Tadalafil

CLINICAL USE

Treatment of erectile dysfunction

DOSE IN NORMAL RENAL FUNCTION

10 to 20 : mg, 30 minutes to 12 hours before sexual activity

PHARMACOKINETICS

Molecular weight :389.4

%Protein binding :94

%Excreted unchanged in urine : 36

Volume of distribution (L/kg) :63 litres

half-life – normal/ESRD (hrs) :17.5/ Increased

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : 10 mg initially and use with caution

<10 : 10 mg initially and use with caution

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unlikely to be dialysed. Dose as in GFR <10 mL/min

HD :Not dialysed. Dose as in GFR <10 mL/min

HDF/high flux :Unlikely to be dialysed. Dose as in GFR <10 mL/min

CAV/VVHD :Unlikely to be dialysed. Dose as in GFR 10 to 20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAlpha-blockers: enhanced hypotensive effect – avoid concomitant useNicorandil: possibly enhanced hypotensive effect – avoid concomitant use

Nitrates: enhanced hypotensive effect– avoid concomitant use

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

–

Comments

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OTHER INFORMATION

Maximum dosing frequency is once daily Due to lack of trial data, maximum recommended dose is 10 mg in severe renal impairment; in practice a higher dose may be used with cautionProtein binding is not affected by renal impairment.

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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