Starting Point: The Physiology
Tadalafil blocks PDE5, letting cGMP linger longer. That relaxes smooth muscle and opens blood vessels. This is why it supports erectile function, improves certain urinary symptoms, and helps reduce pressure in the pulmonary circulation for the right patients.
Where It's Standard of Care
Erectile Dysfunction
Improves erectile response in the setting of sexual arousal; known for long duration compared with some alternatives.
BPH-Related Symptoms
By reducing smooth muscle tone, many experience relief from frequency, urgency, and weak stream.
Pulmonary Arterial Hypertension
Targeted vasodilation in the lungs can improve exercise capacity and symptoms in specific PAH populations.
Active Areas of Research
Because many conditions have a vascular component, tadalafil is studied in:
- Raynaud's phenomenon: easing vasospasm and aiding digital ulcer healing
- Neuromuscular disorders: exploring improved muscle perfusion during exertion
- Cognitive disorders with vascular contributions: carefully controlled trials
- Ureteral stones: relaxing the ureter to support stone passage
Tadalafil at a Glance
- Long half-life (17.5 hours) enables once-daily or on-demand dosing.
- Avoid combining with nitrates or riociguat due to dangerous blood pressure drops.
- PDE5 inhibitor that raises cGMP and relaxes smooth muscle.
- Food has minimal impact; alcohol and grapefruit may interact.
- Approved for ED, BPH-associated LUTS, and PAH (as Adcirca).
- Not a cure; works in presence of sexual stimulation for ED.
- Common effects: headache, flushing, nasal congestion; usually mild.
- Dose adjustments may be needed with strong CYP3A4 inhibitors/inducers.