Megalis (Tadalafil)
Compared with: Blackmores Conceive Well Gold 28 Tablets + 28 Capsules

Megalis (Tadalafil 5 mg, 10 mg, 20 mg) is a long‑acting phosphodiesterase 5 inhibitor indicated for erectile dysfunction (ED), benign prostatic hyperplasia (BPH), and pulmonary arterial hypertension (PAH). By enhancing nitric‑oxide–mediated vasodilation in the corpus cavernosum and pulmonary vasculature, tadalafil provides up to 36 hours of efficacy with once‑daily or as‑needed dosing
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Tadalafil – available in film‑coated tablets of 2.5 mg, 5 mg, 10 mg, and 20 mg
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Cialis® (brand)

Adcirca® (for PAH)

PDE5 inhibitor

Weekend pill” (due to extended duration)

Tadalafil selectively inhibits phosphodiesterase type 5 (PDE5) in vascular smooth muscle. This prevents cGMP breakdown, enhancing nitric‑oxide–mediated relaxation and blood flow in:

Corpus Cavernosum – Facilitates erection during sexual stimulation.

Prostatic and Bladder Vessels – Reduces LUTS in BPH by smooth‑muscle relaxation.

Pulmonary Vasculature – Lowers pulmonary vascular resistance in PAH
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Erectile Dysfunction (ED)

Benign Prostatic Hyperplasia (BPH)

ED + BPH Combined

Pulmonary Arterial Hypertension (PAH)
Indication Initial Dose Frequency & Max Dose Notes
ED (As‑Needed) 10 mg orally Once prior to sexual activity; max 10 mg once per 72 h
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May adjust to 5–20 mg based on response and tolerability
ED (Once Daily) 2.5 mg orally Once daily; may increase to 5 mg based on efficacy
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Taken at same time each day regardless of activity timing
BPH / ED + BPH 5 mg orally Once daily; max 5 mg Improves LUTS and erectile function
PAH (Adcirca®) 40 mg (two × 20 mg tablets) Once daily; do not divide dose
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Take at same time each day; used under specialist supervision
Renal Impairment (ED As‑Needed) CrCl 30–50 mL/min: 5 mg once; <30 mL/min: 5 mg every 72 h — Adjust to avoid accumulation
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Hepatic Impairment (ED As‑Needed) Child‑Pugh A/B: max 10 mg once daily; C: contraindicated — Use with caution in moderate impairment; avoid in severe
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Administration: Swallow tablet whole with water; can be taken with or without food
Missed Dose: If on once‑daily regimen, take as soon as remembered; maintain schedule; do not double.

Formulation: Film‑coated oral tablets

Strengths: 2.5 mg, 5 mg, 10 mg, 20 mg

Route: Oral

Legal Status: Prescription Only Medicine

Pregnancy & Breastfeeding: Tadalafil crosses placenta and excreted in milk; not recommended in pregnancy or lactation without medical supervision.

Pediatric Use: Safety and efficacy not established in <18 years.

Elderly: No initial dose adjustment; monitor for hypotension and interactions.

Renal/Hepatic: See Dosage & Administration adjustments.
Headache, dyspepsia, back pain, myalgia
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Flushing, nasal congestion

Serious (Rare):

Priapism (persistent erection > 4 hours) – seek immediate care.

Sudden vision loss (NAION); sudden hearing decrease or loss – discontinue and evaluate.

Hypotension, syncope, arrhythmia in predisposed patients.

Nitrates: Contraindicated—risk of profound hypotension.

Alpha‑Blockers / Antihypertensives: Additive hypotension—ensure hemodynamic stability before combination.

Cardiovascular Status: Assess risk before prescribing for ED; ensure patient can engage in sexual activity.

Priapism Risk: Advise immediate medical attention for erections > 4 hours.

Visual/Hearing Loss: Discontinue if sudden changes occur.

Therapeutic Class: Erectile Dysfunction Agent, PAH Agent

Pharmacologic Class: Phosphodiesterase 5 Inhibitor

Legal Category: Prescription Only

Concomitant Drug Class Interaction Effect Recommendation
Nitrates Synergistic vasodilation → severe hypotension Absolute contraindication
Alpha‑Blockers Additive BP lowering Initiate tadalafil at 2.5 mg; monitor BP
CYP3A4 Inhibitors (e.g., ketoconazole, ritonavir) ↑Tadalafil exposure ED As‑Needed: max 10 mg/72 h; Daily: max 2.5 mg
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CYP3A4 Inducers (e.g., rifampin) ↓Tadalafil exposure Avoid concomitant use
Antihypertensives Additive hypotension Monitor hemodynamics

ED Efficacy: RCTs demonstrate significant improvement in erectile function domain of IIEF‑EF score with as‑needed and daily dosing versus placebo (P < 0.001)

PAH Outcomes: Tadalafil 40 mg daily improved 6‑minute walk distance by ~33 m over placebo at 12 weeks (P = 0.02)
DailyMed

BPH Benefit: Combination tadalafil 5 mg + tamsulosin improved IPSS and Q_max versus monotherapies in LUTS patients
Medical News Today

FAQs – Megalis (Tadalafil)
Q1. How long before sexual activity should I take Megalis?
A: For as‑needed use, take 10 mg at least 30 minutes before; efficacy lasts up to 36 hours
Practo

Q2. Can I take Megalis every day?
A: Yes—2.5–5 mg once daily regimen is approved for ED, BPH, or both

Q3. What if I miss my once‑daily dose?
A: Take as soon as remembered; maintain 24‑hour interval; do not double dose.

Q4. Can I drink alcohol with Megalis?
A: Moderate alcohol use is acceptable; avoid excessive consumption to reduce orthostatic hypotension risk.

Q5. What should I do if I get an erection lasting > 4 hours?
A: Seek emergency medical attention to prevent tissue damage.

Q6. Is Megalis safe with other ED drugs?
A: Do not combine with other PDE5 inhibitors; risk of adverse effects increases.

Q7. How should I store Megalis?
A: Store at room temperature (15–30 °C), away from moisture and heat.

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