Patient leaflet - Tadafil 5 mg film-coated tablets
1. What Tadalafil is and what it is used for
Tadalafil contains the active substance tadalafil which belongs to a group of medicines called phosphodiesterase type 5 inhibitors.
Tadalafil is used to treat adult men with:
erectile dysfunction. This is when a man cannot get, or keep a hard, erect penis suitable for
sexual activity. Tadalafil has been shown to significantly improve the ability of obtaining a hard erect penis suitable for sexual activity.
Following sexual stimulation this medicine works by helping the blood vessels in your penis to relax, allowing the flow of blood into your penis. The result of this is improved erectile function. Tadalafil will not help you if you do not have erectile dysfunction. It is important to note that this medicine for the treatment of erectile dysfunction does not work if there is no sexual stimulation. You and your partner will need to engage in foreplay, just as you would if you were not taking a medicine for erectile dysfunction.
urinary symptoms associated with a common condition called benign prostatic hyperplasia. This
is when the prostate gland gets bigger with age. Symptoms include difficulty in starting to pass water, a feeling of not completely emptying the bladder and a more frequent need to pass water even at night. Tadalafil improves blood flow to, and relaxes the muscles of, the prostate and bladder which may reduce symptoms of benign prostatic hyperplasia. This medicine has been shown to improve these urinary symptoms as early as 1-2 weeks after starting treatment.
2. What you need to know before you take Tadalafil
Do not take Tadalafil if you:
are allergic to tadalafil or any of the other ingredients of this medicine (listed in section 6). - are taking any form of organic nitrate or nitric oxide donors such as amyl nitrite. This is a group of
medicines (“nitrates”) used in the treatment of angina pectoris (“chest pain”). Tadalafil has been shown to increase the effects of these medicines. If you are taking any form of nitrate or are unsure, tell your doctor.
- have serious heart disease or recently had a heart attack within the last 90 days. - have recently had a stroke within the last 6 months.
- have low blood pressure or uncontrolled high blood pressure.
ever had loss of vision because of non-arteritic anterior ischemic optic neuropathy (NAION),
a condition described as “stroke of the eye”.
are taking riociguat. This medicine is used to treat pulmonary arterial hypertension ( high blood
pressure in the lungs) and chronic thromboembolic pulmonary hypertension ( high blood pressure in the lungs secondary to blood clots). PDE5 inhibitors, such as Tadalafil, have been shown to increase the hypotensive effects of this medicine. If you are taking riociguat or are unsure, tell your doctor.
Warnings and precautions
Talk to your doctor before taking Tadalafil.
Be aware that sexual activity carries a possible risk to patients with heart disease because it puts an extra strain on your heart. If you have a heart problem you should tell your doctor.
Since benign prostatic hyperplasia (prostate gland enlargement) and prostate cancer may have the same symptoms, your doctor will check you for prostate cancer before starting treatment with Tadalafil for benign prostatic hyperplasia. This medicine does not treat prostate cancer.
Before taking the tablets, tell your doctor if you have:
- sickle cell anaemia (an abnormality of red blood cells).
- multiple myeloma (cancer of the bone marrow).
- leukaemia (cancer of the blood cells).
- any deformation of your penis.
- a serious liver problem.
- a severe kidney problem.
It is not known if Tadalafil is effective in patients who have had:
- pelvic surgery.
- removal of all or part of the prostate gland in which nerves of the prostate are cut (radical non- nerve-sparing prostatectomy).
If you experience sudden decrease or loss of vision or your vision is distorted, dimmed while you are, stop taking this medicine and contact your doctor immediately.
Decreased or sudden hearing loss has been noted in some patients taking this medicine. Although it is not known if the event is directly related to tadalafil, if you experience decreased or sudden hearing loss, stop taking Tadalafil and contact your doctor immediately.
Tadalafil is not intended for use by women.
Children and adolescents
Tadalafil is not intended for use by children and adolescents under the age of 18.
Other medicines and Tadalafil
Tell your doctor if you are taking, have recently taken or might take any other medicines
Do not take Tadalafil if you are already taking nitrates.
Some medicines may be affected by Tadalafil or they may affect how well Tadalafil will work. Tell your doctor or pharmacist if you are already taking:
an alpha blocker (used to treat high blood pressure or urinary symptoms associated with benign
prostatic hyperplasia).
- other medicines to treat high blood pressure.
- riociguat (medicine is used to treat high blood pressure in the lungs). See also “Do not take Tadalafil”.
a 5- alpha reductase inhibitor (used to treat benign prostatic hyperplasia). - medicines such as ketoconazole tablets (to treat fungal infections) and protease inhibitors for
treatment of AIDS or HIV infection.
- phenobarbital, phenytoin and carbamazepine (anticonvulsant medicines – to treat fits). - rifampicin, erythromycin , clarithromycin or itraconazole.
- other treatments for erectile dysfunction.
Tadalafil with drink and alcohol
Information on the effect of alcohol is in section 3. Grapefruit juice may affect how well this medicine will work and should be taken with caution. Talk to your doctor for further information.
Fertility
When dogs were treated there was reduced sperm development in the testes. A reduction in sperm was seen in some men. These effects are unlikely to lead to a lack of fertility.
Driving and using machines
Some men taking Tadalafil in clinical studies have reported dizziness. Check carefully how you react to the tablets before driving or using machines.
Tadalafil contains lactose
If you have an intolerance to some sugars, contact your doctor before taking this medicine.
Tadalafil contains sodium
Tadalafil contains less than 1 mmol sodium (23 mg) per tablet, that is to say essentially sodium-free.
3.How to take Tadalafil
Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.
Tadalafil tablets are for oral use in men only. Swallow the tablet whole with some water. The tablets can be taken with or without food.
Drinking alcohol may temporarily lower your blood pressure. If you have taken or are planning to take Tadalafil, avoid excessive drinking (blood alcohol level of 0.08% or greater), since this may increase the risk of dizziness when standing up.
For the treatment of erectile dysfunction
The recommended dose is one 5 mg tablet taken once a day at approximately the same time of the day. Your doctor may adjust the dose to 2.5 mg based on your response to Tadalafil. This will be given as a 2.5 mg tablet.
Do not take Tadalafil more than once a day.
When taken once a day Tadalafil allows you to obtain an erection, when sexually stimulated, at any time point during the 24 hours of the day. Once a day dosing of Tadalafil may be useful to men who anticipate having sexual activity two or more times per week.
It is important to note that Tadalafil does not work if there is no sexual stimulation. You and your partner will need to engage in foreplay, just as you would if you were not taking a medicine for erectile dysfunction.
Drinking alcohol may affect your ability to get an erection.
For the treatment of benign prostatic hyperplasia
The recommended dose is one 5 mg tablet taken once a day at approximately the same time of the day.
If you have benign prostatic hyperplasia and erectile dysfunction, the dose remains one 5 mg tablet taken once a day.
Do not take Tadalafil more than once a day.
If you take more Tadalafil than you should
Contact your doctor. You may experience side effects described in section 4.
If you forget to take Tadalafil
Take your dose as soon as you remember. Do not take a double dose to make up for a forgotten tablet. Do not take this medicine more than once a day.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
4.Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them. These effects are normally mild to moderate in nature.
If you experience any of the following side effects stop using the medicine and seek medical help immediately:
- allergic reactions including rashes (frequency uncommon).
chest pain - do not use nitrates but seek immediate medical assistance (frequency uncommon). - priapism, a prolonged and possibly painful erection after taking Tadalafil (frequency rare).
If you have such an erection, which lasts continuously for more than 4 hours you should contact a doctor immediately.
- sudden loss of vision (frequency rare), distorted, dimmed, blurred central vision or sudden decrease of vision (frequency not known).
Other side effects have been reported:
Common: may affect up to 1 in 10 people
- headache, back pain, muscle aches, pain in arms and legs, facial flushing, nasal congestion, and indigestion.
Uncommon: may affect up to 1 in 100 people
- dizziness, stomach ache, feeling sick, being sick (vomiting), reflux, blurred vision, eye pain, difficulty in breathing, presence of blood in urine, prolonged erection, pounding heartbeat sensation, a fast heart rate, high blood pressure, low blood pressure, nose bleeds, ringing in the ears, swelling of the hands, feet or ankles and feeling tired.
Rare: may affect up to 1 in 1,000 people
- fainting, seizures and passing memory loss, swelling of the eyelids, red eyes, sudden decrease or loss of hearing, hives (itchy red welts on the surface of the skin), penile bleeding, presence of blood in semen and increased sweating.
- Heart attack and stroke. Most of these men had known heart problems before taking this medicine. - Partial, temporary, or permanent decrease or loss of vision in one or both eyes.
Some additional rare side effects have been reported in men taking Tadalafil that were not seen in clinical trials. These include:
- migraine, swelling of the face, serious allergic reaction which causes swelling of the face or throat, serious skin rashes, some disorders affecting blood flow to the eyes, irregular heartbeats, angina and sudden cardiac death (heart attack).
- distorted, dimmed, blurred central vision or sudden decrease of vision (frequency not known).
Dizziness has been reported more frequently in men over 75 years of age taking this medicine.
Diarrhoea has been reported more frequently in men over 65 years of age taking this medicine.
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects, you can help provide more information on the safety of this medicine.
5. How to store Tadalafil
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the carton and blister after ‘EXP’. The expiry date refers to the last day of that month.
This medical product does not require any special storage conditions.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
6. Contents of the pack and other information
What Tadalafil contains
The active substance is tadalafil. Each tablet contains 5 mg of tadalafil. - The other ingredients are:
Tablet core: sodium laurylsulfate (E487), lactose monohydrate, hydroxypropyl cellulose (EF) (E463), croscarmellose sodium (E468), cellulose, microcrystalline (type 102) (E460), magnesium stearate (E572), purified water
Film-coat: hydroxypropyl methylcellulose (HPMC) 5 cP (E464), titanium dioxide, talc, yellow iron oxide (E172), triacetin (E1518).
What Tadalafil looks like and contents of the pack
The 5 mg tablets are approximately 7.6 mm length, almond shaped, biconvex, pale yellow film-coated tablets debossed “5” on one side.
Pack sizes;
Tadalafil 5 mg is available in blister packs containing 28, 56 and 98 film-coated tablets.
Not all pack sizes may be marketed.
Marketing Authorisation Holder and Manufacturer
Marketing Authorisation Holder:
Abdi Farma GmbH
Donnersbergstraße 4
Heppenheim, Germany
Manufacturer:
Interpharma Services Ltd.
43A Cherni Vrach Bvld. Sofia 1407
Bulgaria
Flavine Pharma France
3 Voie d’Allermagne, Vitrolles,
13127 France