Tadalafil

Tadalafil dosage & strength

The dose required varies from person to person. Tadalafil comes in 2.5mg, 5mg, 10mg or 20mg tablets. You should only take the dosage as prescribed to you. Tadalafil 2.5mg and 5mg tablets are prescribed to be taken on a once daily basis.

Tadalafil contraindications

DO NOT take Tadalafil if:

• you are already taking medication for erectile dysfunction, which include any topical creams or ointments
• you have previously had an allergic reaction to it
• you have been advised by your doctor to avoid sexual activity
• you have recently been diagnosed with heart problems, have had a heart attack or a stroke
• you have low blood pressure or high blood pressure that is not well controlled
• you suffer from certain inherited eye diseases such as retinitis pigmentosa or optic neuropathy
• you have any disease or deformity of the penis (e.g. Peyronie’s Disease)
• you are a woman
• you are under 18 years of age

DO NOT take more Tadalafil if you are already taking it to treat benign prostatic hyperplasia (or BPH).

Tadalafil interactions

DO NOT take Tadalafil if you are already taking the following:

• medicines for chest pain (‘angina’) or heart failure, such as nitrates (e.g. glyceryl trinitrate, isosorbide mononitrate, isosorbide dinitrate) or nitric acid donors (e.g. amyl nitrate or “poppers”, nicorandil, sodium nitroprusside). Tadalafil can cause a substantial drop in blood pressure when taken in combination with these medicines.
• medicines for arterial pulmonary hypertension (high blood pressure in the lungs) or chronic thromboembolic pulmonary hypertension (high blood pressure in the lungs due to blood clots), such as riociguat (or other drugs that belong the same group called guanylate cyclase stimulators).
• a medicine called ritonavir for HIV infection

Check with us or your GP first if you are already taking any of the following medicines:

• alpha-blockers (e.g. alfuzosin, doxazosin or tamsulosin) to treat urinary problems due to an enlarged prostate (benign prostatic hyperplasia) or high blood pressure
• protease inhibitors used to treat HIV infection
• cimetidine used to treat heartburn
• itraconazole or ketoconazole used to treat fungal infections
• erythromycin, an antibiotic used to treat bacterial infections

Tadalafil warnings and precautions

You should check with your doctor first, before using Tadalafil if:

• you have a problem with the valves in your heart (valvular heart disease)
• you have a heart condition such as cardiomyopathy
• you have had any surgery to correct or improve blood flow to your heart
• you have previously had high blood pressure that is now under control
• you have ever had a prolonged erection (priapism) that lasted more than 4 hours or any health condition that could cause priapism, such as sickle cell anaemia (abnormal red blood cells), leukaemia (cancer of the blood) or multiple myeloma (cancer of the bone marrow)
• you have a stomach ulcer or a bleeding disorder (haemophilia)
• you have been diagnosed with serious liver or kidney problems
• you have had part or all of your prostate removed
• you have undergone surgery on your pelvis

Alcohol and Tadalafil

Drinking alcohol with Tadalafil may reduce its effectiveness and could make getting an erection more difficult. It can also increase your chances of experiencing dizziness when standing up. We recommend that you avoid alcohol if you intend to use Tadalafil that day.

Driving and Tadalafil

In rare cases Tadalafil has been found to cause dizziness and has the potential to affect your vision, so it is important not to drive or use any machinery if you experience these side effects or feel in any way abnormal.

How to use Tadalafil

You should take one Tadalafil tablet, swallowed whole with a little water.

What to expect when using Tadalafil

Tadalafil will help you get and maintain an erection, but you will need to be sexually aroused for it to take effect. Engaging in foreplay will help you become aroused and give the tablet time to work.

Tadalafil may not work the first time you use it, particularly if it has been a while since you last had an erection. Many men find that the medicine is more effective after the second dose. If you are unsuccessful the first time, you must wait 24 hours before trying again as you cannot take more than one tablet in a day. It can take your body a few doses before you start to respond and you see the full benefits.

If you feel that the medication is not working for you or is too weak, contact us and your licensed prescriber may recommend a higher dose for you. Do not take more than one tablet a day. If you take more tablets than prescribed, you increase the risk of experiencing serious side effects. It is important for a clinician/ prescriber to manage any increase in dose and monitor your response after each dose.

The recommended dose for erectile dysfunction is 10mg taken 30 minutes before sex. Only the 2.5mg and 5mg strengths of Tadalafil are intended for continuous daily use. If you intend to use Tadalafil for sexual activity more than twice a week, a consistent daily dose of 2.5mg or 5mg may be more suitable for you.

Sexual activity can put additional strain on your heart, so it is essential that you check with your doctor first if you often get very breathless or feel chest pain when you partake in light to moderate physical activity, such as climbing the stairs or taking a light jog.

Possible side effects of Tadalafil

Side effects of Tadalafil are usually mild to moderate and only last for a short amount of time. If you experience any side affects you should stop taking the medication.

The most common side effects are headaches, nausea, a sudden feeling of heat in your upper body, indigestion, visual disturbances, dizziness or a stuffy nose. A decrease in the amount and number of sperm has been seen in some men taking Tadalafil, although the quality of the sperm were not affected.

Rare reports of fainting, dry nose, irritability, stroke, heart attack, irregular heartbeat, sudden decrease or loss of hearing have been reported. Visual changes, although rare, have also been reported and include bleeding at the back of the eye, double vision, swelling of the eyes or eyelids, seeing spots in your field of vision or halos around lights, discolouration of the whites of the eye and dilation of the pupils.

You should STOP taking Tadalafil IMMEDIATELY if you experience any of the following symptoms:

• An allergic reaction, the symptoms of which include sudden wheezing, difficulty breathing, dizziness, swelling of the eyelids, face, lips or throat.
• Chest pain, which is uncommon, but if it occurs during or after sex, you should get into a comfortable sitting position, breathe deeply and try to relax. Do not take nitrates to treat your chest pain.
• A sudden decrease in vision or a sudden loss of vision
• Ringing in your ears or dizziness
• A severe skin rash
• Seizures
• An erection that lasts longer than four hours.

In extremely rare cases, unstable angina and sudden death have been reported. Most of the men who experienced these adverse effects had underlying heart problems.

Tadalafil storage and expiration

Tadalafil should always be stored out of reach of children and remain in the pouches or provided vial until you are taking your next dose. The tablets can be kept in a clean, dry place at room temperature. Never share your medicine with anyone else.

Never discard of tadalafil tablets by flushing them down the toilet or washing them down the drain as this will contaminate water and could harm the environment. We always recommend that medicines be returned to your local pharmacy for safe disposal.

Tadalafil tablets should never be used past the expiry date marked on the packaging as EXP. The expiry date is always the last day of the month, after this date it should be discarded.

Your 6-month check up

Erectile dysfunction can be an early warning sign of other underlying health issues, such as heart and blood pressure problems, diabetes, high blood pressure or high cholesterol. If erectile dysfunction happens regularly, you should have a check up with your GP even if you feel healthy and well. We recommend meeting with your GP if you have been using Tadalafil for 6 months.

DO NOT give or share this medicine with anyone else.