Using Daily Cialis (Tadalafil) for Benign Prostatic Hyperplasia (BPH) Treatment
Daily Cialis (tadalafil) was approved for benign prostatic hyperplasia (BPH), providing modest improvement in urinary symptoms. Tadalafil enhances smooth muscle relaxation in the prostate, bladder, and urethra. However, expect only a small improvement in BPH symptoms. Tadalafil improves urinary frequency, urgency, and straining but not urine flow rate. You need to treat six men for 12 weeks for one to benefit.
Continue recommending alpha-blockers (tamsulosin, etc.) as the first line for BPH, as they are more effective and cost less.
- Consider daily Cialis for men with both erectile dysfunction and milder BPH symptoms.
- Alternatively, add daily Cialis if a man with both erectile dysfunction and BPH isn't getting adequate relief from an alpha-blocker. The combination might work better than either drug alone for BPH.
When adding Cialis to an alpha-blocker, start with 2.5 mg/day to reduce hypotension, and titrate to 5 mg/day as needed.
Take-home pointsLearn the benefits and limitations of daily Cialis (tadalafil) for benign prostatic hyperplasia (BPH)...
- Recognize the new use of Cialis for BPH treatment, approved for enhancing smooth muscle relaxation in the prostate, bladder, and urethra.
- Understand that tadalafil (Cialis) modestly improves urinary frequency, urgency, and straining but not urine flow rate.
- Recommend alpha-blockers (tamsulosin, etc.) as the first line for BPH, being more effective and cost-efficient.
- Consider daily Cialis for men with both erectile dysfunction and milder BPH symptoms for better management.
References
- Uckert S, Oelke M. Phosphodiesterase (PDE) inhibitors in the treatment of lower urinary tract dysfunction. Br J Clin Pharmacol. 2011;72(2):197-204. doi:10.1111/j.1365-2125.2010.03828.x
- Govorov A, Kasyan G, Priymak D, Pushkar D, Sorsaburu S. Tadalafil in the management of lower urinary tract symptoms: a review of the literature and current practices in Russia. Cent European J Urol. 2014;67(2):167-177. doi:10.5173/ceju.2014.02.art10
- McVary KT, Monnig W, Camps JL Jr, Young JM, Tseng LJ, van den Ende G. Sildenafil citrate improves erectile function and urinary symptoms in men with erectile dysfunction and lower urinary tract symptoms associated with benign prostatic hyperplasia: a randomized, double-blind trial. J Urol. 2007;177(3):1071-1077. doi:10.1016/j.juro.2006.10.055
- Cantrell MA, Baye J, Vouri SM. Tadalafil: a phosphodiesterase-5 inhibitor for benign prostatic hyperplasia. Pharmacotherapy. 2013;33(6):639-649. doi:10.1002/phar.1243
- Andersson KE, de Groat WC, McVary KT, et al. Tadalafil for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia: pathophysiology and mechanism(s) of action. Neurourol Urodyn. 2011;30(3):292-301. doi:10.1002/nau.20999
Keywords: Daily Cialis, Tadalafil, Benign prostatic hyperplasia, BPH, Urinary symptoms, Erectile dysfunction, Alpha-blockers, Tamsulosin, Smooth muscle relaxation, Hypotension
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