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Tadalafil Administered Once Daily

Drug Class	Interaction Effect	Notes
Nitrates	Severe hypotension	Contraindicated
Alpha-blockers	Additive blood pressure lowering	Use caution, monitor BP
CYP3A4 inhibitors	Increased tadalafil levels	Dose adjustment may be needed
Antibiotics (e.g., erythromycin)	Potential increased levels	Monitor for side effects
Other PDE5 inhibitors	Possible additive effects	Do not combine

for Lower Urinary Tract Symptoms

5.7 Renal Impairment

Both groups demonstrated a significant improvement in post-void residual urine (PVR), with a reduction observed at 1, 3, and 6 months following TURP. However, the difference between the two groups was not statistically significant (P = 0.2) Fig.3. The improvement in the Voiding IPSS score was comparable between the two groups, with no significant difference observed. A slight improvement in persistent storage symptoms was noted in Group A compared to Group B. The mean (± SD) preoperative storage symptom sub-score in Group A was 8.63 ± 1.82, which improved to 3.05 ± 0.78, 1.63 ± 0.49, and 0.92 ± 0.67 at 1, 3, and 6 months post-TURP, respectively (P < 0.001).

Patient characteristics

In Group B, the mean (± SD) preoperative storage symptom sub-score was 8.03 ± 0.22, which improved to 3.22 ± 0.72, 2.48 ± 0.5, and 1.69 ± 0.47 at 1, 3, and 6 months post-TURP, respectively (P < 0.001) (Table 3). Nearly all patients were compliant with daily tadalafil usage. Regarding adverse effects, only 13 patients reported mild headaches and runny noses for a short duration. These symptoms did not result in discontinuation of tadalafil treatment. PDE5-I treatment was more effective than placebo in patients with ED following nerve-sparing radical prostatectomy, promoting the recovery of erectile function and potentially protecting against penile structural changes [10].

Additional file 1: (download PDF )

Tadalafil is safe and effective, and can be used as the first-line medication for the clinical treatment on male ED after transurethral resection of prostate [25]. Administration of 5 mg tadalafil once daily resulted in significant improvements in total International Prostate Symptom Score (IPSS), including both voiding and storage subscores, as well as enhancements in IPSS-related quality of life (QoL) and the BPH Impact Index (BII) [4]. Similarly, in our study, and to the best of our knowledge, this is the first trial to compare the effects of early post-TURP administration of tadalafil 5 mg on persistent storage symptoms and erectile function. In elderly men, ED and LUTS associated with benign prostatic enlargement (BPE) are highly prevalent comorbid conditions that negatively impact quality of life (QoL) and impose a significant economic burden. Preclinical and clinical studies have established that, in addition to aging, various metabolic factors contribute to the onset and progression of both ED and LUTS, leading to penile and nerve alterations, as well as prostate enlargement and inflammation [8]. Secondary to Benign Prostatic

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Hyperplasia: A Dose Finding Study.

• Tadalafil 5mg is primarily used to treat erectile dysfunction.
• It works by relaxing blood vessels in the penis.
• Typically taken once daily for ongoing management.

Sexual Side Effects of Medical

Author information

Montorsi F, Brock G, Stolzenburg J-U, Mulhall J, Moncada I, Patel HRH, Chevallier D, Krajka K, Henneges C, Dickson R, Büttner H. Effects of Tadalafil Treatment on Erectile Function Recovery Following Bilateral Nerve-sparing Radical Prostatectomy: A Randomised Placebo-controlled Study (REACTT). Pavone C, Abbadessa D, Scaduto G, Caruana G, Scalici Gesolfo C, Fontana D, Vaccarella L. Sexual dysfunctions after transurethral resection of the prostate (TURP): evidence from a retrospective study on 264 patients. Porst H, Kim ED, Casabé AR, Mirone V, Secrest RJ, Xu L, Sundin DP, Viktrup L. and Surgical Benign Prostatic Hyperplasia Treatments.

Property	Description	Value/Notes
Active Ingredient	Tadalafil	5 mg
Drug Class	Phosphodiesterase type 5 inhibitor	-
Half-life	17.5 hours	Approximate
Bioavailability	~80%	Oral administration
Absorption Time	2 hours	Peak plasma concentration
Metabolism	Liver (via CYP3A4 enzyme)	-
Excretion	Feces (~61%), Urine (~36%)	-

Yu H, Wu H, Rao D.

Generic vs Brand

TURP is widely recognized as the most effective traditional surgical method for treating BPH. Once the bladder is relieved of obstruction, the thickened bladder wall undergoes atrophy, restoring its elasticity and alleviating irritative symptoms. Notably, the degree of symptom improvement is reported to be particularly high in patients with severe preoperative irritative symptoms [14]. However, a recent study indicated that TURP does not alleviate irritative symptoms in all patients, with 20% to 30% requiring postoperative medication due to persistent symptoms, ultimately leading to a decline in quality of life. Several clinical studies have demonstrated significant improvements in LUTS with the use of PDE5 inhibitors.

Who should not use tadalafil?

Although the precise mechanism underlying LUTS improvement with PDE5 inhibitors remains unclear, proposed mechanisms include the relaxation of smooth muscle cells in the urogenital tract via the NO/cGMP/PDE5 pathway [13]. In our study, we observed a significant improvement in erectile function in Group A. The mean (± SD) IIEF score in Group A was 9.84 ± 2.6 before TURP, increasing to 11.59 ± 1.9, 19.8 ± 1.12, and 20.97 ± 0.72 at 1, 3, and 6 months post-TURP, respectively (P < 0.001). Regarding overall LUTS, both groups demonstrated comparable improvements in IPSS, Qmax, and PVR. However, in Group A, there was a slight greater improvement in persistent irritative symptoms than Group B.

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The mean (± SD) preoperative storage symptom sub-score was 8.63 ± 1.82, which tadalafil daily decreased to 3.05 ± 0.78, 1.63 ± 0.49, and 0.92 ± 0.67 at 1, 3, and 6 months post-TURP, respectively (P < 0.001). Similarly, in the first systematic review on the use of PDE5 inhibitors for LUTS, Laydner et al. reported that PDE5 inhibitors improve the IPSS score and IIEF-5 but do not significantly affect Qmax [15]. Several randomized controlled trials (RCTs) have demonstrated that PDE5 inhibitors significantly reduce IPSS scores, improving both storage and voiding LUTS, and enhancing patients'quality of life. Similarly, a meta-analysis reported significant improvements in IPSS and IIEF scores with PDE5 inhibitor use, though no significant change was observed in Qmax. Analysis of the therapeutic effect of Tadalafil

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Efficacy and Safety of Tadalafil Once Daily in the Treatment of Men With Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia: Results of an International Randomized, Double-Blind, Placebo-Controlled Trial. Porst H, Roehrborn CG, Secrest RJ, Esler A, Viktrup L. Effects of Tadalafil on Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia and on Erectile Dysfunction in Sexually Active Men with Both Conditions: Analyses of Pooled Data from Four Randomized, Placebo-Controlled Tadalafil Clinical Studies. Techniques and Long-Term Results of Surgical Procedures for BPH. Roehrborn CG, McVary KT, Elion-Mboussa A, Viktrup L. on male ED after transurethral resection of prostate.

• Tadalafil 5mg may interact with other medications.
• Follow prescribed instructions for safe use.
• Misuse can lead to serious health risks or side effects.