Uses

1.Erectile Dysfunction (ED)

ED refers to the physiological impairment that causes an adult male to be unable to achieve or sustain an erection for a sufficient amount of time. Tadavar 20 mg is one of the main, on-label medications for ED. It facilitates the dilation of the blood vessels in the penis and improves the blood flow. For ED, generally Tadavar 20 mg is recommended as an on-demand medication.

2.Benign Prostatic Hyperplasia (BPH)

In BPH, there is an abnormal, non-cancerous growth in the prostate that impairs its normal functioning and also causes urinary tract symptoms. For BPH, Tadavar 20 mg facilitates the relaxation of the smooth muscle tissues in the bladder neck and clears the urinary blockage. As a result, the urinary flow and other urinary tract symptoms are improved.

3.Pulmonary Arterial Hypertension (PAH)

PAH is caused by increased blood pressure in the pulmonary artery, which puts a strain on the right heart. In certain cases, Tadalafil is prescribed for PAH as it facilitates vasodilation of the pulmonary artery. As a result, the blood flow in the pulmonary artery is improved. As a result, the excess load on the right heart is reduced, and the pulmonary and circulatory functions proceed efficiently. 

4.Off-Label Indications:

• Raynaud’s Phenomenon
• High-Altitude Pulmonary Edema (HAPE) prevention
• Chronic Pelvic Pain Syndrome
• Lower Urinary Tract Symptoms (LUTS) not due to BPH
• Heart Failure with preserved ejection fraction (HFpEF)
• Microvascular Angina
• Endothelial Dysfunction
• Systemic Sclerosis–associated digital ulcers
• Secondary Pulmonary Hypertension
• Post-prostatectomy erectile rehabilitation
• Sickle Cell Disease–associated pulmonary hypertension
• Erectile dysfunction secondary to diabetes mellitus
• Erectile dysfunction secondary to spinal cord injury
• Antidepressant-induced erectile dysfunction

Dosage Information

Erectile Dysfunction (Regular / Once-Daily Use)

• Recommended dose: 2.5 mg to 5 mg orally once daily at the same time each day.
• Maximum limit: 5 mg per day.
• Important clinical information: Dose should not exceed 5 mg daily. Dose must be reduced for patients with moderate renal impairment. This medication must be avoided in severe hepatic impairment. 

Erectile Dysfunction (On-Demand Use)

• Recommended dose: 10 mg taken before anticipated sexual activity. Dosage can be increased to 20 mg or decreased to 5 mg based on response.
• Maximum limit: 20 mg per day and not more than once in 24 hours.
• Important clinical information: Tadavar 20 mg provides effects for up to 36 hours; avoid repeat dosing within 24 hours. Initial dosing must be reduced for renal/hepatic patients. Higher doses over 20 mg may increase the risk of hypotension and headache.

Benign Prostatic Hyperplasia (BPH)

• Recommended dose: 5 mg once daily
• Maximum limit: 5 mg per day
• Important clinical information: Tadalafil must be consumed daily for symptom relief. However, a 20 mg dosage of Tadalfil is not recommended for BPH. Dosage above 5 mg does not provide any additional benefits and may also increase the chances of side effects.

Erectile Dysfunction with BPH

• Recommended dose: 5 mg once daily
• Maximum limit: 5 mg per day
• Important clinical information: Consistent daily dosing is required for improvement in prostate control symptoms. 20 mg Tadalafil is not advised for ED associated with BPH. 

Pulmonary Arterial Hypertension (PAH)

• Recommended dose: 40 mg in 24 hours (given as two 20 mg tablets)
• Maximum limit: 40 mg per day
• Important clinical information: This dosage must be consumed only once in a single day. Dosage above 40 mg does not guarantee increased efficacy, but may increase side effects

How Tadavar 20mg Works

Tadavar 20 mg is mainly madeof the drug Tadalafil. This drug belongs to the class of PDE-5 inhibitors. It is a highly effective drug in comparison to other PDE-5 inhibitors. Tadavar 20 mg enhances the body’s natural mechanisms by working on the NO-cGMP pathway, involved in the local blood circulation process.

Under normal conditions, the NO-cGMP pathway is activated in response to an external trigger (sexual stimulation, neural activation, endothelial shear stress, etc.). In response to this trigger, the nerve cells/ endothelial tissues release nitric oxide (NO), which rapidly diffuses in the surrounding tissues. NO activates an enzyme called guanylate cyclase. This enzyme is responsible for converting guanosine triphosphate (GTP) into cyclic guanosine monophosphate (cGMP). 

The cGMPs are key molecules acting as secondary chemical messengers to bring about necessary physiological reactions. The cGMPs reduce the amount of intracellular calcium and facilitate the movement of potassium ions into the cells. This action leads to smooth muscle relaxation and blood vessel dilation (vasodilation). As a result, the local blood flow in the region is increased. This reaction is essential in several regions, such as the penis, pulmonary arteries, etc. 

Another enzyme called phosphodiesterase type-5 (PDE-5) is constitutively present in the tissues. The production of PDE-5 is upregulated as a feedback mechanism to excess cGMPs. It breaks down the cGMP molecules, which reverses the effects of cGMP and leads to smooth muscle contraction and reduces blood vessel dilation.

PDE-5 enzyme acts as a “brake” against excessive effect due to cGMPs. In the absence of this “brake”, the smooth muscles would remain relaxed, and vasodilation would persist indefinitely.

However, in some individuals, this PDE-5 effect is observed prematurely or in excess. As a result, the cGMP molecules fail to bring about the required physiological effects. This impairment leads to disorders like ED and PAH, where smooth muscle relaxation and vasodilation are essential for optimum physiological functioning. 

Tadavar 20 mg selectively binds to the PDE-5 enzyme and prevents it from breaking down the cGMP molecules. It facilitates relaxation of the smooth muscle tissues and improves the local blood flow. For ED, Tadavar 20 mg improves the blood flow to the penile tissue, thus facilitating a longer, sustained erection. In PAH, Tadavar 20 mg 

It must be noted that Tadavar 20 mg does not spontaneously activate the NO-cGMP pathway. An external trigger (such as sexual stimulation for ED) is essential for the effectiveness of this medication. 

Possible Side Effects

Very Common Side Effects (≥10%)

• Headache
• Dyspepsia (indigestion)

Common Side Effects (1–10%)

Neurological

• Dizziness
• Migraine

Cardiovascular

• Flushing (redness of face)
• Palpitations

Gastrointestinal

• Nausea
• Vomiting
• Abdominal pain
• Gastroesophageal reflux

Musculoskeletal

• Back pain
• Myalgia (muscle pain)
• Limb pain

Respiratory

• Nasal congestion
• Sinus congestion

General

• Fatigue

Uncommon Side Effects (0.1–1%)

Cardiovascular

• Hypotension
• Hypertension
• Tachycardia
• Chest pain
• Peripheral edema

Neurological

• Syncope (fainting)
• Paresthesia
• Somnolence

Ophthalmic

• Blurred vision
• Eye pain
• Increased tearing
• Conjunctival hyperemia

Auditory

• Tinnitus

Dermatological

• Rash
• Sweating

Gastrointestinal

• Dry mouth

Genitourinary

• Hematuria
• Prolonged erection

Rare Side Effects (<0.1%)

Cardiovascular (Serious)

• Myocardial infarction
• Stroke
• Sudden cardiac death
• Unstable angina
• Ventricular arrhythmia

Ophthalmic (Serious)

• Non-arteritic anterior ischemic optic neuropathy (NAION)
• Sudden vision loss

Auditory (Serious)

• Sudden hearing loss

Genitourinary (Serious)

• Priapism (erection >4 hours)

Hypersensitivity Reactions

• Angioedema
• Anaphylaxis
• Stevens-Johnson syndrome
• Exfoliative dermatitis

Very Rare / Post-Marketing Reports

• Seizures
• Transient global amnesia
• Severe hypotension (especially with nitrates)
• Retinal vascular occlusion

Precautions and Considerations

• Tadavar 20 mg must be consumed only when instructed by a licensed healthcare professional.
• They must strictly follow the dosage and timings as prescribed by their healthcare providers.
• This medication must be avoided in patients for whom sexual activity is not advised.
• While consuming Tadavar 20 mg, alcohol consumption is not advised, as it can lead to dizziness. Similarly, patients must avoid consuming grapefruit while taking this medication.
• Individuals must maintain adequate hydration to reduce any chances of side effects.
• Tadavar 20 mg must be administered cautiously in patients with cardiovascular disorders, especially those suffering from, or with a history of unstable angina, recent MI, stroke, serious arrhythmias, or uncontrolled hypertension.
• Apart from these, Tadavar 20 mg administration must also be considered carefully in patients with hepatic, renal, hematological, neurological, phthalimic, and auditory impairments.
• If individuals experience serious symptoms such as priapism (prolonged erection over 4 hours) and sudden vision loss, they must immediately seek medical attention.
• Tadavar 20 mg is contraindicated in certain drugs such as nitrates, alpha blockers, CYP3A4 inhibitors and inducers, and other PDE-5 inhibitors.
• Tadavar 20 mg is not intended for use in females and children, as its safety profile has not determined in these populations.

Other Information

Frequently Asked Questions

1.Why does Tadavar 20 mg stay effective for 36 hours, but does not lead to a constant erection for 36 hours?

The active ingredient of Tadavar 20 mg, Tadalafil, works by enhancing the body’s natural reaction, but it does not spontaneously procure an erection in the absence of a sexual trigger.

2.Can Tadavar 20 mg improve natural erections over time?

In some patients, improved endothelial function and blood flow to the penis can enhance penile functioning over time. However, it does not treat the underlying cause of ED.

3.Why do we experience a headache after consuming ED?

After consuming Tadavar 20 mg, there can be cerebral vascular dilation. This leads to vascular types of headaches in people consuming Tadavar 20 mg.

4.Does Tadavar 20 mg affect fertility?

There is no scientific evidence that indicates Tadalafil affects the fertility of the person consuming it. However, individuals must regularly monitor the parameters, especially those consuming it on a consistent basis.

5.Can we consume Tadavar 20 mg on an empty stomach?

Yes. Tadavar 20 mg can be consumed on an empty stomach. Heavy or fat-rich meals can delay the effects of this medication.