ADCIRCA can be used in all functional classes of PAH. Studies establishing effectiveness included predominately patients with NYHA Functional Class II–III symptoms and etiologies of idiopathic or heritable PAH (61%) or PAH associated with connective tissue diseases (23%).2
First-line therapy for PAH
ADCIRCA® (tadalafil) is a phosphodiesterase 5 inhibitor (PDE-5i) indicated for the treatment of pulmonary arterial hypertension (PAH) (WHO Group 1) to improve exercise ability.
Studies establishing effectiveness included predominately patients with NYHA Functional Class II–III symptoms and etiologies of idiopathic or heritable PAH (61%) or PAH associated with connective tissue diseases (23%).
Patients taking ADCIRCA increased their 6-minute walk distance by an average of 33 meters (108 feet) after 16 weeks of treatment.2,3
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What is PAH?
PAH is a rare, life-threatening disease in which chronically elevated pressure in the pulmonary arteries causes progressive strain on the right ventricle of the heart. PAH causes narrowing of the smallest pulmonary arteries, elevating blood pressure within them to dangerously high levels.
Learn MoreThis document includes some of the most important information you should know about ADCIRCA, how to take ADCIRCA properly, common side effects, and more.
For answers to common questions about ADCIRCA
ADCIRCA is an inhibitor of phosphodiesterase 5 (PDE-5), the enzyme responsible for the degradation of cyclic guanosine monophosphate (cGMP). PAH is associated with the impaired release of nitric oxide by the vascular endothelium in the pulmonary vasculature. Inhibition of PDE-5 by tadalafil increases the concentrations of cGMP, resulting in relaxation of pulmonary vascular smooth muscle cells and vasodilation of the pulmonary vascular bed.2
ADCIRCA is the only phosphodiesterase 5 inhibitor (PDE-5i) approved for PAH with once-daily dosing. The recommended starting and maintenance dose for most patients for ADCIRCA is 40 mg (two 20-mg tablets). ADCIRCA can be taken with or without food. Dividing the 40-mg dose for ADCIRCA over the course of the day is not recommended.2
Tadalafil is metabolized predominately by CYP3A in the liver. Use of ADCIRCA with potent CYP3A inhibitors, such as ketoconazole and itraconazole, should be avoided. For patients on ADCIRCA therapy that require treatment with ritonavir, ADCIRCA should be discontinued at least 24 hours prior to starting ritonavir. For patients on ritonavir therapy that require treatment with ADCIRCA, start ADCIRCA at 20 mg once a day. Use of ADCIRCA with potent inducers of CYP3A, such as rifampin, should be avoided.2
The use of ADCIRCA is not recommended for patients with severe renal or hepatic impairment. Please see Full Prescribing Information for dosing recommendations for patients with mild to moderate renal or hepatic impairment.2
Resources
United Therapeutics is committed to helping patients with PAH. Please click on the link above for resources that can help you support your patients beginning treatment with ADCIRCA.
ADCIRCA® (tadalafil) is a phosphodiesterase 5 inhibitor (PDE-5i) indicated for the treatment of pulmonary arterial hypertension (PAH) (WHO Group 1) to improve exercise ability. Studies establishing effectiveness included predominately patients with NYHA Functional Class II–III symptoms and etiologies of idiopathic or heritable PAH (61%) or PAH associated with connective tissue diseases (23%).
References
- Data on file, June 2016.
- ADCIRCA [package insert]. Indianapolis, IN: Eli Lilly and Company; 2020.
- Galiè N, Brundage BH, Ghofrani HA, et al; on behalf of the Pulmonary Arterial Hypertension and Response to Tadalafil (PHIRST) Study Group. Tadalafil therapy for pulmonary arterial hypertension.Circulation. 2009;119(22):2894-2903.