Tadalafil

Tadalafil is a phosphodiesterase type 5 (pde5) inhibitor medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

• Erectile dysfunction in adult men.
• Signs and symptoms of benign prostatic hyperplasia in adult men.
• Erectile dysfunction together with benign prostatic hyperplasia in adult men.
• Pulmonary arterial hypertension in adults, when prescribed by a specialist.

The dose and schedule depend on the condition being treated, other medicines, kidney or liver function, and tolerability. For erectile dysfunction it may be prescribed either as needed before sexual activity or as a once-daily low-dose regimen. For benign prostatic hyperplasia it is usually taken once daily. For pulmonary arterial hypertension, dosing should be directed by a specialist. Do not take more than prescribed, and do not combine different tadalafil products unless the doctor specifically advises it.

• Common effects include headache, flushing, indigestion or heartburn, nasal congestion, back pain, muscle aches, dizziness, and limb pain.
• Seek urgent medical help for chest pain, fainting, severe dizziness, an erection lasting more than 4 hours, sudden loss or decrease of vision, or sudden hearing loss or ringing in the ears.
• Allergic reactions such as rash, swelling of the face or throat, or breathing difficulty require emergency care.

Use with caution in people with heart disease, recent heart attack or stroke, uncontrolled high or low blood pressure, severe kidney or liver disease, bleeding disorders, stomach ulcer, penile deformity, conditions predisposing to priapism such as sickle cell disease, leukemia or multiple myeloma, or previous serious eye disease such as non-arteritic anterior ischemic optic neuropathy. Sexual activity may be unsafe for some heart patients; medical assessment is important. Use this medicine under the guidance of a registered doctor or pharmacist.

• Nitrates such as nitroglycerin, isosorbide dinitrate or isosorbide mononitrate can cause life-threatening low blood pressure and must not be used with tadalafil.
• Riociguat must not be used with tadalafil because of the risk of severe hypotension.
• Alpha-blockers and other blood pressure-lowering medicines may increase dizziness or low blood pressure.
• Strong CYP3A4 inhibitors such as ketoconazole, itraconazole, ritonavir, cobicistat, clarithromycin or some other HIV or antifungal medicines can increase tadalafil levels.
• CYP3A4 inducers such as rifampicin, carbamazepine, phenytoin or phenobarbital may reduce its effect.
• Avoid using with other PDE5 inhibitors or other erectile dysfunction medicines unless specifically prescribed.
• Large amounts of alcohol may increase dizziness, headache, fast heartbeat, or low blood pressure.
• Grapefruit or grapefruit juice may increase tadalafil exposure in some people and should be discussed with the prescriber.

• Known allergy to tadalafil or any component of the tablet.
• Use of any nitrate medicine, regularly or intermittently.
• Use of riociguat.
• Patients for whom sexual activity is inadvisable because of unstable or severe cardiovascular disease should not use it for erectile dysfunction.
• History of vision loss in one eye due to non-arteritic anterior ischemic optic neuropathy is generally considered a contraindication or strong reason to avoid use unless a specialist decides otherwise.

Tadalafil is not indicated for erectile dysfunction in women. For pulmonary arterial hypertension, use during pregnancy or breastfeeding should be decided only by a specialist after weighing potential benefits and risks. It is not known whether tadalafil passes into human breast milk, so breastfeeding patients should seek medical advice before use.

Store tablets at room temperature, away from excessive heat, moisture, and direct sunlight. Keep in the original packaging, out of reach of children, and do not use after the expiry date.