Pulmonary arterial hypertension (PAH), functional class II and III

Active Ingredient: Tadalafil

Indication for Tadalafil

Population group: only children (1 year - 12 years old) , adolescents (12 years - 18 years old) , adults (18 years old or older)
Therapeutic intent: Curative procedure

Adults

Treatment of pulmonary arterial hypertension (PAH) classified as WHO functional class II and III, to improve exercise capacity.

Efficacy has been shown in idiopathic PAH (IPAH) and in PAH related to collagen vascular disease.

Paediatric population

Treatment of paediatric patients aged 2 years and above with pulmonary arterial hypertension (PAH) classified as WHO functional class II and III.

For this indication, competent medicine agencies globally authorize below treatments:

40 mg once daily

For:

Dosage regimens

Oral, 40 milligrams tadalafil, once daily.

Detailed description

The recommended dose is 40 mg taken once daily.

Delayed dose, missed dose, or vomiting

If there is a delay in the administration of ADCIRCA, but yet within the same day, the dose should be taken with no changes to the subsequent dose schedules. Patients should not take an extra dose if a dose is missed.

Patients should not take an extra dose if vomiting occurs.

For patients weighting ≥40 kg 40 mg once daily and for patients weighting <40 kg 20 mg once daily

For:

Dosage regimens

Regimen A, in case that patient age in years is ≥ 2 and patient weight is ≥ 40 kg

Oral, 40 milligrams tadalafil, once daily.

Regimen B, in case that patient age in years is ≥ 2 and patient weight is < 40 kg

Oral, 20 milligrams tadalafil, once daily.

Detailed description

The recommended once daily doses based on age and weight categories in paediatric patients are shown below.

Paediatric patient's age and/or weightRecommended daily dose and dosing regimen
Age ≥2 years old
Body weight ≥40 kg
Body weight <40 kg

40 mg once daily
20 mg once daily

* Oral suspension is available for administration to paediatric patients who require 20 mg and are not able to swallow tablets.

For patients <2 years old no PK or efficacy data are available from clinical trials. The most appropriate dose of tadalafil in children aged between 6 months to <2 years has not been established. Therefore, tadalafil is not recommended in this age subset.

Delayed dose, missed dose, or vomiting

If there is a delay in the administration of tadalafil, but yet within the same day, the dose should be taken with no changes to the subsequent dose schedules. Patients should not take an extra dose if a dose is missed.

Active ingredient

Tadalafil

Tadalafil is a selective, reversible inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5). When sexual stimulation causes the local release of nitric oxide, inhibition of PDE5 by tadalafil produces increased levels of cGMP in the corpus cavernosum. This results in smooth muscle relaxation and inflow of blood into the penile tissues, thereby producing an erection. The effect of PDE5 inhibition on cGMP concentration in the corpus cavernosum is also observed in the smooth muscle of the prostate, the bladder and their vascular supply. The resulting vascular relaxation increases blood perfusion which may be the mechanism by which symptoms of benign prostatic hyperplasia are reduced.

Read more about Tadalafil

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