Indications for: TADLIQ
Pulmonary arterial hypertension (WHO Group I) to improve exercise ability.
40mg (10mL) once daily. Mild (CrCl 51–80mL/min) or moderate (CrCl 31–50mL/min) renal impairment: initially 20mg (5mL) once daily; increase to 40mg (10mL) once daily if tolerated. Severe renal impairment (CrCl <30mL/min, on hemodialysis): avoid. Mild or moderate hepatic cirrhosis (Child Pugh Class A or B): consider starting at 20mg (5mL) once daily. Severe hepatic cirrhosis (Child Pugh Class C): avoid. Use with ritonavir: patients receiving ritonavir (for at least 1 week): initiate tadalafil at 20mg (5mL) once daily, may increase to 40mg (10mL) once daily if tolerated; patients already on tadalafil: stop tadalafil at least 24hrs prior to initiating ritonavir; resume tadalafil at 20mg (5mL) once daily after at least 1 week; may increase to 40mg (10mL) once daily if tolerated.
Concomitant organic nitrates, guanylate cyclase stimulators (eg, riociguat).
Underlying cardiovascular disease. Preexisting hypotension, autonomic dysfunction, left ventricular outflow obstruction. Pulmonary veno-occlusive disease, severe renal and hepatic impairment, hereditary degenerative retinal disorders including retinitis pigmentosa: not recommended. Monitor for pulmonary edema. Anatomical penile deformation. Predisposition to priapism. History of non-arteritic anterior ischemic optic neuropathy (NAION). "Crowded" optic disc. Pregnancy. Nursing mothers.
Phosphodiesterase type 5 inhibitor (cGMP-specific).
See Contraindications. Hypotension with nitrates; do not use nitrates within 48hrs of the last tadalafil dose. Avoid concomitant potent CYP3A inhibitors (eg, ketoconazole, itraconazole) and potent CYP3A inducers (eg, rifampin). Concomitant α-blockers (eg, doxazosin, alfuzosin, tamsulosin), alcohol may cause symptomatic hypotension. Concomitant other tadalafil products (eg, Cialis) or PDE5 inhibitors: not recommended. Caution with ritonavir (see Adult dose).
Headache, myalgia, nasopharyngitis, flushing, respiratory tract infection, pain, nausea, dyspepsia, sinus congestion; hypotension, sudden vision or hearing loss, priapism, prolonged erection, NAION.
Generic Drug Availability: