- Approval Id
- e43ea5c6727c0e06
- Drug Name
- CIATUFF 20 FILM-COATED TABLETS 20MG
- Product Name
- CIATUFF 20 FILM-COATED TABLETS 20MG
- Approval Number
- SIN16468P
- Approval Date
- 2022-04-06
- Registrant
- APOTHECA MARKETING PTE LTD
- Licence Holder
- APOTHECA MARKETING PTE LTD
- Drug Type
- Therapeutic
- Forensic Classification
- Prescription Only
- Dosage Form
- TABLET, FILM COATED
- Dosage
- **Posology and method of administration**
Posology
_Erectile Dysfunction_
_Tadalafil for Use as Needed_
The recommended dose is 10mg taken prior to anticipated sexual activity. In those patients in whom tadalafil 10mg does not produce an adequate effect, the maximum dose is 20mg and the maximum dosing frequency is once per day. It may be taken from 30 minutes to 36 hours prior to sexual activity. Tadalafil 10mg and 20mg is intended for use prior to anticipated sexual activity and it is not recommended for continuous daily use.
_Tadalafil for Once Daily Use_
In patients who anticipate a frequent use of Tadalafil (i.e. at least twice weekly) a once daily regimen with the lowest doses of Tadalafil might be considered suitable, based on patient choice and the physician’s judgement. In these patients the recommended starting dose is 2.5mg once a day, taken at approximately the same time every day, without regard to timing of sexual activity. The dose may be increased to 5mg once a day, based on individual efficacy and tolerability. The appropriateness of continued use of the daily regimen should be reassessed periodically.
_Benign Prostatic Hyperplasia_
The recommended dose is 5mg, taken at approximately the same time every day. When therapy
for BPH is initiated with Tadalafil and finasteride, the recommended dose of Tadalafil is 5mg, taken at approximately the same time every day for up to 26 weeks.
_Erectile Dysfunction and Benign Prostatic Hyperplasia_
The recommended dose is 5mg, taken at approximately the same time every day, without regard to timing of sexual activity.
Special populations
_Elderly men_
Dose adjustments are not required in elderly patients.
_Men with renal impairment_
_Tadalafil for Use as Needed_
Mild (creatinine clearance 51 to 80 ml/min): No dose adjustment is required.
Moderate (creatinine clearance 31 to 50 ml/min): A starting dose of 5mg not more than once per day is recommended and the maximum dose is 10mg not more than once in every 48 hours.
Severe (creatinine clearance < 30 ml/min or on hemodialysis): The maximum dose is 5mg not more than once in every 72 hours (see section 4.4 and 5.2 – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_).
_Tadalafil for Once Daily Use_
Mild (creatinine clearance 51 to 80 ml/min): No dose adjustment is required.
Moderate (creatinine clearance 31 to 50 ml/min): No dose adjustment is required.
Severe (creatinine clearance < 30 ml/min or on hemodialysis): Tadalafil for once daily use is not recommended (see section 4.4 and 5.2 – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_).
_Men with hepatic impairment_
_Tadalafil for Use as Needed_
The recommended dose is 10mg taken prior to anticipated sexual activity. There is limited clinical data on the safety of Tadalafil in patients with severe hepatic impairment (Child-Pugh Class C); if prescribed, a careful individual benefit/risk evaluation should be undertaken by the prescribing physician. There are no available data about the administration of doses higher than 10mg of tadalafil to patients with hepatic impairment.
_Tadalafil for Once Daily Use_
Once-a-day dosing has not been extensively evaluated in patients with hepatic impairment; therefore, if prescribed, a careful individual benefit/risk evaluation should be undertaken by the prescribing physician (see section 4.4 and 5.2 – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_).
_Men with diabetes_
Dose adjustments are not required in diabetic patients.
_Paediatric population_
Tadalafil should not be used in individuals below 18 years of age.
_Patients taking CYP3A4 Inhibitors_
_Tadalafil for Use as Needed_
For patients taking concomitant potent inhibitors of CYP3A4, such as ketoconazole or ritonavir, the maximum recommended dose of Tadalafil is 10mg, not to exceed once every 72 hours.
_Tadalafil for Once Daily Use_
For patients taking concomitant potent inhibitors of CYP3A4, such as ketoconazole or ritonavir, the maximum recommended dose of Tadalafil is 2.5mg.
Method of administration
For oral use. Tadalafil can be taken with or without food.
- Route Of Administration
- ORAL
- Indication Info
- **Therapeutic indications**
Treatment of erectile dysfunction (ED) in adult males. In order for tadalafil to be effective for the treatment of ED, sexual stimulation is required.
Treatment of the signs and symptoms of benign prostatic hyperplasia (BPH). If Tadalafil is used with finasteride to initiate BPH treatment, such use is recommended for up to 26 weeks.
Treatment of erectile dysfunction and the signs and symptoms of benign prostatic hyperplasia (ED/BPH).
Tadalafil is not indicated for use by women.
- Contraindications
- **Contraindications**
Hypersensitivity to the active substance or to any of the excipients listed in List of excipients – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_. In clinical studies, tadalafil was shown to augment the hypotensive effects of nitrates. This is thought to result from the combined effects of nitrates and tadalafil on the nitric oxide/cyclic guanosine monophosphate (cGMP) pathway. Therefore, administration of Tadalafil to patients who are using any form of organic nitrate is contraindicated.
Tadalafil must not be used in men with cardiac disease for whom sexual activity is inadvisable. Physicians should consider the potential cardiac risk of sexual activity in patients with pre-existing cardiovascular disease.
The following groups of patients with cardiovascular disease were not included in clinical trials and the use of tadalafil is therefore contraindicated:
- patients with myocardial infarction within the last 90 days,
- patients with unstable angina or angina occurring during sexual intercourse,
- patients with New York Heart Association Class 2 or greater heart failure in the last 6 months,
- patients with uncontrolled arrhythmias, hypotension (< 90/50 mmHg) or uncontrolled hypertension,
- Patients with a stroke within the last 6 months.
Tadalafil is contraindicated in patients who have loss of vision in one eye because of non-arteritic anterior ischaemic optic neuropathy (NAION), regardless of whether this episode was in connection or not with previous phosphodiesterase type 5 (PDE5) inhibitor exposure.
The co-administration of PDE5 inhibitors, including tadalafil, with guanylate cyclase stimulators, such as riociguat, is contraindicated as it may potentially lead to symptomatic hypotension.
- Atc Code
- G04BE08
- Atc Item Name
- tadalafil
- Pharma Manufacturer Name
- APOTHECA MARKETING PTE LTD
- Company Detail Path
- /organization/apotheca-marketing-pte-ltd
