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New applications

John Courtney
Posted in September 12th, 2009
Published in Efficacy
Tags: PDE5, tadalafil
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Recent data have indicated a potential association between epidemiological, physiologic, pathophysiologic, and treatment aspects of ED and lower urinary tract symptoms (LUTS) secondary to BPH. The 17.5 hour half-life of tadalafil makes it the most suitable PDE5 inhibitor for once-daily dosing in a trial of LUTS secondary to BPH. McVary and associates reported a multicentered, […]

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Once-daily dosing

John Courtney
Posted in September 7th, 2009
Published in Efficacy
Tags: Doses, tadalafil
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The latest innovation in the treatment of ED has arrived in the form of a simpler, once-daily dosing schedule for tadalafil, unlinking the temporal association of the medication and the sexual encounter. The unnatural process of taking a medication just prior to sex is a negative aspect of ED treatment for many patients. The 17.5 […]

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ED secondary to diabetes mellitus

John Courtney
Posted in September 1st, 2009
Published in Efficacy
Tags: diabetes, diabetes mellitus, ED, tadalafil
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ED is a common problem afflicting over a third of all men with diabetes mellitus type 2, and diabetes is independently responsible for a 3- to 4-fold increase in the risk of ED according to a survey of 1460 diabetic men. ED is strongly related to the severity of diabetes, with a higher incidence in […]

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Safety and drug interactions

John Courtney
Posted in August 26th, 2009
Published in Pharmacology
Tags: drug interactions, PDE5, safety, tadalafil
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As with every PDE5 inhibitor, tadalafil is absolutely contraindicated with nitrate medications for angina pectoris secondary to the potentiated hypotensive effect the drugs can have together. Because of the longer half-life, treatment with nitrate medications must be deferred for at least 48 hours after ingestion of tadalafil, compared with 24 hours for sildenafil (Viagra) and […]

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Adverse events

John Courtney
Posted in August 22nd, 2009
Published in Pharmacology
Tags: tadalafil
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A large study of 2102 men from 11 different multicentered, randomized, double-blind, placebo controlled trials of tadalafil reported the drug is well tolerated overall. Fifty-one percent of men using tadalafil 20 mg had at least one adverse event (AE), but only 3.2% discontinued treatment. The most common AEs reported with the 20 mg dose were […]

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Metabolism and excretion

John Courtney
Posted in August 17th, 2009
Published in Pharmacology
Tags: tadalafil
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The metabolism of generic tadalafil is via the hepatic enzyme cytochrome P450 34A (CYP34A) to a catechol metabolite, which undergoes further metabolism to its primary circulating metabolite, methylcatechol glucuronide, a 10,000-fold less potent molecule than tadalafil. The CYP34A metabolism pathway of tadalafil was verified with studies using a CYP34A inhibitor ketoconazole and a CYP34A inducer […]

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The general ED population

John Courtney
Posted in August 15th, 2009
Published in Efficacy
Tags: ED, Erectile Dysfunction, tadalafil
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The most frequently referenced study supporting the efficacy of tadalafil is an integrated analysis of 5 randomized, double-blind, placebo controlled, multicentered phase III trials from 1112 men at 74 centers worldwide. The average age was 59, and the etiology of ED was 61% organic, 9% psychogenic, and 31% mixed. The ED severity at baseline was […]

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