17 PATIENT COUNSELING INFORMATION

A comprehensive medical history was obtained for each participant.

Aspect	Details
Recommended Dose	5 mg once daily
Timing of Dose	With or without food, same time daily
Missed Dose	Take as soon as remembered, do not double dose
Duration of Use	As prescribed, typically long-term
Overdose	Seek medical attention; symptoms may include headache, dizziness

Evaluations included the IIEF-5 questionnaire for

2.2 Tadalafil Tablets for Once Daily Use for Erectile Dysfunction

PDE5-Is promote relaxation of the bladder neck and prostate by increasing nitric oxide levels in smooth muscle, thereby directly influencing micturition phases in addition to their role in penile erection [6, 7]. Another study indicates that a once-daily dose of 5 mg tadalafil is a potentially effective, well-tolerated, and safe treatment option for patients with LUTS [4]. Tadalafil 5 mg once daily is currently approved for the treatment of LUTS, regardless of the presence of coexisting ED [16]. Another study reported that Tadalafil 5 mg once daily improved LUTS in men without ED by a magnitude like that observed in men with ED [2]. Once-daily tadalafil 5 mg has been shown to be most effective in enhancing drug-assisted erectile function in men with ED following radical prostatectomy.

Trial Registration

It also facilitates early recovery of erectile function post-prostatectomy and may help protect against penile structural changes. However, unassisted erectile function does not improve after discontinuation of active therapy for nine months [18]. Tadalafil monotherapy significantly improves both storage and voiding lower urinary tract symptoms (LUTS) and enhances the International Prostate Symptom Score (IPSS) [12]. To determine the potential benefits of initiating tadalafil early after TURP, we conducted this study to evaluate the efficacy of daily tadalafil 5 mg in managing persistent storage symptoms and improving erectile function post-TURP. Following approval by the institutional ethics committee, this study was conducted at a tertiary care hospital between May 2021 and October 2022.

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Patients diagnosed with benign prostatic hyperplasia (BPH) who underwent transurethral resection of the prostate (TURP), either monopolar or bipolar, were eligible for inclusion. Informed consent was obtained from all participants prior to enrollment. Patients were then randomized into two groups: Group A received tadalafil 5 mg once daily, while Group B received a placebo. All patients included in the study were sexually active prior to undergoing TURP. Patients who were sexually inactive were excluded from analyses related to sexual function, due to the recognized limitations of the International Index of Erectile Function (IIEF-5) in evaluating erectile function among sexually inactive men. erectile function, the International Prostate Symptom

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Score (IPSS), and the IPSS storage

14.3 Tadalafil Tablets 5 mg for Once Daily Use for Benign Prostatic Hyperplasia (BPH)

Our study has been approved by local ethical committee Kafrelsheikh university(MKSU50-3–1) on 20/5/2021 and by clinical trials (NCT06788704) on 25/1/2025. La fonction érectile a été évaluée à l’aide du questionnaire de l’International Index of Erectile Function-5 (IIEF-5), et les LUTS ont été évalués à l’aide de l’International Prostate Symptom Score (IPSS). Men with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) have a higher incidence of erectile dysfunction (ED) [1]. Moreover, LUTS themselves serve tadalafil 40mg as an independent risk factor for ED, significantly compromising quality of life (QoL). The underlying pathophysiological mechanisms linking LUTS secondary to BPH and ED remain incompletely understood, although both conditions share several common determinants [9, 16].

Limitation of study

Transurethral resection of the prostate (TURP) remains the gold standard for managing benign prostatic hyperplasia (BPH), despite the introduction of newer minimally invasive surgical techniques [5, 22]. However, the impact of TURP on sexual function remains uncertain. While some studies report a negative effect, others suggest an improvement in sexual function among patients with ED [19, 26]. TURP may contribute to ED through various mechanisms, primarily due to thermal injury affecting the cavernous nerves during surgery. Additional factors include the psychological impact of the procedure and the temporary cessation of sexual activity in the postoperative period [24].

Less common

Previous studies have reported that some patients experience persistent irritative symptoms following TURP, requiring postoperative medication to manage ongoing urinary symptoms. These symptoms significantly impact patients'quality of life after surgery. When selecting candidates for TURP, predicting the persistence of irritative bladder symptoms is crucial; however, studies investigating prognostic factors for bladder irritation remain limited. According to recent research, severe preoperative irritative bladder symptoms or frequent nocturia may increase the likelihood of persistent postoperative symptoms [11]. Phosphodiesterase type 5 inhibitors (PDE5-Is) were initially approved for the 20mg tadalafil price treatment of ED; however, they have also been shown to be highly effective in alleviating LUTS in men, regardless of the presence of ED [3, 17, 20, 23]. symptom subscore-15 for assessing storage symptoms.

5.1 Cardiovascular

NCL prescribing guidance is currently under review; however, the existing position remains in effect until updated guidance is formally published. If you would like to discuss your treatment options, please book an appointment and we will be happy to advise you. We conducted a double-blind, randomized controlled trial to evaluate the effect of early administration of tadalafil (5 mg once daily) on persistent storage lower urinary tract symptoms (LUTS) and erectile function following transurethral resection of the prostate (TURP). All enrolled patients underwent TURP and were randomly assigned to one of two groups: Group A received tadalafil (5 mg once daily) postoperatively, while Group B received a placebo. Erectile function was assessed using the International Index of Erectile Function-5 (IIEF-5) questionnaire, and LUTS were evaluated using the International Prostate Symptom Score (IPSS).

Does tadalafil interact with foods or drinks?

The study was conducted at a tertiary care hospital between May 2021 and October 2022. A total of 195 patients were enrolled and randomized into two groups: Group A (n = 103), which received tadalafil 5 mg once daily, and Group B (n = 92), which received a placebo. The mean ± standard deviation (SD) scores for the International Index of Erectile Function (IIEF-5) in Group A at 1, 3, and 6 months post-TURP were 11.59 ± 1.90, 19.80 ± 1.12, and 20.97 ± 0.72, respectively. In Group B, the corresponding scores were 4.88 ± 0.82, 12.86 ± 1.56, and 15.32 ± 1.28. These differences were statistically significant (P < 0.001).

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment:

Similarly, the mean ± SD values for the International Prostate Symptom Score (IPSS) in Group A at 1, 3, and 6 months post-TURP were 7.31 ± 1.66, 4.46 ± 0.97, and 2.33 ± 0.69, respectively, compared to 9.62 ± 3.34, 5.40 ± 1.98, and 2.83 ± 1.27 in Group B (P < 0.001). Regarding storage symptom subscores, Group A demonstrated preoperative and postoperative mean ± SD values of 8.63 ± 1.82, 3.05 ± 0.78, 1.63 ± 0.49, and 0.92 ± 0.67 at preoperative, 1, 3, and 6 months, respectively. In contrast, Group B showed corresponding values of 3.22 ± 0.72, 2.48 ± 0.50, and 1.69 ± 0.47. These differences were also statistically significant (P < 0.001). Tadalafil 5 mg daily as monotherapy following TURP can lead to early improvement in erectile function; however, its effect on persistent storage lower urinary tract symptoms (LUTS) post-TURP appears to be modest. Additional assessments included uroflowmetry, pelvi-abdominal ultrasonography with

Storage Aspect	Condition	Notes
Temperature	Below 30°C (86°F)	Keep away from heat and moisture
Light Exposure	Store in a dark place	Protect from light
Keep Out of Reach	Children and pets	Safety precaution
Packaging	Original container	Keep sealed and intact
Expiry Date	Refer to packaging	Do not use past expiration date

post-void residual (PVR) urine measurement, and laboratory investigations

• Tadalafil 5mg has a duration of action up to 36 hours.
• It can improve spontaneous sexual activity.
• Dosage adjustments may be necessary for certain health conditions.

(urinalysis, urine culture, renal function tests, complete blood

17.11 Recommended Administration

Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur: faintness or lightheadedness when getting up suddenly from a lying or sitting position pain or discomfort in the arms, jaw, back, or neck Painful or prolonged erection of the penis blistering, peeling, or loosening of the skin fast, irregular, pounding, or racing heartbeat or pulse inability to move the arms, legs, or facial muscles numbness or tingling of the face, hands, or feet red skin lesions, often with a purple center sores, ulcers, or white spots in the mouth or on the lips swelling of the feet or lower legs Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings burning feeling in the chest or stomach feeling of constant movement of self or surroundings feeling of warmth, redness of the face, neck, arms and occasionally, upper chest redness, pain, swelling of the eye, eyelid, or inner lining of the eyelid swelling or puffiness of the eyes or face Other side effects not listed may also occur in some patients.

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If you notice any other effects, check with your healthcare professional. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088. Our practice follows North Central London (NCL) prescribing guidance. Tadalafil 5mg once daily is not routinely prescribed in primary care.

Duration of action

Daily tadalafil is only recommended for a short course (maximum 3 months) following specific prostate surgery, and this is prescribed by tadalafil pills the hospital specialist. Daily tadalafil is not recommended for benign prostate enlargement (BPH). Erectile dysfunction is managed in line with the NCL primary care pathway, which may include alternative treatments. If a medicine has been recommended following a private consultation: The private specialist should provide the prescription as part of that episode of care. If transferring to NHS care, treatment must be consistent with what is routinely offered to NHS patients locally. count, coagulation profile, and prostate-specific antigen [PSA] level).

• Overdose signs include painful erections lasting over 4 hours.
• Seek immediate medical attention if overdose is suspected.
• Follow dosage directions strictly to avoid complications.