Kasario (Tadalafil)

Tadalafil acts on the nitric‑oxide/cGMP pathway to facilitate smooth‑muscle relaxation in target tissues.

• Erectile dysfunction: improves ability to achieve and maintain an erection sufficient for sexual activity.
• Benign prostatic hyperplasia: reduces urinary frequency, urgency and improves urinary flow.
• Pulmonary arterial hypertension: lowers pulmonary arterial pressure and improves exercise capacity.

• Tadalafil selectively inhibits the phosphodiesterase type 5 enzyme, preventing the breakdown of cyclic guanosine monophosphate (cGMP) in smooth‑muscle cells. Elevated cGMP levels enhance nitric‑oxide mediated relaxation of vascular and corpus cavernosum smooth muscle, increasing blood flow to the penis and pulmonary vasculature. The prolonged action of tadalafil, due to its long half‑life, sustains these effects for up to 36 hours after dosing. This mechanism also contributes to reduced pulmonary vascular resistance in patients with hypertension.

Tadalafil may cause a range of adverse reactions, varying from mild to serious.

Common Side Effects

• Headache
• Flushing
• Dyspepsia
• Nasal congestion
• Back pain
• Muscle aches

Serious or Rare Side Effects

• Sudden vision loss
• Priapism (prolonged erection)
• Sudden hearing loss
• Severe hypotension
• Allergic reactions such as rash or swelling
• Cardiovascular events including myocardial infarction

Before prescribing Kasario, clinicians should consider several safety aspects.

• Cardiovascular assessment: evaluate for underlying heart disease before prescribing.
• Nitrate use: avoid concurrent use with nitrates due to risk of severe hypotension.
• Alpha‑blocker therapy: use with caution and consider dose adjustment.
• Hepatic impairment: dose may need adjustment in moderate to severe liver disease.
• Sexual activity timing: advise patients to wait the appropriate interval after dosing.
• Store at ambient temperature: keep in original packaging, protect from moisture and heat.

Tadalafil interacts with several medication classes that may require dose modification or avoidance.

Major Interactions (Avoid)

• Nitrates (e.g., nitroglycerin, isosorbide dinitrate)
• Guanylate cyclase stimulators (e.g., riociguat)

Moderate Interactions (Monitor Closely)

• Alpha‑blockers (e.g., tamsulosin)
• Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin)
• Strong CYP3A4 inducers (e.g., rifampin, carbamazepine)
• Antihypertensives (may enhance blood‑pressure‑lowering effect)
• Other PDE5 inhibitors (combined use increases risk of adverse effects)