This is a fixed combination of tamsulosin and tadalafil, used together in men who have both benign prostatic hyperplasia (BPH, an enlarged prostate causing urinary symptoms) and erectile dysfunction (ED), two conditions that commonly occur together. It combines an alpha-blocker with a PDE5 inhibitor. It is a prescription-only medicine.

• Therapeutic Class: Combination therapy for benign prostatic hyperplasia with erectile dysfunction.

• Pharmacological Class: Alpha-1 adrenergic receptor blocker (tamsulosin) plus phosphodiesterase type 5 (PDE5) inhibitor (tadalafil).

• Drug Family: Combination urological/sexual health therapy.

• ATC Classification: Not applicable as a single combined code; tamsulosin alone carries G04CA02, tadalafil G04BE08.

Approved/established use: Lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia, in men who also have erectile dysfunction.

Commonly used for: Men with moderate to severe BPH symptoms (urinary frequency, urgency, weak stream) who also experience erectile dysfunction, where treating both together is considered appropriate.

Off-label use (only under medical guidance): Not typically used off-label; use is specific to the combined BPH/ED indication.

• Oral tablets/capsules: commonly tamsulosin (prolonged-release) 0.4 mg combined with tadalafil 5 mg.

Tamsulosin relaxes smooth muscle in the prostate and bladder neck by blocking alpha-1 receptors, which eases urine flow and reduces BPH-related urinary symptoms. Tadalafil blocks an enzyme called PDE5, helping relax blood vessels in the penis to support erections during sexual stimulation, and has also been separately shown to improve BPH-related urinary symptoms through effects on smooth muscle relaxation in the lower urinary tract.

• Standard dose: One tablet/capsule (tamsulosin 0.4 mg/tadalafil 5 mg) taken orally once daily, generally at the same time each day.

• Condition-wise dose: This combination is intended for regular daily use for BPH/ED symptom management, rather than as-needed dosing typically used for tadalafil alone in ED-only treatment.

• Route: Oral, once daily, approximately 30 minutes after the same meal each day, as tamsulosin absorption can be affected by food timing consistency.

• Missed dose: Take as soon as remembered unless close to the next dose; don't double up.

• Overdose: May cause significant blood pressure drop, dizziness, or headache; requires medical attention.

• Common: Dizziness, headache, abnormal ejaculation (related to tamsulosin), flushing, and nasal congestion.

• Serious: Significant drop in blood pressure (particularly with the first few doses or when combined with other blood-pressure-lowering medicines), fainting, and, rarely, a prolonged or painful erection (priapism, linked to tadalafil).

• Emergency symptoms: An erection lasting more than 4 hours, sudden vision or hearing loss, chest pain, or severe dizziness/fainting.

• Recovery advice: Dizziness is more common with the first few doses and often improves; standing up slowly from sitting or lying positions can help reduce this.

• Pregnancy: Not applicable; used only in men.

• Breastfeeding: Not applicable; used only in men.

• Liver disease: Used with caution; dose adjustment guidance from the prescribing doctor is needed, given both components are processed by the liver.

• Kidney disease: Used with caution; dose adjustment may be needed based on the tadalafil component's known dosing guidance in kidney impairment.

• Elderly: Commonly used in this age group, as BPH becomes more common with age; monitored for blood pressure effects.

• Children: Not applicable; a medicine for adult men.

• Nitrates (e.g., nitroglycerin): combining with tadalafil can cause a dangerous drop in blood pressure; this combination is contraindicated with nitrate use.

• Other alpha-blockers or blood-pressure medicines: can add to the blood-pressure-lowering effect of tamsulosin, increasing dizziness/fainting risk.

• Strong CYP3A4 inhibitors (e.g., ketoconazole, certain HIV protease inhibitors): can increase levels of both components, requiring caution or dose adjustment.

• Cataract surgery-related caution: tamsulosin has been associated with intraoperative floppy iris syndrome during cataract surgery; the surgeon should be informed of tamsulosin use beforehand.

• Blood pressure review, particularly when starting treatment or if combined with other blood-pressure-lowering medicines.

• Assessment of urinary symptom improvement (IPSS score) and erectile function over time.

• General cardiovascular risk assessment before starting, given that sexual activity itself carries a cardiac workload.

Tamsulosin or tadalafil used separately, other alpha-blockers (e.g., alfuzosin, silodosin), other PDE5 inhibitors (e.g., sildenafil) — individual components can be adjusted separately if the fixed combination isn't suitable.

This is itself a fixed combination addressing both BPH and ED together; not typically combined with additional alpha-blockers or PDE5 inhibitors given overlapping mechanisms.

• Benign Prostatic Hyperplasia (BPH) Medicines

• Erectile Dysfunction Treatments

• Male Urological Health

1. Prostate Cancer - Causes, Symptoms and Treatment

2. National Prostate Cancer Awareness Month

• https://link.springer.com/article/10.1007/s00345-026-06306-3

• https://pmc.ncbi.nlm.nih.gov/articles/PMC7591403/

The information on this page is for educational purposes only and is not a substitute for medical advice. Please consult your doctor to know if this treatment is appropriate for your condition.