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Tadalafil (Cialis®)

Last Modified: September 12, 2012

Pronounced: ta-DAL-a-fil
Classification: Phosphodiesterase Inhibitor

About Tadalafil

Tadalafil is a medication that is taken before sexual activity and allows men with erectile dysfunction (ED) to achieve and maintain an erection. ED or impotence is a condition in which a man is unable to achieve or maintain an erection long enough for sexual intercourse. This can be a result of medical conditions such as high blood pressure, diabetes, prostate problems, and heart disease, or a side effect of the medications typically taken for these conditions. Personal lifestyle factors such as stress, alcohol and/or tobacco use can also play a contributing role. During surgery or radiation to the pelvic area (including prostate, bladder, and rectal procedures), damage can occur to the nerves that supply the penis. This can result in either temporary or permanent impotence. Some surgeons perform "nerve-sparing" surgeries in an attempt to preserve erectile function. Even in these cases, however, the nerves will suffer some injury, and it can take 18-24 months or longer for erectile function to return. These men should be treated aggressively with oral or injectable medications for ED in order to speed recovery of the nerves and to prevent muscle wasting in the penis.

Facts about tadalafil and cancer therapy related ED

  • Tadalafil is a medication that is taken before sexual activity and allows men with ED to achieve and maintain an erection.
  • Men who take tadalafil will not have an erection without sexual stimulation. This drug is not an aphrodisiac and does not affect libido or desire.
  • After surgery or radiation to the pelvic area, it can take 24 months or more for the nerves feeding the penis to recover. Treatment with tadalafil or other medications can speed nerve recovery and prevent muscle loss in the penis.
  • Tadalafil will not be effective in men who did not have nerve-sparing surgical procedures.

How to take tadalafil

  • Tadalafil is taken by mouth up to once a day, at least 30-60 minutes before sexual activity, and works for up to 36 hours. Your doctor will determine the dose that is best for you. Having multiple intercourse sessions with one dose has not been studied.
  • It can be taken with or without food. Do not drink excess alcohol while taking tadalafil (for example, more than 5 glasses of wine or 5 alcoholic drinks).
  • Some men require dose adjustments to find the dose that works best for them. You should not adjust your dose without talking to your doctor first.
  • Men who take nitrates, such as nitroglycerin, Nitro-Bid, Isordil, or Deponit should not take tadalafil.
  • Men who take Cardura, Flomax, or Hytrin for urinary symptoms should not take tadalafil.

Possible Side Effects of Tadalafil

There are a number of things you can do to manage the side effects of Tadalafil. Talk to your doctor or nurse about these recommendations. They can help you decide what will work best for you. These are some of the most common side effects:

Headache, facial flushing and upset stomach can occur. Some patients experience back pain or muscle aches that typically occur 12 to 24 hours after taking tadalafil. This typically resolves on its own after 48 hours. If you have pain that persists, contact your doctor. Rarely, patients may have side effects including blurry vision, a bluish hue to the field of vision, a sensitivity to light, or a sudden loss of vision.

If you experience any of the following while using tadalafil, you should seek immediate medical attention:

  • An erection lasting more than 4 hours
  • Chest, arm or neck pain, or nausea during sexual activity
  • Sudden loss of vision

Do not take a higher dose of tadalafil than your doctor orders for you. Remember, tadalafil does not protect against sexually transmitted diseases, nor does it prevent pregnancy.


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