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Tadalafil for pulmonary hypertension

Adcirca, Talmanco

When you collect your prescriptions, check that you have been given the same brand of tablets as before. If the appearance is not the same as usual, speak with your doctor or pharmacist.

The usual dose is 40 mg daily (taken as two 20 mg tablets).

The most common side-effects are headache, flushing, nasal congestion, stomach upset, and muscle aches and pains.

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About tadalafil for pulmonary hypertension

Type of medicine

Vasodilator antihypertensive medicine

Used for

Pulmonary hypertension in adults

Also called

Adcirca®; Talmanco®

Available as


Primary pulmonary hypertension is a rare condition where there is too high a blood pressure in the blood vessels that supply your lungs from your heart.

Tadalafil relaxes the muscle cells in the walls of the blood vessels to your lungs, allowing them to become wider (dilated). This reduces the pressure in these blood vessels and allows blood to flow more easily through them. In turn, this increases the supply of blood to your lungs and improves your ability to do physical activities. It will be prescribed for you by a specialist doctor.

Tadalafil can also be prescribed for men with two completely different conditions - please see the separate medicine leaflet called Tadalafil for erectile dysfunction or enlarged prostate if you have been prescribed tadalafil tablets for either of these reasons.

Before taking tadalafil

Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking tadalafil it is important that your doctor knows:

  • If you are pregnant, trying for a baby, or breastfeeding.

  • If you have any other heart problem or blood vessel condition.

  • If you have had an eye condition causing a loss of vision.

  • If you have problems with the way your liver works, or if you have problems with the way your kidneys work.

  • If you have recently had a heart attack.

  • If you have any disease, injury or deformity of your penis.

  • If you have sickle cell disease.

  • If you have ever had bone marrow cancer or leukaemia.

  • If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines, and recreational drugs.

  • If you have ever had an allergic reaction to a medicine.

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How to take tadalafil

  • Before you take tadalafil, read the manufacturer's printed information leaflet from inside your pack. It will give you more information about the tablets and will provide you with a full list of the side-effects which you could experience from taking them.

  • Take the tablets exactly as your doctor tells you to. The usual dose is two 20 mg tablets taken together, once daily.

  • Unless your doctor tells you otherwise, you can generally take tadalafil at a time of day that suits you. You should, however, try to take your doses at the same time of day, each day.

  • You can take tadalafil either with or without food. Swallow the tablets with a drink of water.

  • If you forget to take a dose, take it as soon as you remember as long as it is still within eight hours of the time you should have taken it. If when you remember, it is more than eight hours later, leave out the missed dose. Do not take two doses together to make up for a forgotten dose.

Getting the most from your treatment

  • It is recommended that you do not drink grapefruit juice with tadalafil. This is because there is a chemical in grapefruit juice which may increase the amount of tadalafil in your bloodstream. This could make side-effects more likely.

  • Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.

  • If you are due to have an operation or some other medical treatment, it is important that you tell the person carrying out the treatment that you are taking tadalafil.

  • Each time you collect a new supply of tablets from the pharmacy, make sure it looks to be the same as you have had before. If you are unsure, ask your pharmacist to check for you.

  • If you buy any medicines, check with a pharmacist that they are suitable to take with your other medicines.

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Can tadalafil cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the more common ones associated with tadalafil. The best place to find a full list of the side-effects which can be associated with your medicine, is from the manufacturer's printed information leaflet supplied with the medicine. Alternatively, you can find an example of a manufacturer's information leaflet in the reference section below. Speak with your doctor or pharmacist if any of the following continue or become troublesome.

Very common tadalafil side-effects

(these affect more than 1 in 10 people)

What can I do if I experience this?

Headache, muscle aches and pains

Ask your pharmacist to recommend a suitable painkiller. If the aches continue, let your doctor know

Facial flushing, nose or throat symptoms

If troublesome, speak with your doctor for advice

Feeling sick (nausea) or being sick (vomiting), indigestion, tummy (abdominal) discomfort

Stick to simple meals - avoid fatty or spicy foods

Common tadalafil side-effects

(these affect fewer than 1 in 10 people)

What can I do if I experience this?

Feeling faint or dizzy, blurred vision

Do not drive and do not use tools or machines until your reactions/vision have returned to normal. If the problem with your eyesight starts suddenly, speak with your doctor

Nosebleeds, the feeling of having a 'thumping heart' (palpitations), increased menstrual bleeding

If any become troublesome, speak with your doctor for advice

Important: if you experience any of the following, contact a doctor for medical attention straightaway:

  • An allergic-type reaction such as a rash or swelling around your face.

  • Chest pains

  • A sudden loss of vision or hearing

  • An erection lasting for more than four hours.

If you experience any other symptoms which you think may be due to the tablets, speak with your doctor or pharmacist for further advice.

How to store tadalafil

  • Keep all medicines out of the reach and sight of children.

  • Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

Important information about all medicines

Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.

This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.

Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about this medicine ask your pharmacist.

Report side effects to a medicine or vaccine

If you experience side effects, you can report them online through the Yellow Card website.

Further reading and references

Article history

The information on this page is written and peer reviewed by qualified clinicians.

  • Next review due: 6 Nov 2025
  • 7 Nov 2022 | Latest version

    Last updated by

    Michael Stewart, MRPharmS

    Peer reviewed by

    Sid Dajani
  • 9 Jul 2013 | Originally published

    Authored by:

    Helen Allen
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