Uses

1.Erectile Dysfunction (ED)

Erectile dysfunction refers to the continuous inability of an individual to obtain or maintain an erection for the required amount of time. This disorder affects men of all age groups, although its prevalence is observed mostly in individuals aged over 40 years. Common causes of ED include diabetes mellitus, hypertension, smoking, dyslipidemia, obesity, psychological stress, and post-pelvic surgery. The physiological effects observed in males with ED are decreased blood flow to the penis, impaired vascular structure, and increased smooth muscle tone. Tadagra 20 mg helps with ED by enhancing the natural process of penile erection. It improves the blood flow to the region and helps sustain the reaction for a significant amount of time.

2.Erectile Dysfunction Associated With Benign Prostatic Hyperplasia (BPH)

Benign Prostatic Hyperplasia (BPH) is characterized by the formation of a non-cancerous mass in the prostate. It is characterized by symptoms like increased urinary frequency, nocturia, weak urinary stream, and reduced vascular and penile function. In most males over 50, ED coexists with BPH. ED can also persist even after the removal of the non-cancerous mass. Tadagra 20 mg in BPH-related ED improves both the penile and urinary functions. Although a low dose of Tadalafil is generally prescribed at comparatively low doses, Tadagra 20 mg is sometimes used intermittently.

3.Pulmonary Arterial Hypertension- PAH (Specialist-Directed Indication)

PAH consists of high blood pressure in the pulmonary arteries. It can be caused due to increased contraction of the pulmonary arteries, which leads to narrow or blocked arteries. PAH is characterised by increased pulmonary vascular resistance, progressive right ventricular strain, and reduced exercise capacity. Tadagra targets the Nitric Oxide-cGMP system that is responsible for the vasodilation/vasoconstriction process. This restores the vascular function of the pulmonary artery and maintains proper blood flow in the region. For this indication, Tadagra must be consumed under strict medical supervision. 

4.Off-Label Uses

• Raynaud’s phenomenon
• Secondary pulmonary hypertension
• Altitude-induced pulmonary hypertension
• Female sexual arousal disorder
• Erectile dysfunction after pelvic surgery
• Erectile dysfunction due to antidepressants
• Erectile dysfunction in spinal cord injury
• Endothelial dysfunction disorders
• Chronic pelvic pain syndrome
• Lower urinary tract symptoms (non-BPH)

Dosage Information

Erectile Dysfunction (ED) – On-Demand Use

• Recommended dose: 20 mg taken orally 30–60 minutes before sexual activity
• Maximum limit: 20 mg in 24 hours
• Important clinical information: This dosage lasts for up to 36 hours. However, sexual stimulation is required.

Erectile Dysfunction (ED) – (Daily Use Dose)

• Recommended dose: 2.5–5 mg once daily (20 mg not recommended)
• Maximum limit: 5 mg per day
• Important clinical information: For daily use, a lower dose must be consumed. Using a high dose every day can increase the chances of side effects.

Benign Prostatic Hyperplasia (BPH)

• Recommended dose: 5 mg once daily
• Maximum limit: 5 mg per day
• Important clinical information: In BPH, Tadagra 20 mg lowers urinary tract symptoms by smooth muscle relaxation, although the 20 mg dose is avoided.

Erectile Dysfunction with Benign Prostatic Hyperplasia

• Recommended dose: 5 mg once daily
• Maximum limit: 5 mg per day
• Important clinical information: Treats both ED and urinary symptoms; higher doses increase the risk of hypotension.

Pulmonary Arterial Hypertension (PAH)

• Recommended dose: 40 mg per day (20 mg twice daily or once daily)
• Maximum limit: 40 mg per day
• Important clinical information: This indication has different dosing guidelines than ED. However, for this dosage, strict medical supervision is required.

How Tadagra 20mg Tablets Works

Tadagra 20 mg is made up of the drug Tadalafil, specifically, 20 mg of this drug. It acts on the Nitric Oxide-cGMP pathway of the penile erectile system.

When a male is sexually aroused, the nerve endings in the penis release Nitric Oxide (NO). It activates an enzyme called guanylate cyclase, which is responsible for increasing the levels of cyclic guanosine monophosphate (cGMP) inside the smooth muscle cells of the penis. The cGMP is the main component for forming an erection. 

cGMP causes the smooth muscle cells in the corpus cavernosum (erectile tissue) to relax. This actin results in vasodilation (dilating of blood vessels). The widened blood vessels facilitate increased blood flow in the region. As more and more blood enters the smooth muscle cells, it becomes trapped in the tissues, leading to a sustained erection.

Next, an enzyme called phosphodiesterase type-5 (PDE-5) breaks down the cGMP molecules, which weakens the erection. Tadagra 20 mg is a PDE-5 inhibitor, which prevents the breakdown of cGMP. As a result, cGMP maintains the high blood levels in the smooth muscle cells of the corpus cavernosum. Hence, without the inhibitory action of the PDE-5 enzyme, the erection remains sustained for a long time. 

This medication does not produce an erection spontaneously as it requires sexual stimulation to work. It enhances the body’s natural reaction by increasing blood flow to the penis, maintaining its blood levels, and maintaining the erection for a longer duration. Tadagra requires 30- 60 minutes to show its effects, which can last for up to 36 hours.

Possible Side Effects

Common Side Effects

(Usually mild to moderate; dose-dependent and self-limiting)

• Facial flushing
• Nasal congestion
• Dyspepsia (indigestion)
• Back pain
• Muscle aches (myalgia)

Gastrointestinal Side Effects

• Nausea
• Acid reflux
• Abdominal discomfort
• Diarrhea

Cardiovascular Side Effects (Related to vasodilation)

• Mild drop in blood pressure
• Palpitations
• Flushing sensation
• Orthostatic hypotension
• Chest discomfort (rare, but important)
• Risk increases when combined with nitrates or alpha-blockers

Nervous System Side Effects

• Headache
• Dizziness
• Light-headedness
• Fatigue

Musculoskeletal Side Effects (More common with tadalafil than other PDE-5 inhibitors)

• Lower back pain
• Muscle stiffness
• Limb pain
• Due to PDE-11 inhibition in skeletal muscle

Visual and Auditory Side Effects (Uncommon but clinically significant)

• Visual
• Blurred vision
• Increased light sensitivity
• Color vision changes (rare)
• Auditory
• Sudden decrease in hearing
• Tinnitus (ringing in the ears)
• Sudden vision or hearing loss requires immediate discontinuation

Genitourinary & Sexual Side Effects

• Prolonged erection
• Priapism (erection over 4 hours) (rare but serious)
• Penile discomfort

Respiratory & ENT Side Effects

• Nasal congestion
• Sinus pressure
• Upper respiratory tract symptoms

Skin & Hypersensitivity Reactions (Rare)

• Rash
• Pruritus (itching)
• Urticaria
• Angioedema (very rare)

Serious / Rare Adverse Effects

• Priapism
• Severe hypotension
• Myocardial infarction (rare, in high-risk cardiac patients)
• Stroke (very rare)
• Non-arteritic anterior ischemic optic neuropathy (NAION)

Precautions and Considerations

• Tadagra 20 mg must be consumed only if it is prescribed by a licensed healthcare professional.
• Patients must stick to the dosage schedule and timings as prescribed by their healthcare provider. 
• Tadagra 20 mg is not a performance enhancer. Therefore, individuals without a diagnosis of erectile dysfunction must not consume this drug.
• If individuals experience priapism (prolonged erection over 4 hours), then they must immediately seek medical attention.
• For ED, Tadagra 20 mg is meant to be an on-demand consumption, and not to be used daily (unless recommended by a medical care provider)
• Heavy or high-fat meals must be avoided before consuming Tadagra 20 mg, as it may delay the effect of this medication.
• Patients must avoid excess alcohol consumption after consuming Tadagra 20 mg, as it may lead to headache, dizziness, or disorientation. 
• This medication must be used cautiously by patients suffering from cardiovascular disorders, especially those with conditions like coronary artery disease, heart failure, arrhythmias, valvular heart disease, angina, and myocardial infarction. 
• Apart from these, patients with hematologic, renal, hepatic, vascular, auditory, and ophthalmic indications must consume Tadagra 20 mg with caution. 
• Tadagra 20 mg is contraindicated with certain drugs, such as CYP3A4 inhibitors (ketoconazole, ritonavir, erythromycin), CYP3A4 inducers (rifampicin reduces efficacy), nitrate-containing medications, nitric oxide donors, alpha-blockers, and other PDE-5 inhibitors.
• For the treatment of PAH and other high dose rgimens, there must be regular monitoring of cardiovascular parameters is required.
• Apart from these, Tadagra 20 mg must not be consumed with certain items like grapefruit and alcohol.

Other Information

Frequently Asked Questions

1.Can Tadagra 20 mg be consumed on an empty stomach?

Yes. Tadagra 20 mg can be consumed with or without food. Unlike other PDE-5 inhibitors, Tadalafil is not affected by food intake. In fact, very heavy or fat-rich meals can delay the effects of this medication. 

2.How long does Tadagra 20 mg stay in the body?

Tadagra 20 mg consists of the drug Tadalafil, which has a half-life of 17.5 hours. Half-life refers to the time it takes for the drug concentration in the blood to drop to 50 %. This means Tadagra 20 mg stays in the blood for approximately 36 hours.

3.Can Tadagra 20 mg cure erectile dysfunction (ED) completely?

In most men, ED manifests as a result of different causes such as cardiovascular disease, diabetes, psychological issues, etc. Tadagra 20 mg can improve the Sexual function, which becomes impaired due to the underlying conditions. However, to permanently cure ED, these underlying conditions must be treated separately.

4.Does Tadagra 20 mg react with herbal or non-pharmaceutical products?

Even natural and herbal products can contain certain biochemicals that can interact with Tadagra 20 mg. For example, grapefruit consists of furanocoumarins that interfere with the metabolism of Tadagra 20 mg. Hence, any herbal or non-pharmaceutical products can only be consumed with Tadagra 20 mg after consulting your healthcare provider.

5.What should we do if a dose is missed?

For most of the cases, Tadagra is consumed on an on-demand basis. Hence, missed-dose instructions are not required.