- 1 About Ajanta Pharma in India
- 2 Scientific Publications on Tadalafil
- 3 Description and Mechanism of Action of Tadalafil
- 4 Tadalis Benefits for ED Patients
- 5 Suitable Doses and Length of Therapy
- 6 Adverse Effects and Important Warnings
- 7 Drug-to-Drug Possible Interactions
- 8 Customer Reviews
- 9 Tadalis Price, Forms and Available Dosage
- 10 Reference List
- 11 Editor's Rating
Tadalis 20mg/10mg is one of the products of the Indian manufacturer Ajanta Pharma’s product line for Tadalafil-containing generic medications. The demand for the production of generic medications for drugs indicated for sexual dysfunction disorders has increased in the past years, as the cost of the brand-name treatments for disorders like erectile dysfunction (ED) in males remained high.
Tadalafil drugs like Tadalis are given to patients with erectile dysfunction since these drugs are able to significantly improve the patients’ sexual function upon each use.
PDE5 inhibitor drugs have other uses aside from being the primary treatment for erectile dysfunction; these drugs are used to aid patients with enlarged prostates (those with benign prostatic hypertrophy in particular) to improve their urinary function as well . Patients with high blood pressure (pulmonary arterial hypertension) are also given PDE5Is like Tadalafil to treat their hypertension.
Concerning Tadalis 10mg/20mg tablet, the drug is only one of the Tadalafil products manufactured by one of India’s famous pharmaceutical companies. The Tadalis product line includes product dosage forms such as oral jellies, pills, and soft tabs.
About Ajanta Pharma in India
One of India’s multinational companies is Ajanta Pharma, which is known for its generic medication manufacturing . The company came to be in 1973  and from then continued to expand its borders and even became a player in the international pharmaceutical scene. Today, the company distributes its products in 30 countries and also has its offices located in those nations . Ajanta has its reach extended to the USA, Philippines, the Middle East, Africa, and CIS .
The company’s focus is the manufacture of branded generics and it specialized in the manufacture of a wide range of products involving antibiotics, dermatological products, ophthalmology products, general health products, respiratory products, products for pediatric use, orthopedic products, diabetes products, cardiology products, anti-malarial, and gynecology products . According to the company, most of its products (130 products) have been the first to be publicly distributed in the Indian market .
Ajanta currently has 6 manufacturing plants which are capable of producing liquid formulations, capsules, tablets, dry powders, jelly formulations, ayurvedic preparations, and active pharmaceutical ingredients (APIs) [4,7]. These facilities were all made in compliance with Good Manufacturing Processes and currently, one of its facilities is accredited by the WHO for GMP and is also approved by the United States’ Food and Drug Administration .
Scientific Publications on Tadalafil
Erectile Dysfunction (ED) in patients comes from various etiologies and sometimes, the disease is comorbid with other medical conditions like diabetes mellitus (DM), for instance. In patients with diabetes mellitus have often limited responses to PDE5 inhibitor therapy; however, Tadalafil studies had positive results for the effectiveness of both the 10 mg and 20 mg dosages when taken on an as-needed basis. Since the effectiveness of the 10 and 20 mg Tadalafil treatments have been established, there were studies who explored whether the daily or continuous administration of Tadalafil is also effective in patients with comorbid ED and DM, like the study of Hatzichristou et al, “Efficacy of tadalafil once a day in men with diabetes mellitus and erectile dysfunction” (2008) . The study determined whether the doses of 2.5 mg and 5 mg of Tadalafil is effective in the management of patients with ED and diabetes when administered daily . 298 patients were included in the study and were administered with Tadalafil 2.5 mg, 5 mg, or placebo once daily, in a 12-week period . The effectiveness of the treatments in patients was evaluated using the IIEF-EF (Primary efficacy measures were International Index of Erectile Function-Erectile Function), while the safety, penetration success, intercourse completion, endothelial function, patient satisfaction, and safety were also evaluated . Compared with placebo, patients taking either of the 2.5 mg or 5 mg daily of Tadalafil were able to exhibit significant changes in the markers of primary efficacy described, although there was no significant change in the endothelial function of the patients . As for the safety aspect, although Tadalafil was generally well-tolerated, the patients experienced side effects such as dyspepsia, headache, and back pain . Based on the positive results of the study, the authors concluded that the daily Tadalafil administration can be an alternative to the as-needed use of Tadalafil in patients, as the daily administration of the drug is also effective, safe, and well-tolerated by patients .
Tadalafil is not the only drug which is used for the treatment of ED in patients. In fact, there are other drugs belonging to the same PDE5I (phosphodiesterase type 5 inhibitor) family. Sildenafil Citrate and Vardenafil products are also being used for ED treatment and Sildenafil drugs are often the first drugs prescribed to patients with ED due to their popularity. Since there is not only one ED treatment belonging to the PDE5I class, studies have been conducted concerning user preference for these medications. The study of Ströberg et al in 2003, “Switching patients with erectile dysfunction from sildenafil citrate to tadalafil: Results of a European multicenter, open-label study of patient preference” determined whether patients who were initially treated with Sildenafil medication would prefer Tadalafil after using the treatment or revert to Sildenafil use . 147 patients (from Italy and Sweden) with at least 3 months ED history and were taking Sildenafil as needed (25-100 mg for about 6-24 weeks) were able to complete the study . It was a 6-phase study consisting of several stages (screening phase [1 week], sildenafil assessment phase [3 weeks], washout phase [1 week], Tadalafil initiation phase [6 weeks], Tadalafil assessment phase [3 weeks], and an extension phase [6 months]) . The study evaluated the patients’ preference ED treatment for the 6-month extension phase . Of all the men who completed the study (147), 90.5% or 133 preferred to receive Tadalafil over Sildenafil for the extension phase, while 9.5% or 14 only preferred to use Sildenafil . The side effects observed in patients in the course of the study for Sildenafil are flushing (7.1%), nasal congestion (6.5%), headache (4.5%), and nasopharyngitis (3.2%); while for Tadalafil, the patients noted the following side effects: headache (4.8%), nasal congestion (4.1%), dyspepsia (3.4%), flushing (2.7%), back pain (2.0%), diarrhea (2.0%), and nausea (2.0%) . Although there were appearances of these side effects, both medications were actually well-tolerated by patients . It was concluded that the patients preferred Tadalafil over Sildenafil .
Description and Mechanism of Action of Tadalafil
The summary of the action of Tadalafil in patients is that it is able to promote vasodilation in the penile walls which encourages blood flow in the penile area, leading to an erection. Tadalafil, however, does not actually have a direct action on the erectile response of the patients; the management of the erectile function is just a consequence of Tadalafil’s actual action.
Tadalafil, being a PDE5 inhibitor, inhibits the PDE5 enzyme from metabolizing the cGMP (cyclic guanosine monophosphate), which is the actual mediator of the erection in men. Since Tadalafil maintains the high level of cGMP in the penile tissue, erection is maintained, and patients are able to have control over their erectile function again. But, this inhibition of PDE5 by Tadalafil is still mediated by sexual stimuli, as there will be no cGMP released to mediate the erectile function unless there is the presence of a sexual stimulus.
Tadalis Benefits for ED Patients
Patients taking Tadalafil for erectile dysfunction (ED) can expect their control for their erectile function restored when using the drug. Patients suffering from ED usually lose control over their sexual response; when diagnosed with ED, men have great difficulty in getting erections and are also having trouble maintaining the erection, even in the presence of sexual stimuli.
Drugs like Tadalafil help these patients get the appropriate sexual response for the sexual stimuli. The mechanism of Tadalafil and other PDE5 inhibitors help them get erections at the appropriate times and also help them get stronger erections which are beneficial for penetration and completion of intercourse.
Suitable Doses and Length of Therapy
Patients are usually given with the initial 10 mg dose (as-needed) for Tadalafil. Patients should take the drug at least 30 minutes to an hour before the intended sexual intercourse for the patients to notice the effect [1,2]. There is no specific recommendation for the duration of Tadalafil treatment, so unless the doctor advises the patients to take the drug, they may do so indefinitely . Depending on the patient tolerance for the initial dose, the dose may be maintained or may be increased to 20-40 mg, or may be decreased to 5 mg to lessen the presence of side effects.
There are also Tadalafil products which are intended for daily use, so patients who are recommended to take the daily dose are prescribed with either 2.5 mg or 5 mg of Tadalafil . The length of therapy for the daily intake of Tadalafil is also indefinite and depends on the doctor’s advice.
Adverse Effects and Important Warnings
There are side effects which clients complain of when taking Tadalafil, although these side effects affect only a fraction of the patient population taking the drug: headaches, dyspepsia, nasopharyngitis, flushing, back pain, diarrhea, and nausea [8,9]. Although these side effects are common, they do not necessarily need to be observed in patients taking the drug, as there are also patients who are asymptomatic of the side effects.
But, in the presence of more serious side effects like: chest pain, irregular heartbeat, vision loss (NAION), stomach/muscle pain, difficulty breathing, blistering and skin peeling, tinnitus, sudden hearing loss, or any other side effect which may be related to the intake of Tadalafil, patients should seek immediate medical help and discontinue the medication [1,2].
Drug-to-Drug Possible Interactions
Patients should be wary of the drug interactions of Tadalafil so that they can avoid having adverse reactions due to the harmful interactions of Tadalafil and other medications. Patients taking blood pressure medication, cardiovascular medication, and angina medication (all of which contain nitrates) should consult their doctors first before taking Tadalafil as the interaction between Tadalafil and these medications can cause extremely low blood pressure.
Concerning other drugs, patients should also not take medications belonging to any of these drug families as they can affect how Tadalafil functions in their bodies: Rifampin/Rifabutin/Rifapentine (antidepressants), Clarithromycin/Erythromycin (antibiotics), Itraconazole/Ketoconazole (antifungal medications), medications for prostate disease, and Atazanavir/Darunavir/Ritonavir (HIV/AIDS medications) .
Tadalis 20mg/10mg seems to be popular with Internet consumers as there are a number of patient reviews available for the brand online. A few examples of the user comments for the drug are from Tadalis-sx.net. There were a few concerns regarding the product, but overall, the comments for Tadalis were positive toward its effect.
Although there were not-so-good comments for the product, overall, Tadalis had good reviews from users who were positive with its results. I think that the product is still recommendable since the product is made by one of India’s most reputable brands. Some patients may react differently to the medication, not because it does not work, but there may be other factors affecting the drug’s effectiveness in the patient’s system.
Tadalis Price, Forms and Available Dosage
Because Tadalis 20mg/10mg is quite popular on the internet, the patients are able to avail of the product online, since there are a number of sellers which have the product available for sale, unlike other brands, which are rarely sold on the internet.
Tadalis 20 mg by Ajanta Pharma is sold at $2.73 per pill by the online shop Sundrugstore.com. The price is not too affordable for a generic medication, but since the product is a “branded generic” treatment, it is understandable; and compared with the actual brand-name Tadalafil treatment, $2.73 is still a cheaper option. Also, online pharmacies typically offer discounts for larger purchases, so buyers can take advantage of their discount offers or bulk order offers when available.
As for the shipping, the same shop (Sundrugstore.com) offers two shipping options, the registered mail option and the EMS option, which are typical shipping choices for online drugstores. Depending on their courier choice, patients can pay for either $20 or $30 for the shipping. Although not too affordable, these shipping rates are standard and do not vary depending on the destination of the orders.
Patients who are curious to try Tadalis 20mg/10mg can have the products shipped to wherever they are residing (US, Australia, or Canada), as there are no restrictions on the sale of this product online. Aside from India, Tadalis is also said to be available in a number of international locations like the US, European countries, and the UK, and patients residing in those areas may be able to find Tadalis at their local pharmacies.
- Inhousepharmacy.vu: Tadalis-sx 20 (Tadalafil). Accessible from: https://www.inhousepharmacy.vu/p-689-tadalis-sx-20-tadalafil.aspx
- Alldaychemist.com: Tadalis SX – 20mg. Accessible from: https://www.alldaychemist.com/tadalis-20-mg.html
- Drugs.com: Tadalafil. Accessible from: https://www.drugs.com/tadalafil.html
- En.wikipedia.org: Ajanta Pharma. Accessible from: https://en.wikipedia.org/wiki/Ajanta_Pharma
- Ajantapharma.com: OVERVIEW. Accessible from: http://www.ajantapharma.com/overview.html
- Ajantapharma.com: Welcome to Ajanta Pharma. Accessible from: http://www.ajantapharma.com/
- Ajantapharma.com: MANUFACTURING. Accessible from: http://www.ajantapharma.com/manufacturing.html#
- Hatzichristou D, Gambla M, Rubio‐Aurioles E, Buvat J, Brock GB, Spera G, Rose L, Lording D, Liang S. Efficacy of tadalafil once daily in men with diabetes mellitus and erectile dysfunction. Diabetic Medicine. 2008 Feb 1;25(2):138-46. Accessible from: http://onlinelibrary.wiley.com/doi/10.1111/j.1464-5491.2007.02338.x/full
- Ströberg P, Costigan T, Murphy A. Switching patients with erectile dysfunction from sildenafil citrate to tadalafil: results of a European multicenter, open-label study of patient preference. Clinical therapeutics. 2003 Nov 30;25(11):2724-37. Accessible from: https://www.researchgate.net/publication/8944729_Switching_Patients_with_Erectile_Dysfunction_from_Sildenafil_Citrate_to_Tadalafil_Results_of_a_European_Multicenter_Open-Label_Study_of_Patient_Preference