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    Tadalafil is used to treat male sexual function problems (impotence or erectile dysfunction-ED). In combination with sexual stimulation, tadalafil works by increasing blood flow to the penis to help a man get and keep an erection. Tadalafil is also used to treat the symptoms of an enlarged prostate (benign prostatic hyperplasia-BPH). It helps to relieve symptoms of BPH such as difficulty in beginning the flow of urine, weak stream, and the need to urinate frequently or urgently (including during the middle of the night). Tadalafil is thought to work by relaxing the smooth muscle in the prostate and bladder. This drug does not protect against sexually transmitted diseases (such as HIV, hepatitis B, gonorrhea, syphilis). Consult your doctor or pharmacist for more details. Read the Patient Information Leaflet provided by your pharmacist before you start taking tadalafil and each time you get a refill. Excipient(s) with known effect: Lactose (as monohydrate) Each 20 mg film-coated tablet contains 367.584 mg lactose (as monohydrate). It is indicated in adults for the treatment of pulmonary arterial hypertension (PAH) classified as WHO functional class II and III, to improve exercise capacity (see section 5.1). In order for tadalafil to be effective for the treatment of erectile dysfunction, sexual stimulation is required. Efficacy has been shown in idiopathic PAH (IPAH) and in PAH related to collagen vascular disease. Erectile dysfunction in adult Men In general, the recommended dose is 10 mg taken prior to anticipated sexual activity and with or without food. In those patients in whom tadalafil 10 mg does not produce an adequate effect, 20 mg might be tried. It may be taken at least 30 minutes prior to sexual activity. Tadalafil 10 mg and 20 mg is intended for use prior to anticipated sexual activity and it is not recommended for continuous daily use. Pulmonary arterial hypertension Treatment should only be initiated and monitored by a physician experienced in the treatment of PAH.

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