Vereinigte Staaten - Englisch - NLM (National Library of Medicine)

remedyrepack inc. - tadalafil (unii: 742sxx0ict) (tadalafil - unii:742sxx0ict) - tadalafil tablets are indicated for the treatment of pulmonary arterial hypertension (pah) (who group 1) to improve exercise ability. studies establishing effectiveness included predominately patients with nyha functional class ii – iii symptoms and etiologies of idiopathic or heritable pah (61%) or pah associated with connective tissue diseases (23%). tadalafil tablets are contraindicated in patients who are using any form of organic nitrate, either regularly or intermittently. do not use nitrates within 48 hours of the last dose of tadalafil tablets. tadalafil tablets potentiate the hypotensive effect of nitrates. this potentiation is thought to result from the combined effects of nitrates and tadalafil tablets on the nitric oxide/cgmp pathway [see clinical pharmacology ( 12.2)] . coadministration of gc stimulators such as riociguat with tadalafil tablets are contraindicated. tadalafil tablets may potentiate the hypotensive effects of gc stimulators. tadalafil tablets are contraindicated in patients with a known serious hypersensitivity to tadalafil (tadalafil tablets or cialis). hypersensitivity reactions have been reported, including stevens-johnson syndrome and exfoliative dermatitis [see adverse reactions ( 6.2)] . risk summary limited data from case series with tadalafil use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes. in animal reproduction studies, no adverse developmental effects were observed with oral administration of tadalafil to pregnant rats or mice during organogenesis at exposures 7 times the exposure at the maximum recommended human dose (mrhd) of 40 mg/day based on auc (see data) . the estimated background risk of major birth defects and miscarriage for the indicated population is unknown. all pregnancies have a background risk of birth defect, loss, or other adverse outcomes. in the u.s. general population, the background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2-4% and 15- 20%, respectively. clinical considerations disease-associated maternal and/or embryo/fetal risk pregnant women with untreated pulmonary arterial hypertension are at risk for heart failure, stroke, preterm delivery, and maternal and fetal death. data animal data tadalafil and/or its metabolites cross the placenta, resulting in fetal exposure in rats. animal reproduction studies showed no evidence of teratogenicity, embryotoxicity, or fetotoxicity when tadalafil was given to pregnant rats or mice at unbound tadalafil exposures up to 7 times the exposure at the maximum recommended human dose (mrhd) of 40 mg/day during organogenesis based on auc. in one of two perinatal/postnatal developmental studies in rats, a reduction of postnatal pup survival was observed at dose levels of 60, 200 and 1000 mg/kg. the no-observed-effect-level (noel) for developmental toxicity was 30 mg/kg, which provided maternal exposure to unbound tadalafil concentrations approximately 5 times the exposure at the mrhd based on auc. signs of maternal toxicity occurred at doses greater than 200 mg/kg/day, which produced aucs greater than 8 times the exposure at the mrhd. surviving offspring had normal development and reproductive performance. risk summary there are no data on the presence of tadalafil and/or its metabolites in human milk, the effects on the breastfed child, or the effects on milk production. tadalafil and/or its metabolites are present in the milk of lactating rats at concentrations approximately 2.4-times that found in the plasma. when a drug is present in animal milk, it is likely that the drug will be present in human milk. the developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for tadalafil tablets and any potential adverse effects on the breastfed child from tadalafil tablets or from the underlying maternal condition. infertility males based on the data from 3 studies in adult males, tadalafil decreased sperm concentrations in the study of 10 mg tadalafil for 6 months and the study of 20 mg tadalafil for 9 months. this effect was not seen in the study of 20 mg tadalafil taken for 6 months. there was no adverse effect of tadalafil 10 mg or 20 mg on mean concentrations of testosterone, luteinizing hormone or follicle stimulating hormone. the clinical significance of the decreased sperm concentrations in the two studies is unknown. there have been no studies evaluating the effect of tadalafil on fertility in men or women [see clinical pharmacology (12.2)] . safety and effectiveness of tadalafil tablets in pediatric patients have not been established. of the total number of subjects in the clinical study of tadalafil for pulmonary arterial hypertension, 28 percent were 65 and over, while 8 percent were 75 and over. no overall differences in safety were observed between subjects over 65 years of age compared to younger subjects or those over 75 years of age. no dose adjustment is warranted based on age alone; however, a greater sensitivity to medications in some older individuals should be considered. [see clinical pharmacology ( 12.3)] . for patients with mild or moderate renal impairment, start tadalafil tablets at 20 mg once daily. increase the dose to 40 mg once daily based upon individual tolerability [see dosage and administration ( 2.2) and clinical pharmacology ( 12.3)] . in patients with severe renal impairment, avoid use of tadalafil tablets because of increased tadalafil exposure (auc), limited clinical experience, and the lack of ability to influence clearance by dialysis [see clinical pharmacology ( 12.3)] . because of limited clinical experience in patients with mild to moderate hepatic cirrhosis (child-pugh class a or b), consider a starting dose of tadalafil tablets 20 mg once daily. patients with severe hepatic cirrhosis (child-pugh class c) have not been studied, thus avoid use of tadalafil tablets in such patients [see dosage and administration ( 2.3) and clinical pharmacology ( 12.3)] .

Irland - Englisch - HPRA (Health Products Regulatory Authority)

accord healthcare limited - tadalafil - film coated tablet - 5 milligram - tadalafil

Malta - Englisch - Medicines Authority

hennig arzneimittel gmbh & co kg liebigstrasse 1-2, d-65439 flörsheim am main, germany - tadalafil - film-coated tablet - tadalafil 5 mg - urologicals

Malta - Englisch - Medicines Authority

hennig arzneimittel gmbh & co kg liebigstrasse 1-2, d-65439 flörsheim am main, germany - tadalafil - film-coated tablet - tadalafil 10 mg - urologicals

Malta - Englisch - Medicines Authority

hennig arzneimittel gmbh & co kg liebigstrasse 1-2, d-65439 flörsheim am main, germany - tadalafil - film-coated tablet - tadalafil 20 mg - urologicals

Malta - Englisch - Medicines Authority

genericon pharma gesellschaft m.b.h hafnerstrasse 211, 8054 graz, austria - tadalafil - film-coated tablet - tadalafil 5 mg - urologicals

Malta - Englisch - Medicines Authority

genericon pharma gesellschaft m.b.h hafnerstrasse 211, 8054 graz, austria - tadalafil - film-coated tablet - tadalafil 10 mg - urologicals

Malta - Englisch - Medicines Authority

genericon pharma gesellschaft m.b.h hafnerstrasse 211, 8054 graz, austria - tadalafil - film-coated tablet - tadalafil 20 mg - urologicals

Malta - Englisch - Medicines Authority

1 a pharma gmbh - tadalafil - film-coated tablet - tadalafil 2.5 milligram(s) - urologicals

Malta - Englisch - Medicines Authority

1 a pharma gmbh - tadalafil - film-coated tablet - tadalafil 5 milligram(s) - urologicals