Tadalafil is the second phosphodiesterase
inhibitor to be marketed in the UK for erectile dysfunction
in men.
- Tadalafil is more effective than placebo in promoting
erections, maintaining erections and achieving successful
completion of sexual intercourse.
- Data comparing efficacy against other treatment
for erectile dysfunction are not currently available.
However in one large trial, 75% of intercourse attempts
were found to be successful using tadalafil compared
with 32% for placebo and in a similarly designed trial,
sildenafil was successful in 69% of attempts, vs. 22%
with placebo.1
- Important contra-indications include cardiovascular
disease, recent stroke and use in patients taking nitrates.
- Side effects of tadalafil are similar to sildenafil
and include headache, dyspepsia, back pain, nasal congestion,
myalgia and vasodilatation/flushing.
- Tadalafil may have a longer duration of efficacy
as its serum half-life is longer than that of sildenafil,
this may suit some patients. However this may also extend
the duration of side effects experienced, although these
have generally been mild to moderate in nature.
Product Tadalafil tablets 10mg in packs of 4, 20mg
in packs of 4 or 8 (Cialis, Lilly Pharmaceuticals).
Indication Erectile dysfunction Dosage One 10 mg
tablet to be taken between half an hour and twelve hours
before anticipated sexual activity.
Dose may be increased to 20mg if necessary. Maximum
one dose daily, but daily use not recommended. NB prescribing
at NHS expense only in certain circumstances, when prescription
should be endorsed ‘SLS’. Note that for two
of the NHS approved indications, radical prostatectomy and
spinal cord injury, patients were excluded from clinical
trials with tadalafil. We understand that studies are ongoing
in patients who have had a prostatectomy.
Date of Launch February 2003
Source: www.ukmicentral.nhs.uk
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