tadalafil, Cialis (cont.)

Pharmacy Author:

Omudhome Ogbru, PharmD

Omudhome Ogbru, PharmD

Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

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Medical and Pharmacy Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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Tadalafil also exaggerates the blood pressure lowering effects of some alpha-blocking drugs for example, terazosin (Hytrin) that primarily are used for treating high blood pressure or enlargement of the prostate. Individuals who take these alpha-blockers should be on a stable dose of the alpha-blocker before tadalafil is started. In such situations, tadalafil should be started at the lowest dose. If the patient is already taking tadalafil, the alpha-blocker should be started at the lowest dose.

Tadalafil and alcohol both lower blood pressure. Therefore, combining tadalafil with alcohol may cause excessive drops in blood pressure and cause dizziness, headaches, and increased heart rate.

Tadalafil should not be combined with Adcirca (another form of tadalafil) or other PDE5 inhibitors, for example, vardenafil (Levitra) or sildenafil (Viagra, Revatio).

PREGNANCY: Tadalafil is not approved for use in women.

NURSING MOTHERS: Tadalafil is not approved for women and has not been evaluated in women who are breastfeeding.

SIDE EFFECTS: The most common side effects of tadalafil are facial flushing (reddening), headaches, stomach upset, diarrhea, flu-like symptoms, and nausea. Tadalafil also may cause low blood pressure, blurred vision and changes in color vision, and abnormal ejaculation. Tadalafil has been associated with prolonged erections or priapism (painful erections lasting more than 6 hours). Patients should seek immediate medical help if they experience an erection lasting more than 4 hours. Use of tadalafil, most often in patients with pre-existing heart disease, has been associated with chest pain, heart attacks, death, strokes, palpitations, and increased heart rate. Rare cases of sudden loss of hearing have been reported with phosphodiesterase inhibitors such as tadalafil, sometimes associated with ringing in the ears and dizziness. If changes in hearing occur, patients should stop their tadalafil and seek immediate medical attention. Phosphodiesterase-5 inhibitors have been associated rarely with non-arteritic anterior ischemic optic neuropathy (NAION), a condition which causes decreased vision and may lead to blindness.

Reference: FDA Prescribing Information

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