english.prescrire.org > Spotlight > Archives : 2008 > In the August issue of Prescrire International: No to daily tadalafil (Cialis°)

Spotlight: Archives

Every month, the subjects in Prescrire’s Spotlight.

2008 : 1 | 30 | 60

Spotlight

Tadalafil (Cialis°, Lilly), a phosphodiesterase type 5 inhibitor, was first marketed in France in 2003, in 10 mg and 20 mg oral tablets for "on demand" treatment of erectile disorders. We concluded that it did not provide a significant advantage over sildenafil.

In late 2007, Lilly added two lower dose strengths (2.5 mg and 5 mg of tadalafil) to its range of Cialis° products and promoted them for once-daily use. The posology section of the SPC mentions that in "responder patients to on demand regimen who anticipate a frequent use of Cialis (i.e., at least twice weekly) a once daily regimen with the lowest doses of Cialis might be considered suitable". The SPCs for the 10 mg and 20 mg tadalafil tablets state that they are "not recommended for continuous daily use" (3).

There is no evidence that daily use of tadalafil offers any advantages in terms of efficacy or adverse effects. The lack of long-term safety data on daily use of tadalafil calls for caution.

It is better to continue using tadalafil "on demand", at the minimum dose required by each individual patient.

This promotion of daily tadalafil is another example of the tendency to promote continuous medication in order to maintain "normality" when the boundary between the normal and the pathological is far from clear.

©Prescrire August 2008

Source: Prescrire International 2008; 17 (96): 142.

- Download this article, and see why you should subscribe today.

- More articles in Prescrire's "Spotlight"...