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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