Cialis for erectile dysfunction and benign prostatic hyperplasia treatment

Cialis is an oral medication containing tadalafil used to treat erectile dysfunction (ED), benign prostatic hyperplasia (BPH), and the combination of both ED and BPH in adult men. It is available in several tablet strengths and can be used either as needed or once daily depending on the condition and patient needs.

Cialis is approved for the following uses in adult men:

• Erectile dysfunction (ED): to improve the ability to achieve and maintain an erection.
• Benign prostatic hyperplasia (BPH): to relieve signs and symptoms associated with an enlarged prostate.
• ED and BPH combined treatment: to manage both erectile dysfunction and BPH symptoms concurrently.

Tadalafil

Cialis contains tadalafil, a phosphodiesterase type 5 (PDE5) inhibitor. By blocking PDE5, it relaxes muscles and increases blood flow to certain areas of the body, including the penis, helping to sustain an erection. It also helps relax muscles in the prostate and bladder, improving symptoms of BPH.

Dosage and Administration

Cialis tablets should be taken whole without splitting.

For Erectile Dysfunction (ED) - Use as needed:

• Starting dose: 10 mg taken prior to anticipated sexual activity.
• Dose may be adjusted to 20 mg or decreased to 5 mg based on efficacy and tolerability.
• Maximum dosing frequency: once per day.
• Effect may last up to 36 hours after the dose.

For Erectile Dysfunction - Once daily use:

• Starting dose: 2.5 mg once daily, taken at approximately the same time every day, regardless of sexual activity timing.
• Dose may be increased to 5 mg based on individual response.

For Benign Prostatic Hyperplasia (BPH) - Once daily use:

• Recommended dose: 5 mg once daily, taken at the same time each day.

For Erectile Dysfunction and BPH combined - Once daily use:

• Recommended dose: 5 mg once daily, taken at the same time every day, without regard to timing of sexual activity.

Special Populations:

• Renal impairment: For use as needed, starting dose is 5 mg once daily if creatinine clearance is 30-50 mL/min; max 10 mg every 48 hours. For clearance below 30 mL/min or hemodialysis patients, max dose is 5 mg every 72 hours. For once daily use in ED, not recommended if clearance under 30 mL/min. For BPH or combined use, start at 2.5 mg if clearance 30-50 mL/min; not recommended if less than 30 mL/min.
• Hepatic impairment: Mild to moderate impairment (Child Pugh A or B) - dose should not exceed 10 mg once daily for use as needed and caution is advised for once daily use. Severe impairment (Child Pugh C) - use not recommended.

Food:

Cialis may be taken with or without food.

Contraindications

• Use with any form of organic nitrates, regularly or intermittently, is contraindicated due to potentiation of hypotensive effects.
• Known serious hypersensitivity to tadalafil (including reactions such as Stevens-Johnson syndrome and exfoliative dermatitis).

Important Warnings and Precautions

• Do not use Cialis if sexual activity is inadvisable because of cardiovascular risk.
• Concomitant use with any form of organic nitrates is contraindicated due to risk of severe hypotension.
• Use with caution if taking alpha blockers or antihypertensives, as concurrent use can cause symptomatic low blood pressure. Cialis is not recommended with alpha blockers for BPH treatment.
• Patients should seek emergency care if an erection lasts longer than 4 hours (priapism), as this can cause irreversible damage.
• Stop Cialis and seek medical help immediately if sudden vision loss occurs in one or both eyes (possible non-arteritic anterior ischemic optic neuropathy - NAION) or if sudden hearing loss or decrease occurs.
• Evaluate and rule out other urological conditions before starting treatment for BPH.
• Caution in patients with left ventricular outflow obstruction (e.g., aortic stenosis) and those with unstable cardiovascular conditions; Cialis is not recommended in patients with recent myocardial infarction, unstable angina, severe heart failure, uncontrolled arrhythmias, hypotension, or recent stroke.
• Caution with potent CYP3A4 inhibitors; dose adjustments required.

Side Effects

The label does not provide a detailed frequency breakdown but notes serious hypersensitivity reactions including Stevens-Johnson syndrome and exfoliative dermatitis have been reported. Other adverse events include rare reports of prolonged erections and priapism. Sudden vision loss and hearing decrease are serious events requiring immediate attention.

Drug Interactions

• Nitrates: Concomitant use is contraindicated due to risk of significant hypotension.
• Alpha blockers: Use cautiously in ED patients stable on alpha blockers starting at lowest dose of Cialis. Not recommended in combination for BPH.
• Potent CYP3A4 inhibitors (e.g., ketoconazole, ritonavir): For use as needed, max dose 10 mg every 72 hours; for once daily use, max dose 2.5 mg.