tadalafil / Generic mfg. - LARVOL DELTA

Simultaneous Liver-Kidney Transplantation in the Setting of Severe Port-Pulmonary Hypertension (ACG 2026) - "She was on tadalafil 40 mg daily and inhaled treprostinil 80 mcg; prior trials of selexipag and macitentan were discontinued due to intolerance and worsening anemia, respectively. Sotatercept was contraindicated given thrombocytopenia...Despite intolerance or contraindication to several standard pulmonary vasodilators, the patient was bridged to transplant with intravenous treprostinil, renal replacement therapy and careful volume management, to meet hemodynamic listing criteria. This case illustrates the importance of individualized, dynamic risk assessment in PoPH patients."

Cardiovascular • Fibrosis • Genetic Disorders • Hematological Disorders • Hepatology • Immunology • Nephrology • Polycystic Kidney Disease • Portal Hypertension • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases • Thrombocytopenia • Thrombosis • Transplantation

Sotatercept Versus Other Add-on Therapies in Pulmonary Arterial Hypertension: a Bayesian Network Meta-Analysis (ERS 2026) - "Oral Treprostinil (MD 17m), Inhaled Iloprost (MD 26.0m), Selexipag (MD 8.3m), Ralinepag (MD 7.3m), and MK-5475 (MD -5.7m) showed non-significant effects (Figure 1). Sotatercept demonstrated the highest probability of being the most effective add-on therapy for improving 6MWD in PAH, supporting its positioning as preferred add-on for patients not achieving treatment goals."

Retrospective data • Cardiovascular • Pulmonary Arterial Hypertension • Respiratory Diseases

Dual Phosphodiesterase-5 Inhibitor-Induced Gastric Stasis Leading to Esophageal Variceal Hemorrhage: A Cautionary Case (ACG 2026) - "Case Description/ A 56-year-old male with Child-Pugh Class B alcoholic cirrhosis MELD 3.0 14 presented with large-volume hematemesis after forceful vomiting 72 hours after taking his prescribed 20mg tadalafil dose and self-medicating with 50mg sildenafil. Figure: Figure 2. Grade II esophageal varices with stigmata of bleeding."

Clinical • Cardiovascular • Erectile Dysfunction • Fibrosis • Gastroenterology • Hematological Disorders • Hepatology • Hypotension • Immunology • Liver Cirrhosis • Portal Hypertension • CYP3A4

Medical Expulsive Therapy after Extracorporeal Shock Wave Lithotripsy: A Systematic Review and Network Meta-Analysis. (PubMed, Yonsei Med J) - "The tamsulosin-tadalafil combination represents the optimal pharmacological adjunct to ESWL. Our findings suggest that effective post-ESWL MET requires a broad therapeutic approach targeting multi-segmental ureteral relaxation and inflammation to clear fragment "showers," distinguishing it from the management of solitary ureteral stones."

Clinical • Journal • Retrospective data • Review • Inflammation • Renal Calculi

IDENTIFYING MEANINGFUL PATIENT SAVINGS ON GENERICS: DIRECT-TO-CONSUMER PRICES VS COMMERCIAL INSURANCE (ISPOR 2026) - "DTC pharmacies such as MCCPDC meaningfully lower out-of-pocket costs for higher-cost generic prescriptions which could otherwise be difficult to afford. Commercially insured patients should consider DTC pharmacies when their copayment or coinsurance for a generic medication exceeds $15, and particularly when it exceeds $100."

Clinical • Reimbursement • US reimbursement • CNS Disorders • Depression • Endocrine Disorders • Erectile Dysfunction • Multiple Sclerosis

Pathologic Treatment Effect and Survival in HPV-Negative HNSCC Following Neoadjuvant Nivolumab. (PubMed, JAMA Otolaryngol Head Neck Surg) - P1, P2 | "Patients were treated with neoadjuvant nivolumab with or without the addition of immunomodulating medications (tadalafil or indoleamine 2,3 dioxygenase inhibitor). This cohort study found that patients with HPV-negative disease who are deemed pathologic responders (pTE >57%) to neoadjuvant nivolumab may have improved survival outcomes compared with those who are low or nonresponders. Not only does this suggest a role for using pathologic response as a surrogate marker, but it further highlights the neoadjuvant strategy in HNSCC as associated with improved survival."

IO biomarker • Journal • Head and Neck Cancer • Oncology • Solid Tumor • Squamous Cell Carcinoma • Squamous Cell Carcinoma of Head and Neck

Preparation of Deuterium-Labeled Tadalafil and Omeprazole by Carbon Hydrogen-Deuterium Exchange: Hydrogen Scrambling, Acid-Induced Transformation, and LC-MS Applications. (PubMed, Rapid Commun Mass Spectrom) - "Base-catalyzed carbon hydrogen-deuterium exchange provides a rapid and cost-effective approach for preparing stable isotope-labeled tadalafil and omeprazole suitable for LC-MS applications. The study further demonstrates that carbon-bound deuterium constitutes a valuable mechanistic probe, enabling investigation of hydrogen scrambling during tandem mass spectrometry and evaluation of isotope-label stability during acid-induced molecular transformation. The combined HRMS, tandem MS, NMR, and DFT approach establishes a comprehensive framework for characterization of deuterium-labeled compounds and supports their future application in quantitative analysis as well as structural elucidation by mass spectrometry."

Journal

Assessing the therapeutic potential of PDE-5 inhibitors in adults: Insights from a multi-omics study. (PubMed, Physiol Rep) - "Sixteen men and women aged 50-60 were administered daily sildenafil/tadalafil for 1 month. However, this did not translate to immunohistochemical changes. Additional research is warranted to investigate PDE-5 inhibitor effects on various tissues, which can inform prospective applications for drug repurposing."

Journal • Alzheimer's Disease • CNS Disorders • Dementia • Oncology

The role of the atherogenic index of plasma in response to once-daily tadalafil in men with erectile dysfunction. (PubMed, Aging Male) - "ROC analysis yielded an AUC of 0.650 (95% CI 0.540-0.760, p = 0.008), with an optimal cutoff of 0.130. Higher baseline AIP was independently associated with nonresponse to once-daily tadalafil in men with ED, suggesting AIP may offer additional prognostic information, though further validation is needed."

Journal • Erectile Dysfunction • Metabolic Disorders

Eisenmenger Syndrome After Delayed Atrial Septal Defect Closure at High Altitude: A Case Report. (PubMed, Am J Case Rep) - "Multidisciplinary management included bosentan 125 mg twice daily, tadalafil 10 mg once daily, nocturnal oxygen, diuretics, and anticoagulation, resulting in symptomatic stabilization and discharge on day 4. CONCLUSIONS Delayed atrial septal defect repair at high altitude can lead to irreversible Eisenmenger syndrome, for which current therapy is palliative. Early defect recognition and closure, congenital heart screening, and access to pulmonary vasodilators and transplant programs are imperative in resource-constrained mountainous regions."

Journal • Cardiovascular • Congestive Heart Failure • Heart Failure • Hematological Disorders • Hypertension • Palliative care • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases • Transplantation

A pilot phase Ib study to evaluate tadalafil to overcome immunosuppression during chemoradiotherapy for IDH-wild-type glioblastoma. (PubMed, Neurooncol Adv) - "Patients with newly diagnosed IDH-wild-type GBM received radiation therapy (RT) and temozolomide (TMZ) combined with oral tadalafil for 2 months. Concurrent tadalafil is well tolerated during chemoradiotherapy for GBM. Tadalafil is associated with a reduction of peripheral MDSCs after chemoradiotherapy and increased CD8 T-cell proliferation and activation."

Journal • P1 data • Brain Cancer • CNS Tumor • Glioblastoma • Oncology • Solid Tumor • CD28 • CD38 • CD8 • GZMB • IL1B

Phosphodiesterase-5 Inhibitor Use Masking a Necrotizing Syphilitic Infection: A Rare Differential Diagnosis of Priapism. (PubMed, Case Rep Urol) - "A 43-year-old male with a history of intravenous drug use presented with acute penile swelling and leukocytosis (20,500/μL) following unprotected sexual intercourse and tadalafil consumption...The patient was admitted to the clinic, and empiric intravenous antibiotics (piperacillin/tazobactam and clindamycin) were initiated...Acute penile enlargement following Phosphodiesterase-5 inhibitor use is not necessarily attributable to priapism and may instead be caused by infectious or necrotizing etiologies. Prompt recognition, initiation of antimicrobial therapy, and timely surgical intervention are critical to preserve penile tissue and erectile function."

Journal • Dermatology • Infectious Disease

Comparison of sildenafil and tadalafil in pulmonary arterial hypertension: A retrospective, propensity score matched analysis (ERS 2026) - "These findings may reflect differences in compliance, tolerance, or pharmacokinetics. Head-to-head RCTs are needed to confirm these findings."

Retrospective data • Cardiovascular • Congestive Heart Failure • Heart Failure • Pulmonary Arterial Hypertension • Respiratory Diseases

A SHOCKING MIXTURE: A CASE OF POPPER-INDUCED METHEMOGLOBINEMIA AND TADALAFIL COINGESTION LEADING TO REFRACTORY SHOCK (CHEST 2026) - No abstract available

Clinical • Hematological Disorders

Sensorineural Hearing Loss and Phosphodiesterase-5 Inhibitors: A Systematic Review. (PubMed, Int Arch Otorhinolaryngol) - "Sildenafil, vardenafil, and tadalafil were the most commonly used PDE-5is. The current systematic review underscores the importance of monitoring hearing in PDE5i patients and advising them about the potential risk. Further research with larger samples and control groups is needed to establish a definitive causal link."

Journal • Review • Otorhinolaryngology • Vertigo

Quantification of tadalafil in HLMs using an ultrafast UPLC-MS/MS method to assess metabolic stability, including in silico analysis of metabolic lability, DEREK alerts, and ADME characteristics. (PubMed, Anal Methods) - "TDF and baricitinib (internal standard) were separated using an Eclipse Plus 1.8 µm C18 column (reversed-phase; 50 mm × 2.1 mm), with a mobile phase of 0.1% HCOOH in water (45%) and in acetonitrile (55%). TDF's in vitro half-life was 59.65 min, with a slow intrinsic clearance (Clint) of 13.59 mL min-1 kg-1. In silico results reveal that minor modifications at C28 of the 1,3-benzodioxole ring (95%) could enhance the safety and stability of the new derivatives relative to TDF."

Journal • Benign Prostatic Hyperplasia • Cardiovascular • Erectile Dysfunction • Hypertension • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases

ROBOPREP: Multimodal Prehabilitation and Rehabilitation for Men Undergoing Robot-Assisted Radical Prostatectomy (clinicaltrials.gov) - P2 | N=64 | Recruiting | Sponsor: Surgical Outcomes Research Centre (SOuRCe) | Trial completion date: Nov 2028 ➔ Nov 2029 | Initiation date: May 2026 ➔ Aug 2026 | Trial primary completion date: Feb 2028 ➔ Dec 2028 | Not yet recruiting ➔ Recruiting

Enrollment open • Trial completion date • Trial initiation date • Trial primary completion date • Erectile Dysfunction • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor • Urinary Incontinence • Urology

Efficacy and safety of hyaluronic acid and enzymatic mix intralesional therapy in Peyronie's disease: a prospective, randomized, controlled pilot study of outcomes and patient satisfaction. (PubMed, J Sex Med) - P=N/A | "Fibrorestil intralesional therapy demonstrates possible improvements in curvature and patient-reported outcomes versus conservative care in stable-phase PD and appears safe, while conservative care alone showed no meaningful improvement. Given baseline imbalances, small pilot sample size, open-label design, and lack of an equivalent sham injection control, these findings should be considered exploratory and require confirmation in larger randomized trials."

Clinical • Journal • Diabetes • Fibrosis • Metabolic Disorders

Comparative One-Year Outcomes of Sildenafil-to-Tadalafil Transition Therapy versus Sildenafil Monotherapy in Pediatric Pulmonary Hypertension: A Real-World Propensity-Matched Cohort Study (AHA 2026) - "Abstract is embargoed at this time."

Clinical • Monotherapy • Real-world • Real-world evidence • Cardiovascular • Pediatrics • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases

QbD consideration for developing and validating the dissolution test method for quantitative analysis of tadalafil chewable tablets. (PubMed, J Chromatogr Sci) - "Additionally, reagent consumption and operational costs were reduced by ~45%, improving overall efficiency. These findings validate the suitability of the method for reliable industrial quality control of tadalafil chewable tablets and new formulations."

Journal • Erectile Dysfunction

Identification of RING finger protein-related biomarkers in sepsis based on explainable machine learning: A comprehensive analysis. (PubMed, Biochem Biophys Res Commun) - "RNF175 is an early sepsis biomarker with both diagnostic value and causal relevance, potentially acting through T-cell modulation. Tadalafil may be a pathway-targeted repurposable drug. This study provides new perspectives for precision medicine in sepsis."

Biomarker • Journal • Infectious Disease • Septic Shock • ZFP36

Efficacy of Transcutaneous Electrical Neural Stimulation and Tadalafil in Men With Erectile Dysfunction: A Randomized, Double-Blind, Bi-centric, Placebo- and Sham-Controlled Trial (clinicaltrials.gov) - P4 | N=185 | Completed | Sponsor: Menoufia University | Initiation date: Jun 2024 ➔ May 2025 | Trial primary completion date: Oct 2025 ➔ Jan 2026

Trial initiation date • Trial primary completion date • Erectile Dysfunction

AIVERT: Atherogenic Index of Plasma and Tadalafil Response in Erectile Dysfunction (clinicaltrials.gov) - P=N/A | N=176 | Completed | Sponsor: Taksim Egitim ve Arastirma Hastanesi | Active, not recruiting ➔ Completed | N=132 ➔ 176 | Trial completion date: Apr 2027 ➔ Feb 2026 | Initiation date: Oct 2025 ➔ Apr 2025

Enrollment change • Trial completion • Trial completion date • Trial initiation date • Erectile Dysfunction

cAMP and cGMP pathways modulate spontaneous contractile activity in human seminal vesicle smooth muscle. (PubMed, Auton Neurosci) - "Pharmacological enhancement of cyclic nucleotide signaling reduced phenylephrine-induced hSV contractile activity. Rolipram showed the lowest apparent IC50. Mirabegron-sensitive relaxation together with ADRB3 transcript detection was compatible with possible β3-adrenoceptor involvement in hSV smooth muscle."

Journal

Alternans of the atrial posterior wall pulmonary vein junction as a driver for atrial fibrillation and a target for pharmacological therapy (ESC 2026) - "In both healthy and HF sheep, the pulmonary vein junction is more susceptible to cardiac alternans with greater magnitude. Acute tadalafil treatment can suppress the susceptibility and magnitude of alternans which we expect will limit the transition of alternans to AF and represents a potential antiarrhythmic strategy in HF."

Atrial Fibrillation • Cardiovascular • Congestive Heart Failure • Heart Failure • RHOD