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PDE5 inhibitor

Tadalafil

Brand names: Cialis, Adcirca

Adult dose

Dose: ED PRN: 10–20mg PO 30min before sex. ED daily: 2.5–5mg OD. BPH: 5mg OD. PAH: 40mg OD
Route: PO
Frequency: PRN or OD

Dose adjustments

Renal

Reduce in severe renal impairment

Clinical pearls

  • Long half-life (~17.5h) — 'weekend pill'
  • BPH + ED combination indication

Contraindications

  • Concurrent nitrates
  • Recent MI/stroke (≤90d)
  • Severe hepatic impairment
  • Severe hypotension
  • Hereditary degenerative retinal disorders

Side effects

  • Headache
  • Flushing
  • Dyspepsia
  • Nasal congestion
  • Back pain
  • Priapism
  • NAION
  • Hearing loss

Interactions

  • Nitrates (avoid)
  • α-blockers
  • Strong CYP3A4 modulators
  • Riociguat (avoid)

Reference: BNF; NICE CG97; ESC; https://bnf.nice.org.uk/drugs/tadalafil/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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