Finally sorted my ED changed to tadalafil!

Can you compare Cialis to Tamsulosin? Pros and cons of each?

Thanks!

Tamsulosin -- retrograde (dry) orgasm, no change in erections.

Daily Cialis -- no retrograde orgasm, some enhancement in erections. 

I found both improved bph symptons about the same but not significantly, and the improvement seemed short lived. Others have had both better and not as good results. 

Side effect wise, I found both similar with slight blurry vision, and mild occasional headaches, if I remember correctly. Daily Cialis gave me (and some others here) heartburn, which I'm sensitive to. I was able to eliminate the heartburn by taking one OTC Prilosec a day, one hour before breakfast, but antacids might be all you need if you happen to get it. 

Jim

I am already on omeprazole to counteract the effects of the NSAIDs I take on my stomach so heartburn wouldn't be an issue.I am already on two meds for hypertension but on cialis the daily reading is still textbook at around 123/72. Blurry vison I am still evaluating but I think i may be getting a little. Headaches none yet.. on blance I am loving the improvements. Nocturia frequencey unchanged .. stil 2 to 4 times nightly but I still manage a total of 6 - 8 hours kip

Jim

They cover it but normally it is for only one pill a week.

I once had a stroke of luck when a Polish pharmacist did not understand my GP's prescription and took it to be one a day for the two month prescription. He apologised for not having enough in stock and said he would get the balance for the next day.

Fortunately the one checking the prescription was also Polish. I did tell my GP and he laughed at my good fortune.

Being a Senior citizen I don't have to pay for my prescriptions.

That's a funny story Derek! Are you sure it wasn't one 20mg pill the covered for the week, as opposed to the 5mg Daily Cialis? 

Jim

Jim

Go to the Cialis web site. They usually run an introductory one month free, or money off offer. I think it was one month free when I started. Also, your doc should have samples in his drawer unless he's taking them home

Jim

The NHS covers Tadalafil only if you meet certain criteria such as pelvic surgery - including prostate surgery.  The patent for "use before sex" Tadalafil expires at the end of this year so prices should drop if you have to pay for a private prescription, however the patent for 2.5mg and 5mg one-a-day will remain.  5mg per day is the only one licenced to treat both BPH and ED so unless you meet the NHS criteria you will have to pay.

@Grunthos: The patent for "use before sex" Tadalafil expires at the end of this year so prices should drop if you have to pay for a private prescription, however the patent for 2.5mg and 5mg one-a-day will remain.

---------------------------------

Sounds like buying 20mg Cialis and a pill cutter may be in order!

Jim

Mine is free as I am 70 years old and don't pay for scrips. It is now on my regular repeat prescription. The only surgery I have had is 3 biopsies and then refused the greenlight laser removal of part of the prostate. I kind of think GPs interpret the guidelines as they think is fitting

..buying 20mg Cialis and a pill cutter may be in order!

Ha ha! This is one of those situations pilling cutting won't work. 20mg Cialis costs more than 4X 5mg. Haank

Is there a difference between "use before sex" and "one-a-day" Tadalafil ? Hank

Hank,

"Grunthros" just reported that the patent for Cialis runs out this year suggesting significant savings, but only in the 20mg format. 

Jim

What type of insurance do you have?

Jim

Hank,

"Use before sex" is generally 10 or 20mg. From memory, if you compute the blood concentration of Daily 5mg Cialis, using the half life formulation, you multiple times 1.6. So that means the blood concentration of someone on 5 Daily mg Cialis is 8mg after a week or so.

Jim

Jim, I still don't get it. Are 20mg and 10mg imply "use before sex", and 5mg and 2.5mg imply "one-a-day" ? Hank

I'm in the UK so it's on the national health service

It's marketing sort of. 

2.5 and 5mg Cialis are marketed for once a day use, for bph/lus.

20mg and 10mg are marketed for "use before sex" or the "weekend pill". 

The reality is that if you were on Daily 5mg Cialis for awhile, on any given day, the concentration of Cialis in your system would be 8mg, almost the same as if you took a 10mg "use before sex" dose. 

Now, if you had a "big" night planned, I suppose you could take another 5mg tab which would bring you up to 13mg, or alternatively another 10mg tab, which would bring you up to 18mg. Doing so are off label, and warned against, and I had a big "discussion" with my former urologist about this trying to explain to him that taking another 5mg once, is not more harmful than a person not on Daily 5 mg Cialis taking 13mg once. But no, he just kept referring back to the label instructions, and then my 20 minutes were up!

Jim

Thanks. My medicare rx plan here in the U.S. pays for only part of Daily 5mg Cialis. It ends up costing around $100 a month out of pocket, or at least that's what it cost a year or so ago when I last used it. 

Jim

Thanks Jim. It's rather complicated. No wonder I did not get it. Hank

Haha. Maybe I made it too complicated, I'll try again. 

Originally Cialis came in a 10 and 20mg version and was marketed/used for ED. Because it had a longer half life than Viagra, it was called the "weekend pill" because a 10 or 20mg dose could give erection benefits for 2 to three days. 

Then, later on, they found out that lower doses of Cialis, taken daily -- namely 2.5 mg and 5mg -- had similar benefits for BPH as alpha blockers like tamsulosin. So based on these results they then came out with a 2.5mg and 5 mg version of Cialis. 

But since it's really the same drug, just different doses, the smaller doses -- 2.5 and 5mg versions also help erectile function just like the larger 10 and 20mg doses, just probably not as much. 

As to the "before sex" that is just the instructions for the larger doses because they are generally not prescribed for bph on a daily basis, but just before sex on a once a week or so basis. 

Likewise, the rx for Daily 5 or 2.5mg Cialis is written/indicated for BPH, with the instructions "take daily" because that is the indication for it. 

Hopefully that's clearer, but if not, ask away. I just had my Omega 3 sardines so my brain should be firing on all cylinders!

Jim

Thanks Jim, I think I understand it now. The only thing that is still puzzling me is how you use half life formulation to come up with 1.6 factor and conclude that 8mg (1.6 x 5mg) of Cialis is in the blood. I know what a drug half life is and that's about it. Perhaps if I had sardines for dinner, I might understand better. Unfortunately, I only had tuna. Hank

The 8mg (1.6 x 5) is from memory, but I'm pretty sure it's either on the money or very close. While it's based on the half life, that's not how I figured it out. I found the numbers in a paper or study after researching it out. My urologist didn't have a clue nor did the person at the Cialis information line. I wanted to know so I could compare the drug level of 5 mg daily Cialis against a single dose of Cialis 

Jim

Well, I guess the sardines do help

From a study on ncbi.nlm.nih.gov,  titled "A once-daily dose of tadalafil for erectile dysfunction: compliance and efficacy"

"...Tadalafil has linear pharmacokinetics over the dose range of 2.5–20 mg.12 A steady state of tadalafil is reached after 5 days of daily administration, with a plasma concentration that is roughly 1.6 times higher than that of a single dose.12 In other words, cumulative plasma exposure at steady state of a 5-mg daily dose corresponds roughly to an 8-mg on-demand dose..."

Jim

Proud of Polish people! 😅😅😅