Not recommended for continuous daily use. Consider patient's CV status before treatment w/ tadalafil. Has vasodilator properties, resulting in mild & transient decreases in BP. Not known if effective in patients who have undergone pelvic surgery or radical non-nerve-sparing prostatectomy. Reports of serious CV events, including MI, sudden cardiac death, unstable angina pectoris, ventricular arrhythmia, stroke, transient ischaemic attacks, chest pain, palpitations & tachycardia. Reports of visual defects & cases of NAION; cases of sudden hearing loss. Discontinue treatment in case of sudden visual defect or sudden decrease or loss of hearing. Caution in patients w/ anatomical deformation of the penis (eg, angulation, cavernosal fibrosis, or Peyronie's disease) or in patients w/ conditions which may predispose them to priapism (eg, sickle cell anaemia, multiple myeloma or leukaemia). Concomitant administration w/ α
1 blockers may lead to symptomatic hypotension in some patients. Combination w/ doxazosin is not recommended. Caution when prescribing to patients using potent CYP3A4 inhibitors (ritonavir, saquinavir, ketoconazole, itraconazole, & erythromycin). Do not take in combination w/ other PDE5 inhibitors or other treatments for erectile dysfunction. Rare hereditary problems of galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. Patients w/ severe hepatic impairment (Child-Pugh class C). Not indicated for use by women. No relevant use in the paed population.
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