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Cialis
tadalafil
Adult Dosing .
Dosage forms: TAB: 2.5 mg, 5 mg, 10 mg, 20 mg
erectile dysfxn
- [prn dosing regimen]
- Dose: 5-20 mg PO x1; Start: 10 mg PO x1; Max: 20 mg/dose up to 1 dose/24h; Info: give at least 30min before sexual activity; effects may last 36h
- [daily dosing regimen]
- Dose: 2.5-5 mg PO qd; Start: 2.5 mg PO qd; Max: 5 mg/day; Info: give without regard to sexual activity
BPH
- [5 mg PO qd]
- Info: for pts w/ or w/o erectile dysfxn
renal dosing
- [erectile dysfxn prn dosing]
- CrCl 30-50: start 5 mg x1, max 1 dose/24h up to 10 mg/48h; CrCl <30: max 5 mg/72h
- HD: max 5 mg/72h; no supplement after dialysis; PD: not defined
- [erectile dysfxn daily dosing]
- CrCl <30: avoid use
- HD: avoid use; PD: not defined
- [BPH]
- CrCl 30-50: start 2.5 mg qd; CrCl <30: avoid use
- HD: avoid use; PD: not defined
hepatic dosing
- [erectile dysfxn prn dosing]
- Child-Pugh Class A or B: max 10 mg/24h; Child-Pugh Class C: avoid use
- [erectile dysfxn or BPH daily dosing]
- Child-Pugh Class A or B: not defined, caution advised; Child-Pugh Class C: avoid use
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- nitrate use w/in 48h
- pulmonary veno-occlusive dz (pulmonary HTN use)
- retinal disorder, hereditary degenerative
- CrCl <30 (BPH or erectile dysfxn daily use)
- CrCl <31 (pulmonary HTN use)
- hepatic impairment, Child-Pugh Class C
- caution: hypersensitivity to tartrazine (generic form)
- caution: CrCl <30 (erectile dysfxn prn use)
- caution: CrCl 30-50 (erectile dysfxn prn or BPH use)
- caution: CrCl 31-80 (pulmonary HTN use)
- caution: hepatic impairment, Child-Pugh Class A-B
- caution: alcohol use, concurrent
- caution: pts >50 yo
- caution: smokers
- caution: stroke w/in 6mo (erectile dysfxn or BPH use)
- caution: HTN, uncontrolled
- caution: BP <90/50
- caution: LV outflow obstruction
- caution: autonomic dysfxn
- caution: NYHA Class II-IV CHF w/in 6mo (erectile dysfxn or BPH use)
- caution: MI w/in 90 days (erectile dysfxn or BPH use)
- caution: angina during sexual intercourse (erectile dysfxn or BPH use)
- caution: unstable angina during sexual intercourse (erectile dysfxn or BPH use)
- caution: arrhythmia, uncontrolled (erectile dysfxn or BPH use)
- caution: CAD
- caution: diabetes mellitus
- caution: hyperlipidemia
- caution: anterior ischemic optic neuropathy hx, non-arteritic
- caution: optic cup-to-disc ratio, low
- caution: penile deformity
- caution: priapism risk
- caution: bleeding risk
Drug Interactions .
Overview
tadalafil
PDE5 inhibitor
- CYP3A4 substrate
- ototoxicity
- vasodilator agent
Contraindicated
- isosorbide dinitrate
- isosorbide mononitrate
- nitroglycerin
- nitroprusside
- riociguat
- vericiguat
Avoid/Use Alternative
- adagrasib
- aldesleukin
- alfuzosin
- amikacin
- amikacin inhaled
- apalutamide
- atazanavir
- avanafil
- bosentan
- butalbital
- carbamazepine
- cenobamate
- ceritinib
- chloramphenicol
- clarithromycin
- cobicistat
- dabrafenib
- doxazosin
- efavirenz
- encorafenib
- enzalutamide
- ethacrynic acid
- etravirine
- fexinidazole
- fosphenytoin
- gentamicin
- idelalisib
- itraconazole
- ivosidenib
- ketoconazole
- lenacapavir
- levoketoconazole
- lofexidine
- lonafarnib
- lopinavir/ritonavir
- lorlatinib
- lumacaftor/ivacaftor
- mavacamten
- mifepristone
- mitapivat
- mitotane
- modafinil
- nafcillin
- nefazodone
- nelfinavir
- neomycin
- netupitant
- pacritinib
- pentobarbital
- pexidartinib
- phenobarbital
- phenytoin
- plazomicin
- posaconazole
- prazosin
- primidone
- repotrectinib
- ribociclib
- rifabutin
- rifampin
- rifapentine
- ritonavir
- sildenafil
- silodosin
- sotorasib
- St. John's wort
- streptomycin
- tadalafil
- tamsulosin
- terazosin
- tipranavir
- tobramycin
- tobramycin inhaled
- tucatinib
- vardenafil
- voriconazole
Monitor/Modify Tx
- acebutolol
- alfentanil
- aliskiren
- alprazolam
- amantadine
- amifostine
- amiloride
- amiodarone
- amitriptyline
- amlodipine
- amoxapine
- apomorphine
- apraclonidine ophthalmic
- aprepitant
- aprocitentan
- aripiprazole bimonthly injection
- aripiprazole lauroxil
- aripiprazole monthly injection
- aripiprazole oral
- articaine
- asciminib
- asenapine
- atenolol
- atorvastatin
- avacopan
- azilsartan medoxomil
- belumosudil
- benazepril
- berberine
- berotralstat
- betaxolol
- betaxolol ophthalmic
- bethanechol
- bexagliflozin
- bicalutamide
- bisoprolol
- bortezomib
- brexpiprazole
- brimonidine ophthalmic
- brimonidine topical
- bromocriptine
- bumetanide
- bupivacaine
- bupivacaine liposomal
- buprenorphine
- butorphanol
- cabergoline
- canagliflozin
- candesartan cilexetil
- cannabis
- capivasertib
- captopril
- cariprazine
- carteolol ophthalmic
- carvedilol
- chloroprocaine
- chlorothiazide
- chlorpromazine
- chlorthalidone
- chlorzoxazone
- cilostazol
- cimetidine
- ciprofloxacin
- cisplatin
- clevidipine
- clofarabine
- clofazimine
- clomipramine
- clonidine
- clotrimazole oropharyngeal
- clozapine
- codeine
- coenzyme Q-10
- conivaptan
- cranberry
- crizotinib
- cyclosporine
- danazol
- dapagliflozin
- daridorexant
- darunavir
- deferasirox
- deferoxamine
- denileukin diftitox
- desflurane
- desipramine
- dexmedetomidine
- dexmedetomidine injection
- dihydrocodeine
- diltiazem
- dinutuximab
- diosmin
- dipyridamole
- doxepin
- dronabinol
- dronedarone
- duloxetine
- duvelisib
- eflornithine
- empagliflozin
- enalapril
- enalaprilat
- entacapone
- entrectinib
- eplerenone
- epoprostenol
- ertugliflozin
- erythromycin
- esmolol
- ethanol
- ethinyl estradiol (contraceptive)
- everolimus
- fedratinib
- felodipine
- fenoldopam
- fentanyl
- ferumoxytol
- finerenone
- flaxseed
- flibanserin
- fluconazole
- fluphenazine
- fluvoxamine
- fosamprenavir
- fosaprepitant
- fosinopril
- foslevodopa
- fostamatinib
- furosemide
- garlic
- gepotidacin
- gilteritinib
- ginkgo
- givinostat
- givosiran
- glecaprevir
- goldenseal
- grapefruit
- grazoprevir
- guanfacine
- haloperidol
- hydralazine
- hydrochlorothiazide
- hydrocodone
- hydromorphone
- iloperidone
- iloprost
- iloprost inhaled
- imatinib
- imipramine
- indapamide
- irbesartan
- iron sucrose
- isavuconazonium
- isocarboxazid
- isoflurane
- isoniazid
- isradipine
- istradefylline
- ivacaftor
- kratom
- labetalol
- landiolol
- lapatinib
- larotrectinib
- lazertinib
- lefamulin
- letermovir
- levobunolol ophthalmic
- levodopa
- levorphanol
- lidocaine
- lisinopril
- lomitapide
- losartan
- lovastatin
- loxapine
- lubiprostone
- lumateperone
- lurasidone
- magnesium sulfate
- maraviroc
- maribavir
- mavorixafor
- meperidine
- mepivacaine
- methadone
- methohexital
- methyldopa
- methylene blue injection
- metolazone
- metoprolol
- midazolam
- milrinone
- minoxidil
- mirtazapine
- moexipril
- molindone
- morphine
- nadolol
- nalbuphine
- nattokinase
- naxitamab
- nebivolol
- niacin (vitamin B3)
- nicardipine
- nifedipine
- nilotinib
- nimodipine
- nirogacestat
- nisoldipine
- nitric oxide
- nitrite
- nortriptyline
- obinutuzumab
- olanzapine
- oliceridine
- olmesartan medoxomil
- opicapone
- opium
- osilodrostat
- oxaliplatin
- oxazepam
- oxycodone
- oxymorphone
- palbociclib
- paliperidone
- palopegteriparatide
- paromomycin
- pazopanib
- pentamidine
- pentazocine
- peppermint
- perindopril
- perphenazine
- phenelzine
- phenoxybenzamine
- phentolamine
- phenylephrine injection
- pibrentasvir
- pindolol
- pirtobrutinib
- pramipexole
- procarbazine
- prochlorperazine
- promethazine
- propafenone
- propofol
- propranolol
- protriptyline
- quercetin
- quetiapine
- quinapril
- ramipril
- ranolazine
- rasagiline
- remdesivir
- remifentanil
- remimazolam
- resveratrol
- risperidone
- ritlecitinib
- ropinirole
- ropivacaine
- rotigotine transdermal
- rucaparib
- sacubitril
- safinamide
- sapropterin
- selegiline
- selegiline transdermal
- selpercatinib
- sevoflurane
- sodium ferric gluconate complex
- sotagliflozin
- sotalol
- sparsentan
- spironolactone
- stiripentol
- sufentanil
- tagraxofusp
- tapentadol
- taurine
- telmisartan
- teprotumumab
- thalidomide
- thioridazine
- thiothixene
- ticagrelor
- timolol
- timolol ophthalmic
- tizanidine
- tolcapone
- tolvaptan
- torsemide
- tramadol
- trandolapril
- tranylcypromine
- trazodone
- treosulfan
- treprostinil
- triamterene
- trifluoperazine
- trimipramine
- trofinetide
- valsartan
- vancomycin
- verapamil
- viloxazine
- vonoprazan
- vosoritide
- voxelotor
- xanomeline
- yohimbe
- zileuton
- ziprasidone
Caution Advised
- amphotericin
- armodafinil
- artemether/lumefantrine
- belzutifan
- bexarotene
- brigatinib
- carboplatin
- chloroquine
- clobazam
- danshen
- darolutamide
- dexamethasone
- dicloxacillin
- docetaxel
- echinacea
- elafibranor
- elagolix
- enasidenib
- eslicarbazepine acetate
- felbamate
- fenoprofen
- fludarabine
- galsulfase
- ginseng, Asian
- glycerol phenylbutyrate
- griseofulvin
- isotretinoin
- meropenem
- mobocertinib
- naproxen
- neomycin otic
- nevirapine
- odevixibat
- olutasidenib
- omaveloxolone
- oxcarbazepine
- perampanel
- pioglitazone
- prednisone
- quinidine (antiarrhythmic)
- quinidine (CYP2D6 inhibitor)
- quinine
- rufinamide
- salsalate
- sarilumab
- somatropin
- sunvozertinib
- suzetrigine
- tazemetostat
- tecovirimat
- telotristat ethyl
- tocilizumab
- topiramate
- tovorafenib
- vaborbactam
- vamorolone
- vemurafenib
- verteporfin
- vinblastine
- vincristine
- vinorelbine
- vorasidenib
- zanubrutinib
Adverse Reactions .
Serious Reactions
- hypersensitivity rxn
- Stevens-Johnson syndrome
- exfoliative dermatitis
- sudden death
- MI
- stroke
- angina
- hypotension, severe
- non-arteritic anterior ischemic optic neuropathy
- vision loss
- hearing loss
- seizures
- priapism
- syncope (erectile dysfxn or BPH use)
Common Reactions
- headache
- myalgia
- nasopharyngitis
- flushing
- respiratory infection
- extremity pain
- nausea (pulmonary HTN use)
- back pain
- dyspepsia
- rhinitis
- sinusitis
- diarrhea (erectile dysfxn or BPH use)
Safety/Monitoring .
Monitoring Parameters
Cr at baseline
Look/Sound-Alike Drug Names
tadalafil confused with: sildenafil; vardenafil
Pregnancy/Lactation .
Pregnancy
Clinical Summary
N/A; drug unlikely to be used during pregnancy based on indication
Lactation
Clinical Summary
N/A; drug unlikely to be used while breastfeeding based on indication
Pharmacology .
Metabolism: liver; CYP450: 3A4 substrate
Excretion: feces 61%, urine 36%; Half-life: 15-35h (pulmonary HTN use), 17.5h (erectile dysfxn or BPH use)
Subclass: Benign Prostatic Hyperplasia (BPH) ; Erectile Dysfunction ; Sexual Dysfunction
Mechanism of Action
inhibits phosphodiesterase type 5, enhancing effects of nitric oxide-activated increases in cGMP
Formulary .
No Formulary Selected
Manufacturer/Pricing .
Manufacturer: Lilly ICOS, LLC
DEA/FDA: Rx
Approximate Retail Price
from http://www.goodrx.com/cialis
oral tablet:
- 2.5 mg (30 ea): $373.00
- 5 mg (30 ea): $373.00
- 10 mg (30 ea): $2,136.00
- 20 mg (30 ea): $2,136.00
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