your healthcare provider.