Cialis Super Active+ (Tadalafil)
Class and Category of Drug
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Chemical class: Phosphodiesterase inhibitor
Therapeutic class: Anti-impotence
Pregnancy category: B
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Drug Indications and Dosages
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To treat erectile dysfunction
Tablets
Adults. Initial: 10 mg daily taken 1 hr before sexual activity; dosage decreased to 5 mg or increased to 20 mg, as prescribed, based on clinical response. Maximum: 20 mg daily. Or, 2.5 mg once daily, increased to 5 mg once daily, if needed.
Dosage Adjustment For patients taking potent CYP3A4 inhibitors such as itraconazole, ketoconazole, or ritonavir, dosage shouldn't exceed 10 mg every 72 hr. For patients with moderate to severe renal insufficiency who take drug on an as-needed basis, dosage shouldn't exceed 5 mg daily. For patients with mild to moderate hepatic impairment who take drug on an as-needed basis, dosage shouldn't exceed 10 mg daily. For patients who take drug once daily, no dosage adjustment is needed with mild to moderate hepatic or renal impairment; once daily dosing not recommended for use with severe hepatic or renal impairment.
To treat pulmonary arterial hypertension in order to improve exercise ability in patients classified as group 1 by the World Health Organization
Tablets (Adcirca) Adults. 40 mg once daily.
Dosage Adjustment For patients with mild to moderate hepatic or renal impairment or who have already taken ritonavir for at least 1 week, initial dosage of 20 mg once daily and then increased as tolerated. For patient already taking tadalafil and being prescribed ritonavir, tadalafil temporarily discontinued for at least 24 hours before ritonavir starts. Then, after at least 1 week of ritonavir, tadalafil restarted at 20 mg once daily and then increased to 40 mg once daily, as tolerated.
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Contraindications of Drug
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Continuous or intermittent nitrate therapy, hypersensitivity to tadalafil or its components, retinitis pigmentosa
Interactions
Drugs
carbamazepine, phenytoin, phenobarbitol: Possibly decreased tadalafil effects doxazosin, tamsulosin and other alpha blockers: Increased risk of symptomatic hypotension
erythromycin, itraconazole, ketoconazole, ritonavir: Prolonged tadalafil effects nitrates: Profound hypotension
protease inhibitors (other than ritonavir): Possibly prolonged tadalafil effects rifampin: Decreased tadalafil effects
Foods
grapefruit juice: Possibly prolonged tadalafil effects
Activities
alcohol use: Potentiated blood pressure lowering effects
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Drugs Adverse Reactions
Central Nervous System: Asthenia, dizziness, fatigue, headache, hypesthesia, insomnia, migraine, paresthesia, seizures, somnolence, stroke, syncope, transient global amnesia, vertigo
Cardiovascular: Angina pectoris, chest pain, hypotension, hypertension, MI, postural hypotension, palpitations, sudden cardiac death, tachycardia
Eyes, Ears, Nose, And Throat: Blurred vision, changes in color vision, conjunctivitis, dry mouth, epistaxis, eyelid swelling, eye pain, hearing loss, increased lacrimation, nasal congestion, nasopharyngitis, nonarteritic anterior ishcemic optic neuropathy, pharyngitis, retinal artery or vein occlusion, visual field defects
Gastrointestinal: Abnormal liver function studies, diarrhea, dysphagia, dyspepsia, esophagitis, gastroesophageal reflux, gastritis, increased gamma-glutamyl transpeptidase levels, nausea, upper abdominal pain, vomiting
Genitourinary: Priapism, spontaneous penile erection, urinary tract infection
Musculoskeletal: Arthralgia, back or neck pain, extremity pain, myalgia
Respiratory: Bronchitis, cough, dyspnea, upper respiratory tract infection
Skin: Diaphoresis, exfoliative dermatitis, flushing, pruritus, rash, Stevens-Johnson syndrome, urticaria
Other: Facial edema, flulike symptoms, hypersensitivity reactions
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Nursing Considerations for Generic Drugs
• Know that patients with hereditary degenerative retinal disorders, including retinitis pigmentosa, should not receive tadalafil because of the risk of serious ophthalmic adverse reactions.
• Patients with severe hepatic or renal impairment should not receive tadalafil because its effects in these patients are unknown.
• Use tadalafil cautiously in patients with left ventricular outflow obstruction, such as aortic stenosis and idiopathic hypertrophic subaortic stenosis, and those with severely impaired autonomic control of blood pressure because these conditions increase sensitivity to vasodilators such as tadalafil.
• Use tadalafil cautiously in patients with conditions that may predispose them to priapism, such as sickle cell anemia, multiple myeloma, leukemia, or penile deformities (such as angulation, cavernosal fibrosis, or Peyronie's disease).
• Monitor blood pressure and heart rate and rhythm before and during therapy.
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Tadalafil
Preparations
International Brand Drug Names
The information about drugs (tablets, pills, capsules, creams, solution, nasal spray, inhaler) around the world.
Proprietary Preparations
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