Alyq Side Effects Center

SIDE EFFECTS

The following serious adverse reactions are discussed elsewhere in the labeling:

• Hypotension [see WARNINGS AND PRECAUTIONS]
• Visual Loss [see WARNINGS AND PRECAUTIONS and PATIENT INFORMATION]
• Hearing loss [see WARNINGS AND PRECAUTIONS]
• Priapism [see WARNINGS AND PRECAUTIONS]

Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

Tadalafil was administered to 398 patients with PAH during clinical trials worldwide. In trials of ALYQ™, a total of 311 and 251 subjects have been treated for at least 182 days and 360 days, respectively. The overall rates of discontinuation because of an adverse event (AE) in the placebo-controlled trial were 9% for ALYQ™ 40 mg and 15% for placebo. The rates of discontinuation because of AEs, other than those related to worsening of PAH, in patients treated with ALYQ™ 40 mg was 4% compared to 5% in placebo-treated patients.

In the placebo-controlled study, the most common AEs were generally transient and mild to moderate in intensity. Table 1 presents treatment-emergent adverse events reported by ≥9% of patients in the ALYQ™ 40 mg group and occurring more frequently than with placebo.

Table 1: Treatment-Emergent Adverse Events Reported by ≥9% of Patients in ALYQ™ and More Frequent than Placebo by 2%

Postmarketing Experience

The following adverse reactions have been identified during post-approval use of tadalafil. These events have been chosen for inclusion either because of their seriousness, reporting frequency, lack of clear alternative causation, or a combination of these factors. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to estimate reliably their frequency or establish a causal relationship to drug exposure. The list does not include adverse events that are reported from clinical trials and that are listed elsewhere in this section.

Cardiovascular And Cerebrovascular

Serious cardiovascular events, including myocardial infarction, sudden cardiac death, stroke, chest pain, palpitations, and tachycardia, have been reported postmarketing in temporal association with the use of tadalafil [see CONTRAINDICATIONS]. Most, but not all, of these patients had preexisting cardiovascular risk factors. Many of these events were reported to occur during or shortly after sexual activity, and a few were reported to occur shortly after the use of tadalafil without sexual activity. Others were reported to have occurred hours to days after the use of tadalafil and sexual activity. It is not possible to determine whether these events are related directly to tadalafil, to sexual activity, to the patient’s underlying cardiovascular disease, to a combination of these factors, or to other factors.

Body As A whole

Hypersensitivity reactions including urticaria, Stevens–Johnson syndrome, and exfoliative dermatitis

Nervous

Migraine, seizure and seizure recurrence, and transient global amnesia

Ophthalmologic

Visual field defect, retinal vein occlusion, retinal artery occlusion, and NAION [see WARNINGS AND PRECAUTIONS and PATIENT INFORMATION].

Otologic

Cases of sudden decrease or loss of hearing have been reported postmarketing in temporal association with the use of PDE5 inhibitors, including tadalafil. In some of the cases, medical conditions and other factors were reported that may have also played a role in the otologic adverse events. In many cases, medical follow-up information was limited. It is not possible to determine whether these reported events are related directly to the use of tadalafil, to the patient’s underlying risk factors for hearing loss, a combination of these factors, or to other factors [see WARNINGS AND PRECAUTIONS and PATIENT INFORMATION].

Urogenital

Priapism [see WARNINGS AND PRECAUTIONS].

DRUG INTERACTIONS

Nitrates

Administration of nitrates within 48 hours after the last dose of ALYQ™ is contraindicated [see CONTRAINDICATIONS].

Alpha-Blockers

PDE5 inhibitors, including ALYQ™, and alpha–adrenergic blocking agents are both vasodilators with blood-pressure-lowering effects. When vasodilators are used in combination, an additive effect on blood pressure may be anticipated. Clinical pharmacology studies have been conducted with coadministration of tadalafil with doxazosin, alfuzosin or tamsulosin [see CLINICAL PHARMACOLOGY].

Antihypertensives

PDE5 inhibitors, including ALYQ™, are mild systemic vasodilators. Clinical pharmacology studies were conducted to assess the effect of tadalafil on the potentiation of the blood–pressure–lowering effects of selected antihypertensive medications (amlodipine, angiotensin II receptor blockers, bendroflumethiazide, enalapril, and metoprolol). Small reductions in blood pressure occurred following coadministration of tadalafil with these agents compared with placebo [see CLINICAL PHARMACOLOGY].

Alcohol

Both alcohol and tadalafil, a PDE5 inhibitor, act as mild vasodilators. When mild vasodilators are taken in combination, blood pressure–lowering effects of each individual compound may be increased. Substantial consumption of alcohol (e.g., 5 units or greater) in combination with ALYQ™ can increase the potential for orthostatic signs and symptoms, including increase in heart rate, decrease in standing blood pressure, dizziness, and headache. Tadalafil (10 mg or 20 mg) did not affect alcohol plasma concentrations and alcohol did not affect tadalafil plasma concentrations. [see CLINICAL PHARMACOLOGY].

CYP3A Inhibitors/Inducers

Ritonavir

Ritonavir initially inhibits and later induces CYP3A, the enzyme involved in the metabolism of tadalafil. At steady state of ritonavir (about 1 week), the exposure to tadalafil is similar as in the absence of ritonavir [see DOSAGE AND ADMINISTRATION and CLINICAL PHARMACOLOGY].

Potent Inhibitors Of CYP3A

Tadalafil is metabolized predominantly by CYP3A in the liver. In patients taking potent inhibitors of CYP3A such as ketoconazole, and itraconazole, avoid use of ALYQ™ [see CLINICAL PHARMACOLOGY].

Potent Inducers Of CYP3A

For patients chronically taking potent inducers of CYP3A, such as rifampin, avoid use of ALYQ™ [see CLINICAL PHARMACOLOGY].

Read the entire FDA prescribing information for Alyq (Tadalafil Tablets)