Urology Book

http://www.fpnotebook.com/

CialisAka: Tadalafil

Advertisement

  1. Indications
    1. Psychogenic Impotence
    2. Neurogenic Impotence
    3. Vasculogenic Impotence
  2. Contraindications
    1. Absolute Contraindications (risk of hypotension)
      1. Men using nitrates (i.e. Nitroglycerin)
      2. Men using alpha blockers (e.g. Hytrin for BPH)
    2. Relative Contraindications
      1. Active coronary ischemia in men not on nitrates
      2. Congestive Heart Failure
        1. Borderline low Blood Pressure
        2. Bordrline low volume status
      3. Multidrug antihypertensive regimen
      4. Taking Cytochrome P450-3A4 (CYP3A4) inhibitor
  3. Mechanism
    1. Phosphodiesterase Type 5 causes Erection to subside
    2. Cialis blocks Phosphodiesterase Type 5
      1. Results in enhanced Erection if man is aroused
      2. Unlike Alprostadil, will not cause Erection
    3. Cialis enhances vasodilating effect of Nitrous Oxide
      1. Normally released during sexual stimulation
  4. Pharmacokinetics
    1. Onset within 30 to 60 minutes
    2. Duration as long as 36 hours
      1. Contrast with 4 hours with Viagra
      2. Prolonged effect also leads to prolonged side effects
  5. Dosing
    1. Start 20 mg PO 1 hour before intercourse
      1. Do not take more than once per 2 days
      2. Most insurance limits to 6 per month
    2. Indications to start with half dosing (10 mg)
      1. Age over 65 years
      2. Hepatic Impairment
      3. Renal Impairment
      4. Concurrent use of Cytochrome P3A4 inhibitor below
  6. Drug Interactions
    1. Inhibit breakdown of Viagra via Cytochrome P3A4
      1. Cimetidine (Tagamet)
      2. Erythromycin
      3. Ketoconazole (Nizoral)
      4. Itraconazole (Sporonox)
      5. Mibefradil (Posicor)
    2. Profound Vasodilitation and Hypotension (Avoid)
      1. Nitrates
      2. Alpha-blockers (use Tamsulosin instead)
        1. Uroxatral
        2. Doxazosin
        3. Terazosin
        4. Prazosin
  7. Adverse Effects
    1. Hypotensive effect for men on Nitrates (Avoid)
    2. Temporary color vision disturbance
      1. Blue colors may appear to be green
    3. Mild Headache
    4. Facial Flushing
    5. Myalgias
    6. Indigestion or Dyspepsia
    7. Does not cause Priapism
  8. References
    1. () 2 003 Med Lett Drug Ther 45:101

Cialis (C0967376)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHC429886
EnglishCialis, Lilly brand of tadalafil
Parent ConceptsMoved elsewhere (C1274021)
SourcesMSH, MTH, NCI, PDQ, RXNORM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


tadalafil (C1176316)

Definition (NCI)A carboline-based compound with vasodilatory properties. Tadalafil selectively inhibits the cyclic guanosine monophosphate (cGMP)-specific type 5 phosphodiesterase- (PDE-5)-mediated degradation of cGMP, which is found in the smooth muscle of the corpus cavernosa and corpus spongiosum of the penis. Inhibition of cGMP degradation by tadalafil results in prolonged muscle relaxation, vasodilation, and blood engorgement of the corpus cavernosa, thereby prolonged penile erection.
Definition (PDQ)A carboline-based compound with vasodilatory properties. Tadalfil selectively inhibits the cyclic guanosine monophosphate (cGMP)-specific type 5 phosphodiesterase- (PDE-5)-mediated degradation of cGMP, which is found in the smooth muscle of the corpus cavernosa and corpus spongiosum of the penis. Inhibition of cGMP degradation by tadalfil results in prolonged muscle relaxation, vasodilation, and blood engorgement of the corpus cavernosa, and, so, prolonged penile erection. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=462366&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=462366&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C47743" NCI Thesaurus)
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHC429886
Englishtadalafil, TADALAFIL @ @ UNIDENTIFIED, TADALAFIL UNIDENTIFIED
Spanishtadalafil
Parent ConceptsPhosphodiesterase Inhibitors (C0031638), Antispasmodics (C0037766), Smooth muscle relaxant (C0304437), Phosphodiesterase 5 inhibitor (C1318700), Genital system agent (C1320003)
SourcesMSH, MTHSPL, NCI, PDQ, RXNORM, SCTSPA, SNOMEDCT, USPMG, VANDF
Derived from the NIH UMLS (Unified Medical Language System)



Navigation Tree