Tadalafil

PDE5 Inhibitor·Urology

Erectile dysfunction, Benign Prostatic Hyperplasia (BPH LUTS)

PDE5 INHIBITORCialis5 mg tabletS4TGA

Max Dose

20 mg/day

Half-life

17.5 h

Duration

36 HOURS

Nitrates

FATAL

Rapid Summary

Overview

Ultra-long-acting PDE5 inhibitor. Dubbed 'The Weekend Pill' due to its massive 36-hour duration of action. Highly effective for BPH as well as ED.

Maximum Dose

Max 20 mg/day (PRN use) or 5 mg/day (Daily use).

Clinical Focus

Because of the 17.5 hour half-life, Nitrates are strictly contraindicated for a full 48 HOURS after the last Tadalafil dose.

Bottom Line

Tadalafil is the long-acting PDE5 inhibitor offering up to 36 hours of effect for ED and daily dosing for BPH, but carries the same absolute nitrate contraindication as all PDE5 inhibitors.

Formulation & Access

Brand Names

Cialis

Oral Routes

Tablets (5 mg, 10 mg, 20 mg). Food does NOT affect absorption.

Prescribing & PBS

Private script.

Indications & Use

Primary

TGA

Erectile dysfunction, Benign Prostatic Hyperplasia (BPH LUTS).

Clinical Place

Preferred over Sildenafil when patients want spontaneity without planning a pill 1 hour before, or if they have concurrent BPH.

Quick reference

Class & Role

PDE5 Inhibitor — Ultra-long-acting PDE5 inhibitor.

Route / Formulation

Tablets (5 mg, 10 mg, 20 mg). Food does NOT affect absorption. (Cialis)

Usual Dose & Max

PO 10-20 mg at least 30 mins before sexual activity. Max 1 dose in 24h.

Key Indication Doses

Erectile Dysfunction (PRN): PO 10-20 mg at least 30 mins before sexual activity. Max 1 dose in 24h. ED / BPH (Daily dosing): PO 5 mg OD (Provides continuous steady-state levels). Renal Impairment: Max 10 mg PRN if eGFR 30-50. Max 5 mg/day if eGFR < 30.

Best Uses

Tadalafil is the long-acting PDE5 inhibitor offering up to 36 hours of effect for ED and daily dosing for BPH, but carries the same absolute nitrate contraindication as all PDE5 inhibitors.

Avoid / Cautions

Concurrent nitrates. Recent MI/Stroke. Severe hepatic impairment.

Key Risks

Cardiovascular: Flushing, hypotension. Musculoskeletal: Back pain, severe myalgia (unique to Tadalafil due to mild PDE11 inhibition in skeletal muscle). Gastrointestinal: Dyspepsia (relaxes lower esophageal sphincter).

Key Interactions

Nitrates. Must withhold GTN for 48 HOURS post-tadalafil. Alpha-blockers (Tamsulosin). Tadalafil 5mg daily is approved for BPH, but if the patient is already on Tamsulosin, the combo can cause severe orthostatic drops.

Monitoring

Check BP. Assess for severe back pain (can mimic renal colic but is a benign side effect).

Clinical Pearl

Tadalafil 5mg daily relaxes the prostate and bladder neck via nitric oxide pathways. It is a highly effective, official treatment for BPH LUTS, effectively treating two conditions (BPH + ED) with one pill.

Access

Cialis5 mg tablet

Brand: Cialis
Formulation: Tablets (5 mg, 10 mg, 20 mg)

Tadalafil

PDE5 Inhibitor·Urology

Erectile dysfunction, Benign Prostatic Hyperplasia (BPH LUTS)

PDE5 INHIBITORCialis5 mg tabletS4TGA

Max Dose

20 mg/day

Half-life

17.5 h

Duration

36 HOURS

Nitrates

FATAL

Rapid Summary

Overview

Ultra-long-acting PDE5 inhibitor. Dubbed 'The Weekend Pill' due to its massive 36-hour duration of action. Highly effective for BPH as well as ED.

Maximum Dose

Max 20 mg/day (PRN use) or 5 mg/day (Daily use).

Clinical Focus

Because of the 17.5 hour half-life, Nitrates are strictly contraindicated for a full 48 HOURS after the last Tadalafil dose.

Bottom Line

Tadalafil is the long-acting PDE5 inhibitor offering up to 36 hours of effect for ED and daily dosing for BPH, but carries the same absolute nitrate contraindication as all PDE5 inhibitors.

Formulation & Access

Brand Names

Cialis

Oral Routes

Tablets (5 mg, 10 mg, 20 mg). Food does NOT affect absorption.

Prescribing & PBS

Private script.

Indications & Use

Primary

TGA

Erectile dysfunction, Benign Prostatic Hyperplasia (BPH LUTS).

Clinical Place

Preferred over Sildenafil when patients want spontaneity without planning a pill 1 hour before, or if they have concurrent BPH.

Quick reference

Class & Role

PDE5 Inhibitor — Ultra-long-acting PDE5 inhibitor.

Route / Formulation

Tablets (5 mg, 10 mg, 20 mg). Food does NOT affect absorption. (Cialis)

Usual Dose & Max

PO 10-20 mg at least 30 mins before sexual activity. Max 1 dose in 24h.

Key Indication Doses

Best Uses

Tadalafil is the long-acting PDE5 inhibitor offering up to 36 hours of effect for ED and daily dosing for BPH, but carries the same absolute nitrate contraindication as all PDE5 inhibitors.

Avoid / Cautions

Concurrent nitrates. Recent MI/Stroke. Severe hepatic impairment.

Key Risks

Key Interactions

Monitoring

Check BP. Assess for severe back pain (can mimic renal colic but is a benign side effect).

Clinical Pearl

Access

Cialis5 mg tablet

Brand: Cialis
Formulation: Tablets (5 mg, 10 mg, 20 mg)