![]() ![]() This translates to a longer duration of action, which is partly responsible for "The Weekend Pill" nickname. Duration of action Īlthough sildenafil, vardenafil, and tadalafil all work by inhibiting PDE5, tadalafil's pharmacologic distinction is its longer half-life (17.5 hours), compared to sildenafil and vardenafil, which are both 4–5 hours. However, because sexual stimulation is required to initiate the local penile release of nitric oxide, tadalafil's inhibition of PDE5 will have no effect without sexual stimulation. Tadalafil (and sildenafil and vardenafil) inhibits PDE5. The inhibition of phosphodiesterase type 5 (PDE5) enhances erectile function by increasing the amount of cGMP. cGMP relaxes smooth muscle and increases blood flow to the corpus cavernosum. This response is mediated by the release of nitric oxide (NO) from nerve terminals and endothelial cells, which stimulates the synthesis of cyclic guanosine monophosphate (more commonly known as cyclic GMP or cGMP) in smooth muscle cells. Penile erection during sexual stimulation is caused by increased penile blood flow resulting from the relaxation of penile arteries and the smooth muscle of the corpus cavernosum. Tadalafil is metabolized predominantly by the liver CYP3A4 enzyme system. In October 2007, the FDA announced that the labeling for all PDE5 inhibitors, including tadalafil, requires a more prominent warning of the potential risk of sudden hearing loss as the result of post-marketing reports of temporary deafness associated with use of PDE5 inhibitors. A 2019 meta-analysis found that tadalafil exposure was not associated with NAION. The FDA concluded that they were not able to draw a cause and effect relationship, only an association the label of all three PDE5 inhibitors was changed to alert clinicians to that fact. Most, but not all, of these patients had underlying anatomic or vascular risk factors for development of NAION, unrelated to PDE5 use. In May 2005, the US Food and Drug Administration (FDA) found that tadalafil (along with other PDE5 inhibitors) was associated with vision impairment related to NAION ( non-arteritic anterior ischemic optic neuropathy). These side effects reflect the ability of PDE5 inhibition to cause vasodilation (cause blood vessels to widen), and usually resolve after a few hours. Diarrhea was reported more frequently in patients 65 or older than in younger subjects. Also common are dizziness, peripheral edema, fatigue, and urinary or respiratory tract infection both diarrhea and constipation have been reported. The most common potential side effects when using tadalafil are headache, stomach discomfort or pain, indigestion, burping, acid reflux, back pain, myalgia (pain in limbs and extremities), flushing, hypertension (or uncommonly hypotension), and stuffy/ runny nose. ![]() Tadalafil is approved in the United States, Canada, and Japan to improve exercise ability in people with pulmonary arterial hypertension. Tadalafil was found to have similar benefits for lower urinary tract symptoms as the usually prescribed tamsulosin. Tadalafil is FDA-approved for men as a therapy to treat and prevent symptoms of benign prostatic hypertrophy, such as urinary urgency, hesitancy, weak stream, dribbling, and incontinence. Benign prostatic hypertrophy Ī meta‐analysis found that tadalafil is an effective treatment for lower urinary tract symptoms due to prostatic hyperplasia and that such treatment had a low rate of adverse effects. In the US, tadalafil (as Cialis) is indicated for the treatment of erectile dysfunction and the signs and symptoms of benign prostatic hyperplasia and (as Adcirca) for the treatment of pulmonary arterial hypertension to improve exercise ability. Tadalafil is used to treat erectile dysfunction, benign prostatic hyperplasia, and pulmonary arterial hypertension. In 2020, it was the 261st most commonly prescribed medication in the United States, with more than 1 million prescriptions. Tadalafil was approved for medical use in the United States in 2003. It also dilates blood vessels in the lungs, which lowers the pulmonary artery pressure. Tadalafil is a PDE5 inhibitor which increases blood flow to the penis. Tadalafil is not recommended in people taking nitrovasodilators such as nitroglycerin, as this may result in a serious drop in blood pressure. Rare but serious side effects include a prolonged erection that can lead to damage to the penis, vision problems, and hearing loss. Caution is advised in those with cardiovascular disease. ![]() Ĭommon side effects include headache, muscle pain, flushed skin, and nausea. Onset is typically within half an hour and the duration is up to 36 hours. Tadalafil, sold under the brand name Cialis among others, is a medication used to treat erectile dysfunction, benign prostatic hyperplasia, and pulmonary arterial hypertension. ![]()
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