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Tadalafil (active ingredient)

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Gettting started with Tadalafil (Cialis™️)

What is Tadalafil?


Tadalafil is the active ingredient in Cialis. Tadalafil is a prescribed drug that is used primarily to treat erectile dysfunction (ED), also known as impotence, which is the inability to get or maintain an erection satisfactory for intercourse. Tadalafil can also be used to treat symptoms of benign prostatic hyperplasia (BPH), which is an enlarged prostate, as well as pulmonary arterial hypertension.

Tadalafil (Cialis) was approved by the U.S. Food and Drug Administration (FDA) in 2003 for the treatment of ED and is available in several doses: 2.5 milligrams (mg), 5 mg, 10 mg, and 20 mg. [CK1]

[CK1]Calling your attn. to this so you can verify this is all correct, since it is new information to this article.




How does an erection occur?


The process of achieving an erection is complex. The first step is for a man to experience sexual arousal or an erotic stimulus. This arousal signals a cascade of events that relaxes cavernosal artery smooth muscles in the phallus. Parasympathetic nerves in the phallus release nitric oxide (N.O.), which increases cyclic GMP (cGMP), decreases intracellular calcium levels, and enhances smooth muscle relaxation. The relaxation of smooth muscle in the phallus allows for an influx of arterial blood, increased intracavernosal pressure, and erectile expansion and rigidity. Increased venous outflow, a passive process, maintains the phallus in an erect state.

When arousal has subsided, sympathetic nerves release norepinephrine, which stimulates alpha-adrenergic receptors. The resulting smooth muscle contraction causes the erection to reduce in size in rigidity.




How is phosphodiesterase (PDE) important for erectile function?


Nitric oxide and cGMP are essential components for smooth muscle relaxation in the phallus and vascular dilation. Without enough nitric oxide or cGMP, not enough blood can flow to the phallus for an erection.

Phosphodiesterase (PDE) enhances the breakdown of nitric oxide (N.O.) and reduces the presence of cGMP. There are several types of PDE enzymes, but PDE-5 is the primary PDE enzyme in the male phallus. By preventing or inhibiting PDE-5, cGMP can maintain blood flow by increasing N.O. to the phallus, promoting an erection.

All oral ED medications, including Tadalafil (Cialis), are PDE-5 inhibitors.




What causes erectile dysfunction?


Erectile dysfunction is the inability to obtain or maintain an erection that is strong enough for sexual activity, including sexual intercourse. Approximately 52% of men older than 40 years old and 26% of men less than 40 years old have some degree of erectile dysfunction.

Many situations can interfere with a normal erectile function, including stress, depression, anxiety, low testosterone, and the use of alcohol and/or drugs.

Other causes for ED can include an underlying cardiovascular condition or atherosclerosis. For example, obstructed or narrowed blood vessels can make it difficult for an erection to occur. Tadalafil specifically aims to address blood vessel-related erectile dysfunction by enhancing blood flow, relaxing cavernosal smooth muscle and increasing intracavernosal pressure resulting in a firm, rigid, and natural erection.




How does Tadalafil work?


The purpose of Tadalafil is to relax restricted or narrowed blood vessels and relax smooth muscles in the phallus in order for an erection to be achieved.

Tadalafil is one example of a type of drug known as a PDE-5 inhibitor (phosphodiesterase). PDE-5 inhibitors prevent the breakdown of nitric oxide (NO), a potent vasodilator that is necessary to maintain a rigid and firm erection. Taking Tadalafil typically results in increased NO in the penile cavernosal tissue and muscles, which ensures a prolonged, stronger, more easily attained erection.




What is the difference between Tadalafil and Cialis?


Tadalafil is the active ingredient in Cialis. (There are several inactive ingredients, too.) Cialis is a brand name of the drug, whereas Tadalafil is the generic ingredient that can often be obtained in compound or at a more affordable price. Cialis is specifically marketed for the on-demand treatment of ED, although it can be taken daily for the treatment of both ED and BPH.




What is the difference between Tadalafil and Adcirca?


Adcirca is another brand name for Tadalafil. Adcirca is related to Cialis but it is marketed for the treatment of pulmonary arterial hypertension for improved exercise capability instead of ED. Adcirca can be taken by both men and women as directed by a doctor.




What is the best way to use Tadalafil for ED?


The best way to take Tadalafil is 30 minutes prior to sexual activity, with or without food. Swallow the medication whole or allow it to dissolve underneath your tongue.

For men who desire a more spontaneous approach to sexual activity without having to remember to take a pill before sex, taking a low dose of Tadalafil daily will provide for more spontaneity.




How does Tadalafil differ from other ED medications?


All oral PDE-5 inhibitors work along the same pathway in the penis to promote smooth muscle relaxation and blood vessel dilation by increasing nitric oxide in the penis. Various PDE-5 inhibitors differ in immediacy of action, half-life, side effect profile and whether they can be taken with or without food.

Tadalafil is unique as it can be taken with or without food. Onset of an erection can occur as soon as 30 minutes after ingestion. Tadalafil also has a longer duration of action when a man can obtain an erection for up to 36 hours after ingestion. In comparison, Sildenafil (Viagra) must be taken on an empty stomach and the duration of action is highest within only 4-6 hours.





Safety Information

What are the common side effects of Tadalafil?


Tadalafil can cause a sudden drop in blood pressure. When combined with other specific medications, your blood pressure can drop to particularly unsafe levels, resulting in dizziness, fainting, and even a heart attack of stroke. Seek immediate medical help if this occurs.

Other common side effects include:

  • Headache
  • Flushing
  • Indigestions
  • Runny or stuffy nose

These side effects generally decrease over time, going away altogether within a few hours.

You may also experience back or muscle aches within 12-24 hours of taking Tadalafil. These aches typically go away completely within two (2) days.

Sexual activity can strain your heart, particularly if previous heart issues such as heart disease or a heart attack have already weakened your heart. If you experience chest pains, dizziness, or nausea during sexual activity, stop right away and seek professional medical help immediately.




What are the uncommon side effects of Tadalafil?


Uncommon side effects of Tadalafil may include, but are not limited to, the following:

  • An erection lasting longer than four (4) hours. Known as priapism, an erection that won’t go away must be treated as soon as possible to avoid longterm damage, including the inability to have an erection.
  • Changes in color vision. You may see a blue hue or have difficulty differentiating between blue and green colors.
  • Sudden decrease in or loss of vision. In particularly rare instances, men taking Tadalafil or other ED medications may have a sudden decrease in or loss of vision in one or both eyes. If you experience a sudden vision decrease or loss, stop taking Tadalafil and seek immediate medical help.
  • Sudden decrease in or loss of hearing. Ringing in your ears and/or dizziness may accompany a sudden decrease in or loss of hearing, though it is rare. If you experience a sudden hearing decrease or loss, stop taking Tadalafil and seek immediate medical help.




What should I avoid while taking Tadalafil?


Combining alcohol with Tadalafil may cause side effects, especially if you are drinking more than the recommended amount.

Combining grapefruit or grapefruit juice with Tadalafil can result in unwanted side effects.




How long does Tadalafil stay active in my body?


One tablet of Tadalafil contains active ingredients that may stay in your body for up to or past two (2) days. Other medications you may be on, especially for kidney or liver health, can cause the active ingredients to linger longer than two days.




Who should not take Tadalafil?


Tadalafil is not right for everyone. Only your healthcare provider and you can decide if Tadalafil is right for you.

Children under the age of 18 should not take Tadalafil. Women may be prescribed Tadalafil or Adcirca for symptoms related to pulmonary arterial hypertension.

Only those who have specifically been prescribed Tadalafil should take it. Never share Tadalafil with others, even if their symptoms are similar, as it may cause serious harm.




Who should I contact if I have a reaction to Tadalafil?


If you experience serious side effects such as fainting, heart attack, loss of vision or hearing, or significant allergic reaction, seek immediate medical help.

Contact your physician or professional health care provider if you have questions about Tadalafil.




What is the best way to store Tadalafil?


Keep Tadalafil at room temperature, between 59°F and 85°F (15-30°C). Always store Tadalafil and all medications out of reach from children.




What medications interfere with (are contraindicated) Tadalafil?


Do not take Tadalafil if you are currently taking other ED medicines or treatments, including Cialis or Adcirca.

Do not take Tadalafil if you are currently taking any medications known as “nitrates”. Nitrates are often used to treat angina, a symptom of heart disease, that can result in pains in your jaw, chest, or arm. Nitrates may also be found in medicines including:

  • Isosorbide dinitrate
  • Isosorbide mononitrate
  • Recreational drugs known as “poppers”, which often contain nitrites called amyl nitrite or butyl nitrite

Ask your physician or healthcare provider if any of your other medications are nitrates.

Other medications that can affect how you handle Tadalafil include:

  • Medicines known as “alpha blockers”, which can be prescribed for prostate problems and/or high blood pressure, among other issues. Combining alpha blockers with Tadalafil can result in dizziness or fainting. Alpha blocks may include, but are not limited to the following:
    • Cardura, aka doxazosin mesylate
    • Flomax, aka tamsulosin HCl
    • Hytrin, also known as (aka) terazosin HCl
    • Jalyn, aka dutasteride or tamsulosin HCl
    • Minipress, aka prazosin HCl
    • Rapaflo, aka silodosin
    • Uroxatral, aka alfuzosin HCl
  • Medicines that treats high blood pressure (hypertension)
  • Some types of antibiotics, including:
    • Biaxin, aka clarithromycin
    • Ketek, aka telithromycin
    • Erythromycin, aka several brand names
  • Medicines known as “HIV protease inhibitors”, such as Norvir or Kaletra, aka ritonavir
  • Some types of antifungals, including:
    • Nizoral, aka ketoconazole
    • Sporanox, aka itraconazole




Can I take Tadalafil if I am allergic to Cialis or Adcirca?


No. If you have had an allergic reaction to Cialis or Adcirca, do not take Tadalafil. Allergic reactions can include:

  • Hives
  • Rash
  • Swelling of your lips, throat, or tongue
  • Difficulty breathing or swallowing




What does my healthcare provider need to know before I take Tadalafil?


Tadalafil is not right for everyone. Only your healthcare provider and you can decide if Tadalafil is right for you. Your physician or healthcare provider must know all medications and non-prescription drugs or medicines you are currently taking.

Ask your healthcare provider if your heart is healthy enough for you to have sexual activity. You should not take Tadalafil if your healthcare provider has told you not to engage in sexual activity due to health problems. Before taking Tadalafil, tell your healthcare provider about all your medical problems, particularly if you have ever had:

  • Previous heart issues, such as irregular heartbeats, angina, heart failure, or heart attack
  • Low blood pressure
  • High blood pressure that is not currently under control
  • Stroke
  • Liver problems
  • Kidney problems and/or required dialysis
  • Retinitis pigmentosa (a rare eye disease)
  • Severe vision loss, including a condition known as NAION
  • Stomach ulcers
  • Bleeding problems
  • Deformed penis shape and/or Peyronie’s disease
  • History of priapism (an erection that’s lasted for longer than four (4) hours)
  • Blood cell problems, such as multiple myeloma, sickle cell anemia, or leukemia

In the case of an emergency medical situation related to your heart, you must disclose the last time you took Tadalafil.




Warning for Airplane Pilots


The U.S. Federal Aviation Authority approves the use of Tadalafil (Cialis) for the treatment of ED in its pilots. However, pilots who use Tadalafil for use as needed may not use Tadalafil within 24 hours of pilot duties. Pilots who use Tadalafil for daily use may only use up to 5 mg a day, if no side effects present after seven (7) days.

The FAA also restricts the use of other ED medications for pilots.





Tadalafil FAQs

Can I take Tadalafil for ED and BPH?


Yes.




How should I take Tadalafil?


Take Tadalafil exactly as prescribed by your physician or healthcare professional. A dose of 10 milligrams (mg) is standard, though your physician may increase dosage up to 20 mg or decrease as low as 2.5 mg based on your initial and longer-term tolerability and efficacy.

Do not take Tadalafil more than one (1) time per day. Do not break or split a Tadalafil tablet; swallow it in its entirety, unless otherwise instructed by your healthcare provider. Do not use other ED medicines or treatments while taking Tadalafil.

Tadalafil is typically prescribed in one of two ways:

  1. For use as needed. Your doctor may prescribe one (1) Tadalafil tablet before you expect to engage in sexual activity and/or intercourse.
  2. For use once daily. Whether taking Tadalafil for ED or BPH, here are common instructions:
    • Take one (1) tablet once per day.
    • Take your single tablet around the same time of day.
    • Should you miss a dose, take it when you remember, but do not take more than one dose per day.

Sometimes Tadalafil can be prescribed by your doctor for reasons unrelated to ED or BPH. In this instance, do not use Tadalafil for a condition your doctor did not intend it. Never share Tadalafil with others, even if their symptoms are similar, as it may cause serious harm.




When is the best time to take Tadalafil before sex?


If you are taking Tadalafil on an as-needed basis, you may take one tablet before expected sexual activity. Generally, Tadalafil can help you have sex within 30 minutes and up to 36 hours after taking one dose.

If you are taking Tadalafil on a daily basis, you may engage in sexual activity or attempt sexual intercourse at any time between doses. Taking Tadalafil daily can encourage more spontaneous sexual activity.

Despite taking Tadalafil as prescribed, sexual stimulation is still necessary for an erection.




Can Tadalafil improve my sexual desire?


Tadalafil will not improve your desire for sexual activity or cure ED. A man’s sexual desire is only one of the many functions of testosterone. A low testosterone level can decrease a man’s desire for sexual activity. Tadalafil does not protect from sexually transmitted diseases (STDs). Tadalafil is not a form of birth control for men.




Should I take Tadalafil with food?


You can take Tadalafil with or without food.




Can I take Tadalafil and drink alcohol?


Do not take Tadalafil with more than a moderate amount of alcohol. Drinking too much alcohol can increase your odds of a headache, dizziness, elevated heart rate, or lower blood pressure.

The Centers for Disease Control and Prevention generally recommend no more than two (2) drinks per day for men. One drink is generally defined as 12 ounces of a regular beer (approximately 5% ABV), 5 ounces of wine, or 1.5 ounces of distilled spirits (such as vodka, whiskey, gin, tequila, etc.).





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Disclaimer: The content on this website is not medical advice or a substitute for professional medical care, diagnosis or treatment. Your physician will determine if you are a candidate for therapy and advise how you should take the medication.

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