Adcirca

Adcirca is a prescription medicine used to improve the ability to exercise in people with pulmonary arterial hypertension. Adcirca
is in a group of medications called phosphodiesterase 5 (PDE5) inhibitors. Adcirca treats PAH by relaxing the blood vessels in the lungs to allow blood to flow more easily.

Adcirca comes in tablet form and is usually taken once daily, with or without food.

The most common side effect with Adcirca is headache.

Do not take Adcirca if you are taking other medications called "nitrates."

Adcirca is a prescription medicine used to improve the ability to exercise in people with pulmonary arterial hypertension, or PAH. PAH is high blood pressure in the vessels carrying blood to the lungs, causing shortness of breath, dizziness, and tiredness

• Lilly, Eli & Company

Serious side effects have been reported with Adcirca. See "Drug Precautions".

The most common side effects with Adcirca are:

• headache
• indigestion
• back pain
• muscle aches
• flushing
• stuffy or runny nose

These side effects usually go away after a few hours.  Men who get back pain and muscle aches usually get it 12 to 24 hours after taking Adcirca. Back pain and muscle aches usually go away within 2 days.  

Call your healthcare provider if you get any side effect that bothers you or one that does not go away.

 Uncommon side effects include:

• an erection that won't go away (priapism).  If you get an erection that lasts more than 4 hours, get medical help right away. Priapism must be treated as soon as possible or lasting damage can happen to your penis, including the inability to have erections.
• color vision changes, such as seeing a blue tinge (shade) to objects or having difficulty telling the difference between the colors blue and green

In rare instances, men taking PDE5 inhibitors (oral erectile dysfunction medicines, including Adcirca) reported a sudden decrease or loss of vision in one or both eyes. It is not possible to determine whether these events are related directly to these medicines, to other factors such as high blood pressure or diabetes, or to a combination of these. If you experience sudden decrease or loss of vision, stop taking PDE5 inhibitors, including Adcirca, and call a healthcare provider right away.

Sudden loss or decrease in hearing, sometimes with ringing in the ears and dizziness, has been rarely reported in people taking PDE5 inhibitors, including Adcirca. It is not possible to determine whether these events are related directly to the PDE5 inhibitors, to other diseases or medications, to other factors, or to a combination of factors. If you experience these symptoms, stop taking Adcirca and contact a healthcare provider right away.

These are not all the possible side effects of Adcirca. For more information, ask your healthcare provider or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Adcirca and other medicines may affect each other. Always check with your doctor before starting or stopping any medicines. Especially tell your doctor if you take any of the following:

• medicines called nitrates 
• medicines called alpha blockers. These include Hytrin (terazosin HCl), Flomax (tamsulosin HCl), Cardura (doxazosin mesylate), Minipress (prazosin HCl) or Uroxatral (alfuzosin HCl). Alpha blockers are sometimes prescribed for prostate problems or high blood pressure. If tadalafil is taken with certain alpha blockers, your blood pressure could suddenly drop. You could get dizzy or faint.
• other medicines to treat high blood pressure (hypertension)
• medications that block a protein in the body (CYPA4) such as some macrolide antibiotics (clarithromycin, telithromycin), some HIV protease inhibitors (indinavir, nelfinavir, ritonavir, saquinavir), some HCV protease inhibitors (boceprevir, telaprevir), some azole antifungals (ketoconazole, itraconazole, posaconazole, voriconazole), conivaptan (Vaprisol), delavirdine (Rescriptor), and nefazodone (Serzone)
• medications that increase the activity of the enzyme CYP3A4 such as carbamazepine (Tegretol, Equetro, Carbatrol), phenobarbital, phenytoin (Dilantin), rifampin (Rifadin), St John's wort, and nimodipine (Nimotop)
• other medicines or treatments for ED such as sildenafil citrate (Viagra) or also known as Revatio when used to treat pulmonary arterial hypertension (PAH).

Do not take Adcirca if you take Cialis. Do not take both at the same time, because they are the same medication.

This is not a complete list of Adcirca drug interactions. Ask your doctor or pharmacist for more information.

• Adcirca can cause your blood pressure to drop suddenly to an unsafe level if it is taken with certain other medicines. You could get dizzy, faint, or have a heart attack or stroke.
• Do not take Adcirca f you take any medicines called “nitrates.” Nitrates are commonly used to treat angina. Angina is a symptom of heart disease and can cause pain in your chest, jaw, or down your arm.
  • Medicines called nitrates include nitroglycerin that is found in tablets, sprays, ointments, pastes, or patches. Nitrates can also be found in other medicines such as isosorbide dinitrate or isosorbide mononitrate. Some recreational drugs called “poppers” also contain nitrates, such as amyl nitrite and butyl nitrite.
  • Ask your healthcare provider or pharmacist if you are not sure if any of your medicines are nitrates.
• Tell all of your healthcare providers that you take Adcirca. If you need emergency medical care for a heart problem, it will be important for your healthcare provider to know when you last took Adcirca.
• After taking a single tablet, some of the active ingredient of Adcirca remains in your body for more than 2 days. The active ingredient can remain longer if you have problems with your kidneys or liver, or you are taking certain other medications.
• Seek immediate medical attention if sudden loss of vision occurs, which could be a sign of non-arteritic ischemic optic neuropathy (NAION).
• Seek immediate medical attention if sudden decrease or loss of hearing occurs.

Do not take Adcirca if you:

• take any medicines called “nitrates”.
• use recreational drugs called “poppers” like amyl nitrite and butyl nitrite
• are allergic to Adcirca or any of its ingredients. Symptoms of an allergic reaction may include:
  • rash
  • hives
  • swelling of the lips, tongue, or throat
  • difficulty breathing or swallowing

Call your healthcare provider or get help right away if you have any of the symptoms of an allergic reaction listed above.

Grapefruit and grapefruit juice may interact with Adcirca and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor.

Before taking Adcirca, tell your healthcare provider about all your medical problems, including if you:

• have heart problems such as angina, heart failure, irregular heartbeats, or have had a heart attack. Ask your healthcare provider if it is safe for you to have sexual activity. You should not take tadalafil if your healthcare provider has told you not to have sexual activity because of your health problems.
• have low blood pressure or have high blood pressure that is not controlled
• have had a stroke
• have liver problems
• have kidney problems or require dialysis
• have retinitis pigmentosa, a rare genetic (runs in families) eye disease
• have ever had severe vision loss, including a condition called NAION
• have stomach ulcers
• have a bleeding problem
• have a deformed penis shape or Peyronie's disease
• have had an erection that lasted more than 4 hours
• have blood cell problems such as sickle cell anemia, multiple myeloma, or leukemia

Tell your doctor about all of the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

This medication falls into category B. Based on animal studies, Adcirca is not predicted to increase the risk of adverse developmental abnormalities in humans. There are, however, no adequate and well-controlled studies of Adcirca in pregnant women.

Take Adcirca exactly as your healthcare provider prescribes it. Your healthcare provider will prescribe the dose that is right for you.

• Do not change your dose or the way you take Adcirca without talking to your healthcare provider. Your healthcare provider may lower or raise your dose, depending on how your body reacts to Adcirca and your health condition.
• Adcirca may be taken with or without meals.
• If you take too much Adcirca, call your healthcare provider or emergency room right away.

• Take once daily with or without food. Dividing the dose over the course of the day is not recommended.

Take Adcirca exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

Adcirca  for use in PAH:

If you take too much this medication, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

• Store Adcirca at 25°C (77°F).
• Keep Adcirca and all medicines out of the reach of children.