ADCIRCA 20 mg film-coated tablets

ATC Code
ADCIRCA 20 mg film-coated tablets

Eli Lilly Nederland B.V.

Narcotic Psychotropic
No No
Pharmacological group Urologicals


All to know


Eli Lilly Nederland B.V.

What is it?

Adcirca is a medicine that contains the active substance tadalafil. It is available as orange, almond-shaped tablets (20 mg).

What is it used for?

Adcirca is used to treat adults with pulmonary arterial hypertension (PAH) to improve exercise capacity (the ability to carry out physical activity). PAH is abnormally high blood pressure in the arteries of the lungs. Adcirca is used in patients with class II or III disease. The ?class? reflects the seriousness of the disease: ?class II? involves slight limitation of physical activity and ?class III? involves marked limitation of physical activity. Adcirca has been shown to be effective in PAH with no identified cause and in PAH caused by collagen vascular disease.
The medicine can only be obtained with a prescription.


How is it used?

Adcirca treatment should only be started and monitored by a doctor who has experience in the treatment of PAH.
Adcirca is taken as two tablets (40 mg) once a day, with or without food. Patients with mild or moderate kidney or liver problems should start with a lower dose, but this can be increased if necessary depending on the patient?s response. Adcirca is not recommended for patients with severe kidney or liver problems.

How does it work?

PAH is a debilitating disease where there is severe constriction (narrowing) of the blood vessels of the lungs. It causes high blood pressure in the vessels taking blood from the heart to the lungs. This pressure reduces the amount of oxygen that can get into the blood in the lungs, making physical activity more difficult. The active substance in Adcirca, tadalafil, belongs to a group of medicines called ?phosphodiesterase type 5 (PDE5) inhibitors?, which means that it blocks the PDE5 enzyme. This enzyme is found in the blood vessels of the lungs. When the enzyme is blocked, a substance called ?cyclic guanosine monophosphate? (cGMP) cannot be broken down and remains in the vessels

1 Previously known as Tadalafil Lilly. where it causes the relaxation and widening of the blood vessels. In patients with PAH, Adcirca widens the blood vessels of the lungs, which lowers the blood pressure and improves symptoms.

How has it been studied?

Four doses of Adcirca (2.5, 10, 20 and 40 mg once a day) have been compared with placebo (a dummy treatment) in one main study involving 406 patients with PAH, most of whom had class II or class III disease that was of unknown cause or caused by collagen vascular disease. The main measure of effectiveness was the change in the distance the patients could walk in six minutes after 16 weeks of treatment. This is a way of measuring the change in exercise capacity.

What benefits has it shown during the studies?

Adcirca was more effective than placebo at improving exercise capacity. Before treatment, the patients could walk an average of 343 metres in six minutes. After 16 weeks, this distance had increased by 26 metres more in the patients taking 40 mg Adcirca than in the patients taking placebo.

What is the risk associated?

The most common side effects with Adcirca (seen in more than 1 patient in 10) are headache, flushing (reddening of the skin), nasopharyngitis (inflammation of the nose and throat) including a blocked or runny nose and blocked sinuses, nausea (feeling sick), dyspepsia (heartburn) including stomach ache, myalgia (muscle pain), back pain and pain in the extremities (arms, hands, legs and feet). For the full list of all side effects reported with Adcirca, see the Package Leaflet.
Adcirca should not be used in people who may be hypersensitive (allergic) to tadalafil or any of the other ingredients. It must not be used in patients who have had an acute myocardial infarction (sudden heart attack) with the last three months, or who have severe hypotension (low blood pressure). Adcirca must not be taken with nitrates (a group of medicines used to treat angina). It must not be used in patients who have ever had loss of vision because of a problem called non-arteritic anterior ischemic optic neuropathy (NAION) that affects the blood flow to the nerve in the eye.

Why has it been approved?

The Committee for Medicinal Products for Human Use (CHMP) decided that Adcirca?s benefits are greater than its risks and recommended that it be given marketing authorisation.

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