Medically reviewed by: Thomas Fischer (Pharmacist). This article has been written according to strict guidelines and medical standards.
Medically reviewed by: Thomas Fischer (Pharmacist)
Cialis is a prescription-only substance, primarily used to treat erectile dysfunction (ED). The active ingredient in Cialis is called tadalafil. It is also known as generic Cialis. Prescription medications require a consultation with a registered medical professional. In most cases, this will be a medical doctor, such as a general practitioner (GP).
Tadalafil: Definition and How it Is Used
Tadalafil is a Food & Drug Administration (FDA) approved substance, taken in tablet form (Brand Name: Cialis / read more: What is Cialis? Health Benefits, Uses, and Risks of Cialis). Users can rest assured that medication under the FDA label has been subjected to a rigorous review process to ensure that generic medicines undergo screenings. This is done to ensure the generic version contains the same active ingredients as the original version before it is approved to go to market (s. also: Tadalafil 10mg Tablet: How To Buy Safely Online).
Tadalafil is primarily used by men to treat ED, the inability to have or to keep an erection (read more: What Is Impotence (Erectile Dysfunction)? Signs & Diagnosis). In addition to ED, Tadalafil could be prescribed to treat benign prostatic hyperplasia (BPH). BHP is the enlargement of the prostate gland, a condition associated with urination challenges that may occur for mostly older men.
The medicine can be taken in tablet form in two ways. It can either be taken ‘on-demand’ or as needed, before intercourse. In addition to the ‘on-demand’ option, it can also be taken daily, in a smaller dose. The latter option has the benefit of being more spontaneous, and users do not need to plan for intercourse.
Tadalafil should only be used under medical supervision and is therefore not available as an over the counter (OTC) drug. A consultation with a medical practitioner will be required to obtain a Tadalafil prescription (read more: “Ordering Tadalafil Without A Prescription – Risks To Consider” and “Generic Cialis Without A Prescription – Risks To Consider“).
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How Does Tadalafil Work?
Tadalafil is classified as a phosphodiesterase type 5 inhibitor (PDE-5 inhibitor). PDE-5 is an enzyme found throughout the human body, with higher levels occurring in the penis, in the lungs and the retina.
Cyclic guanosine monophosphate (cGMP) works in the body to relax the muscle layers. PDE-5 likes to attack cGMP. Tadalafil works by blocking the action of a PDE-5. The result is a temporary increase in blood flow to specific areas of the body.
The increased blood flow is a result of the widening of blood vessels. An erection will not merely occur when taking one of these tablets. Tadalafil is used to help achieve and maintain an erection during sexual stimulation.
By no means is tadalafil a cure for ED, it temporarily assists with blood flow in the body to help create and maintain an erection, for a short period (related article: Cialis Does Not Work – What To Do If Tadalafil Does Not Work?).
Tadalafil: Dosage and Intake
Tadalafil is available in strengths of 2.5 mg; 5 mg; 10 mg and 20 mg. Following a comprehensive consultation, a full treatment plan and dosage should be discussed with your doctor. This should include how long the patient plans to take this medication (read more: Cialis Dosage – Use of 5 mg, 10 mg & 20 mg Tadalafil).
The dosage will be dependent on each patient’s current health conditions. Lower Tadalafil doses of either 2.5mg or 5mg are often prescribed for those using it every day (read more: Cialis 5mg – Uses, Benefits And Ordering Online). When taken ‘on-demand’ or as required, a higher treatment of 10mg to 20mg may be prescribed. Users should be mindful that Tadalafil could remain in the bloodstream for up to 36 hours after it has been taken.
When used to treat ED, the starting dose could, as an example, be 10 mg once a day as needed, up to 30 minutes before intercourse. When used for the treatment of BPH symptoms, the dosage will be different. It is recommended that the tablets are taken at the same time of the day, in one single dose. Tadalafil tablets should be swallowed whole and can be taken before or after a meal as they don’t interact with food.
Part of the discussion in a treatment plan should include how to use Tadalafil in a potentially adjusted maintenance dose. A maintenance dose could either be higher or lower than the initial dose, based on individual reaction and how effective it has been.
A revised dosage will consider the side effects and how the user has tolerated the initial prescribed dose. A good treatment plan should be adjustable over time.
Guidelines and essential notes on Tadalafil dosage and intake:
- Always take Tadalafil as directed by a doctor
- Take note of the instructions and read the enclosed instructions in the packaging
- When the medication is dispensed, the pharmacist should have clear dosage instructions displayed on the packaging
- It may take some time for Tadalafil to start working, results may not be immediate
- Contact your doctor if the symptoms worsen when taking the medication
- Always store prescribed medicines at room temperature
- All medicine should be kept out of the reach of children
- Get emergency medical assistance in the instance of an overdose
Tadalafil is not approved for use by women or children under the age of 18 years old.
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The Contraindications of Taking Tadalafil
Taking medication comes with a potential risk, and can be harmful. Tadalafil should not be used in the following known instances:
- Allergic reactions or hypersensitivity to Tadalafil
- Hypotension, very low blood pressure or excessive drops in blood pressure
- Pulmonary hypertension - high blood pressure in the lungs
- Uncontrolled hypertension or high blood pressure
- Angina - heart-related chest pain
- Anemia - lack of adequate healthy red blood cells
- Leukemia - cancer of the blood and bone marrow
- Heart failure, heart attack or chronic heart conditions
- Cerebrovascular incidents or a stroke
- Liver and kidney disease or patients on dialysis
- Stomach ulcers
Tadalafil potentially has several drug interactions, and a doctor would have to consider these before prescribing it (read more: Cialis Interactions & Contraindications). It is important to share any pre-known conditions and side effects as a result of taking Tadalafil with the doctor or pharmacists.
Follow-up consultations are necessary for effective ongoing treatment. This is also an opportunity to adjust the dosage and resolve possible side effects.
Side Effects of Taking Tadalafil
Taking Tadalafil may come with side effects (s. also Common and Rare Side Effects of Tadalafil (Cialis)). For this reason, a consultation with a medical practitioner to assess your overall health will be required. Your doctor and pharmacist will fill you in on the commonly experienced side effects.
Side effects reported when taking Tadalafil can also be dose-dependent. Some side effects may go away after some time and others may require an adjustment in the dosage.
Patients with a history of heart conditions and low blood pressure, or with pre-existing conditions like diabetes, liver and kidney diseases, cardiovascular and blood pressure-related conditions may experience excessive side effects.
Some of the possible risks and more commonly experienced side effects of Tadalafil include, but are not limited to, the following:
- A decrease in blood pressure
- Facial flushing
- Increased or rapid heart rate
- Indigestion or heartburn
- Headaches
- Dizziness
In some cases, these side effects have been reported as irregularly experienced:
- Cold and flu-like symptoms such as a blocked nose, coughing and throat irritations
- Abdominal pain
- Acid reflux
- Nausea or diarrhea
- Back ache
- Muscle pain
Can Tadalafil Be Taken With Other Medication?
Your complete medical history and overall health and lifestyle should be considered before you start taking any medicine. Consideration should be given to not only the risks and side effects of tadalafil, but also other medications you are taking.
Moderate to severe interactions have been reported when taking this pharmaceutical in conjunction with other medications. In addition to prescription drugs, some over-the-counter (OTC) medicines and other health and wellness related products like vitamins and herbal remedies may also react with tadalafil.
The doctor prescribing tadalafil or a pharmacist should be able to provide more information. Some medicines may either decrease the effect of this medication or could increase side effects. When an interaction is experienced, it does not always require the cessation of taking either of these medicines. It is, however, important to discuss this with your medical practitioner and consider this as part of your ongoing treatment plans.
Lifestyle choices can also affect. Drinking alcohol, or taking illicit drugs, when taking this medication, can cause side effects or affect how it works (read more: Cialis & Alcohol – Are There Compatibility Issues?).
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Clinical Studies on the Effectiveness of Tadalafil
Clinical studies have reported the effectiveness of tadalafil taken in daily doses and taken ‘on-demand’ to be similar. The prescribed doses showed no significant difference in safety when used as instructed. When taken ‘on-demand’, tadalafil has been reported to have remained active for up to 36 hours after taking the dosage.
The demographic group mostly making use of ED medicines are men ranging between 40 and 70 years old. Tadalafil is not available to persons under the age of 18, and the effectiveness in people under this age has not been studied or established.
Findings in clinical studies support the longer-term use of tadalafil in the management of ED and BPH. Doses of between 2.5mg to 20mg, when taken as prescribed, are safe and useful for a period of up to 18 months.
Some clinical studies have shown that Tadalafil can, in clinically managed, prescribed daily doses, be safe and tolerated for up to 24 months. Users have reported back positively regarding regaining satisfaction with intercourse and the overall quality of life-related to the use of this medicine.
Article Sources
- Questions and Answers for Cialis (tadalafil). In: U.S. Food and Drug Administration. URL: https://www.fda.gov/
- Parker-Pope, Tara (August 28, 2009). “The Cost of Treating Erectile Dysfunction“. New York Times.
- CIALIS- tadalafil tablet, film coated. Eli Lilly and Company. URL: https://uspl.lilly.com/
- A Study of Tadalafil and Sildenafil in Men With Erectile Dysfunction in China. Information provided by (Responsible Party): Eli Lilly and Company. URL: https://clinicaltrials.gov/ct2/show/NCT01352507
- Porst, Hartmut et al. Efficacy of tadalafil for the treatment of erectile dysfunction at 24 and 36 hours after dosing: a randomized controlled trial. In: Urology Volume 62, 07/2003. Elsevier Inc.
- Brock, Gerald et al. Efficacy and Safety of Tadalafil for the Treatment of Erectile Dysfunction: Results of Integrated Analyses. In: The Journal of Urology Volume 168, 10/2002. Elsevier Inc.
- Eli Lilly and Company Limited (2017). Cialis 20mg film-coated tablets. EMC. [online] Available at: https://www.medicines.org.uk/emc/files/pil.7430.pdf [accessed 20th July, 2020].
- Moncada, I., Bethencourt, F, R and Lledó-García et al., (2014). Effects of Tadalafil Once Daily or On Demand Versus Placebo on Time to Recovery of Erectile Function in Patients After Bilateral Nerve-Sparing Radical Prostatectomy. World J Urol: 33, pp 1031-1038.