Tadalafil dosage : Uses and Location
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Tadalafil (Cialis) DOSAGE for Erectile Dysfunction
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Tadalafil is an approved type 5 (PDE5) inhibitor used in treating erectile dysfunction (ED). The class of phosphodiesterase type 5 (PDE5) inhibitors includes drugs such as vardenafil [Levitra] and sildenafil [Viagra]. These drugs help increase penile blood flow, thus contributing to erectile response when someone is sexually stimulated. However, tadalafil is more effective than sildenafil or vardenafil by ensuring a longer duration of action. [1]
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Tadalafil has few side effects unless used together with other reactive drugs. It can cause a drop in the user’s blood pressure if the patient uses combines it with α1-adrenergic blockers such as terazosin (Hytrin), doxazosin (Cardura), and prazosin (Minipress), except for tamsulosin (Flomax).
Tadalafil can also lower blood pressure when used with nitrate, such as in recreational poppers. Suppose a critically ill patient on tadalafil must use nitrates. In that case, they can do so under two conditions: at least 48 hours have passed from the last tadalafil dose, and the doctors closely monitor hemodynamics. This is necessary because if tadalafil is used with antihypertensive drugs, it lowers blow pressure further by 4 to 10 mm Hg.
Additionally, if the patient is on drugs such as ketoconazole (Nizoral), erythromycin, protease inhibitors, itraconazole (Sporanox), and drugs that regulate the CYP3A4 enzyme system1, the tadalafil drug can only be administered after 72-hour and the dosage reduced to 10 mg.
However, studies excluded patients with cardiovascular diseases since there is inadequate information about the tadalafil’s safety in this population1. If a patient on PDE5 inhibitor experiences coital angina, they should call emergency services and rush to the hospital for observation2. Reports show that a condition of prolonged penis erection (priapism) was noted with all drugs in this class1. Since tadalafil contributes to longer periods of action, patients on this drug erect longer than with sildenafil or vardenafil . The study did not establish the drug’s long-term safety.
Tolerability
Tadalafil's common side effects include headaches in 11 to 15% of patients and dyspepsia in 18 to 10% of patients. After the dose, the patient may also experience back pain that starts after 12 to 24 hours of taking the drug and could last up to 48 hours. The study showed that 5 t 6% of men had this side effect compared to the 3% of those receiving a placebo.
Tadalafil’s clinical trial also reported a change in color vision as a side effect in less than 0.1% of the patients1. Since tadalafil has less affinity for PDE6 and 11 than sildenafil, it has fewer ocular side effects but contributes to more back pain than sildenafil.
Effectiveness
Every study on Erectile dysfunction aims to determine if the drug contributes to an erection, successful intercourse, and sexual satisfaction. Five studies evaluated the effects of tadalafil's 5, 10, and 20 mg doses compared to those on a placebo. 321 men who participated were placed on a 10 mg dose, and 68 to 77% reported an erection suitable for penetration compared to 42 to 55% of those on a placebo (number needed to treat to avoid unfavorable outcome (NNT)= 4 to 4.5) Nevertheless, fewer men said they had successful intercourse (51 to 70%) Out of the maximum score of 15 for sexual satisfaction, 9.3 men on tadalafil reported satisfaction compared to 7.4 scores for men on a placebo. Generally, tadalafil men experienced a 6.7 satisfaction score out of 10 compared to a 5.2 score for those on a placebo Like other ED drugs, the study disregarded its effectiveness in patients with erectile dysfunction due to antidepressants. Although no study has directly compared sildenafil or vardenafil with tadalafil, the overall efficacy is comparable for the three drugs.
Price
If a patient desires sexual activity weekly, the cost of the tadalafil dose per month would be approximately $39. Since it results in a longer duration of action, you may need fewer doses, thus contributing to savings over time.
Simplicity
Tadalafil’s usual dose is 10 mg taken orally no more than once a day and at least 30 minutes to 1 hour before sex. The drug's effect can last for 36 hours 1 6. You can increase the dosage to 20 mg, but safe dosing should be adjusted downward to 5 mg, especially for patients with renal insufficiency. If a patient has mild or moderate hepatic dysfunction, the tadalafil dosage should not exceed 10 mg. Individuals with severe hepatic dysfunction should not take tadalafil, even in its small dosage.
Bottom line
Like other drugs with PDE5 inhibitors, tadalafil helps men with erectile dysfunction to have a more prolonged erection and achieve successful intercourse. The drug is less effective in men with diabetes-induced ED, but it can still help. Since it has a longer duration of action, the patient should avoid its frequent use, and the patient can take it earlier before the planned sexual act. Some experts argue that since sildenafil has an established safety record, the patient should choose it over tadalafil .
