Generic Cialis For BPH

Eight years ago, in 2012 the European Medicines Agency's Committee of Experts has given a positive opinion to a new indication for Cialis: the treatment of the signs and symptoms of benign prostatic hypertrophy in adult males, including those who also have erectile dysfunction. The two pathologies are often coexisting. This makes using Cialis for BPH and ED economically beneficial – the proverbial killing of two birds with one stone.

Cialis has been approved for the treatment of erectile dysfunction since 2003. In two clinical trials, men with BPH took Cialis 5 mg daily with significant improvement in disease symptoms compared with men treated with placebo. The studies based their results on a reduction according to the International Prostate Symptom Score (IPSS). Later, Cialis for BPH dosage was established to be effecttive at a range of 2.5mg to 5mg of tadalafil taken daily.

In a third study, men with both ED and BPH took 5 mg tadalafil daily and showed an improvement in the symptoms of both conditions compared to men taking placebo. ED improvements were measured with the Erectile Function domain score of the International Index Of Erectile Function.

Tadalafil joined a long list of other drugs approved to treat symptoms related to BPH: alfuzosin, doxazosin, dutasteride, dutasteride plus tamsulosin, finasteride, tamsulosin, terazosin, and lately silodosin.

BPH facts, figures and prognosis

Prostatic hypertrophy is the excessive and benign growth of the prostate tissue that occurs over the years. There are many men who suffer from prostate hypertrophy: about 5-10% of men in their 40s, 60% of those over 60 and even 80% of men over 80. If in most cases this enlargement does not cause major problems, 30% of patients over 65 years of age have symptoms that can seriously affect the quality of life.

The symptoms concern the lower urinary tract: increased need to urinate especially at night, difficulty in urinating, feeling of still having a full bladder even after urination is complete. In severe cases, water retention caused by complete obstruction of the urethra by the hypertrophic prostate and therefore renal failure can be a risk in the long term. The pharmacological therapies used in the treatment of prostatic hypertrophy (alpha-blockers and 5a-reductase inhibitors) are not able to be effective in all cases. If the drug therapy does not give results, it is necessary to undergo surgery.

How does Cialis help BPH?

Tadalafil is an inhibitor of PDE5, the substance present in high concentration in the penis. This enzyme promotes the degradation of another substance, called cGMP. The increase in cGMP translates into a relaxation of smooth muscle cells, which allows an increase in the flow of blood into the penis. This is the basis of the erection mechanism. An increase in cGMP also happens in the smooth muscle of the prostate, bladder and their vascular system. This effect increases the perfusion of blood in the pelvis and the relaxation of the smooth muscles of the prostate and bladder can be achieved. This mechanism makes Cialis beneficial in BPH patients.

Cautious use of Cialis in BPH: contraindications

The association of tadalafil with nitrate drugs such as nitroglycerin (used for chest pain) is strongly contraindicated since the association can induce a very dangerous drop in blood pressure. Simulteneous use with drugs belonging to the class of alphalytics (alfuzosin, tamsulosin, terazosin) is also not recommended as this association theoretically could also induce a sharp drop in pressure even if there is no significant clinical evidence.