Tadalafil (CIALIPEX 20)

Tadalafil is an oral medication used to treat erectile dysfunction (difficulty achieving or maintaining an erection) and benign prostatic hyperplasia (BPH). It belongs to a group of medications known as phosphodiesterase type-5 (PDE5) inhibitors, the same category as sildenafil and vardenafil.

An erection occurs when the penis fills with blood. This happens because the blood vessels supplying the penis expand to allow increased blood flow, while the vessels that normally carry blood away constrict. Sexual stimulation triggers the release of nitric oxide in penile tissue. Nitric oxide activates an enzyme called guanylate cyclase, which produces cyclic guanosine monophosphate (cGMP). cGMP relaxes smooth muscle and widens blood vessels, allowing an erection to develop.

Normally, the enzyme PDE5 breaks down cGMP, which causes blood vessels to return to their usual size and the erection to subside. Tadalafil works by blocking PDE5, allowing cGMP to remain active longer. This helps maintain improved blood flow and supports a firmer, longer-lasting erection.

In men with BPH, PDE5 is also found in the smooth muscle of the prostate and bladder. Although the exact mechanism is not fully defined, tadalafil may relax these muscles, making urination easier and reducing pressure around the urethra.

Tadalafil received FDA approval in November 2003.

Important: Tadalafil should never be taken with nitrate medications used for chest pain or heart conditions, including nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate. It must also not be combined with recreational nitrates such as amyl nitrite (“poppers”). Mixing these substances can cause a severe and sudden drop in blood pressure.

How to Use Tadalafil

• Taken orally

• Can be used daily or as needed, depending on prescription

• May be taken with or without food

• Do not exceed prescribed dose

• Never combine with nitrate medications

• Consult a healthcare provider if you have heart, liver, or kidney conditions

Importance of Tadalafil

• Improves blood flow to support erections

• Helps maintain erections by prolonging cGMP activity

• May reduce urinary symptoms in BPH

• Long duration of action compared to similar medications

• Provides flexibility with daily or on-demand use

Side Effects of Tadalafil

• Headache

• Flushing

• Indigestion

• Nasal congestion

• Back or muscle pain

• Dizziness

• Possible drop in blood pressure

• Rare risk of prolonged erection (medical emergency)

• Seek medical attention for chest pain, vision changes, or severe reactions