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Tadalafil belongs to a class of chemicals known as PDE5 inhibitors. Tadalafil is used in treatment of erectile dysfunction and pulmonary hypertension. PDE5 inhibitors act through the nitric oxide pathway; when sexual stimulation occurs to the penis, nitric oxide is released. Nitric oxide stimulates release of the guanylate cyclase enzyme. Guanylate cyclase interacts with cyclic-GMP (c-GMP) which relaxes the smooth muscle lining blood vessels of the corpus cavernosum thereby inducing penile erection. In subjects with erectile dysfunction, inhibition of c-GMP specific phosphodiesterase-5 (PDE5) helps treat the inability to achieve erections. Tadalafil is not entirely specific to PDE5; it mildly inhibits other phosphodiesterase enzymes, which is responsible for most side-effects with higher doses of PDE5 inhibitors sometimes experienced by individuals such as vision distortions (caused by phosphodiesterase inhibition in the retina). Tadalafil‚ action in treatment of pulmonary hypertension works similarly to its mechanism for treating erectile dysfunction. Super-selective PDE5 inhibitors are currently in development but are unlikely to be introduced soon due to the success in the current market of first-generation PDE5 inhibitors.



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