Tastylia 20 Mg (Tadalafil)

What is Tastylia 20 mg?

• Tastylia 20 is a prescription medicine for erectile dysfunction.
• It treats ED in adult men only.
• Each strip contains 20 mg of tadalafil IP.
• Healing Pharma India Pvt Ltd, Mumbai, manufactures it.
• It is an orally disintegrating strip, often shortened to ODS.
• The strip is thin and dissolves on the tongue in seconds.
• No water is needed to take it.
• Tadalafil belongs to the PDE-5 inhibitor drug class.
• The same molecule is sold worldwide as Cialis.
• Tadalafil is often called ‘the weekend pill’ because of its long action.
• A single dose can improve erectile function for up to 36 hours.
• Healing Pharma also makes a 10 mg strength in this range.

What it does, and what it does not do

• It helps a man get and keep an erection during sexual stimulation.
• It does not produce an erection on its own.
• Sexual arousal is always required for the medicine to work.
• It does not increase sexual desire or libido.
• It does not change the size or shape of the penis.
• It is not a hormone, an aphrodisiac, or a fertility treatment.
• It manages ED symptoms. It does not cure the condition.
• It is not for women or for anyone under 18 years.
• It gives no protection against HIV or other sexually transmitted infections.

Regulatory status, stated for accuracy

• Tadalafil is an approved molecule in India, the US, the UK and the EU.
• This product is not approved by the FDA, the EMA or the MHRA.
• Tadalafil appears in FDA-approved medicines. This product is not one of them.
• Buy only from a licensed pharmacy against a valid prescription.

How It Works (Mechanism of Action)

The erection pathway, step by step:

1. Sexual stimulation releases nitric oxide (NO) from nerves and vessel lining.
2. Nitric oxide triggers production of cyclic guanosine monophosphate (cGMP).
3. cGMP relaxes the smooth muscle of the penile arteries and corpus cavernosum.
4. Relaxed muscle allows more blood to flow into the penis.
5. The enzyme PDE-5 normally breaks cGMP down.
6. Tadalafil inhibits PDE-5, so cGMP levels stay higher.
7. Blood flow improves and the erection becomes firmer and longer-lasting.

What the strip format actually does

• The strip dissolves in the mouth, so no water is needed.
• The dissolved medicine is then swallowed with saliva.
• Absorption happens in the gut, as it does with a tablet.
• Tadalafil is practically insoluble in water.
• It therefore cannot be absorbed through the mouth lining in any real quantity.
• The strip solves a swallowing problem, not an absorption problem.
• That is a genuine benefit. It is just a different benefit than speed.

Key pharmacology points

• Tadalafil has no effect without sexual stimulation.
• It is over 10,000 times more selective for PDE-5 than PDE-3.
• PDE-3 is found in the heart and blood vessels.
• It is 700 times more selective for PDE-5 than PDE-6.
• PDE-6 sits in the retina. This is why colour vision changes are rare.
• Colour vision changes were reported in under 0.1 percent of patients.
• Tadalafil also inhibits PDE-11, found in muscle and prostate.
• The clinical meaning of PDE-11 inhibition is not defined.

Absorption and clearance

• Figures below are for the approved tadalafil tablet.
• No published absorption data exists for a tadalafil oral strip.
• Peak blood level occurs between 30 minutes and 6 hours.
• The median time to peak level is 2 hours.
• Food does not affect the rate or extent of absorption.
• The mean terminal half-life is 17.5 hours.
• About 94 percent of tadalafil in blood is bound to proteins.
• The liver clears it, mainly through the enzyme CYP3A4.
• About 61 percent leaves in the faeces and about 36 percent in urine.

Dosage Guide

A doctor must set the dose. This table reflects approved tadalafil labelling.

Patient group or use	Starting dose	Maximum dose	Frequency	Which product fits?
ED, adult men new to tadalafil	10 mg	20 mg	Once in 24 hours	Start with Tastylia 10
ED, men already tolerating 10 mg	20 mg	20 mg	Once in 24 hours	Tastylia 20. This is the fit.
ED, once daily use	2.5 mg	5 mg	Once every day	Neither. Needs a 5 mg product.
BPH symptoms	5 mg	5 mg	Once every day	Neither. Needs a 5 mg product.
Kidney: CrCl 30-50 mL/min	5 mg	10 mg	Once in 48 hours	Tastylia 10 at most
Kidney: CrCl under 30 or dialysis	5 mg	5 mg	Once in 72 hours	Neither. Needs a 5 mg product.
Liver: mild or moderate	Doctor decides	10 mg	Once in 24 hours	Tastylia 10 at most
Liver: severe (Child-Pugh C)	Not recommended	Not recommended	Not applicable	Neither. Do not use.
On potent CYP3A4 inhibitors	Doctor decides	10 mg	Once in 72 hours	Tastylia 10 at most
Men over 65	No change for age alone	As above	As above	Depends on other factors
Women, children, under-18s	Not indicated	Not indicated	Not applicable	Neither. Not for these groups.

How to Take It

Step-by-step:

1. Confirm your dose and suitability with a registered doctor.
2. Check the sachet seal and the printed expiry date.
3. Dry your hands before handling the strip.
4. Peel the strip out carefully. It is thin and tears easily.
5. Place the whole strip on your tongue.
6. Let it dissolve completely. Do not chew or spit it out.
7. Swallow normally once it has dissolved. Water is optional.
8. Take it at least 30 minutes before planned sexual activity.
9. Take it with or without food. Food makes no difference.
10. Allow sexual stimulation to occur. Arousal is essential.
11. Use one strip only. Never take a second within 24 hours.

Timing and the 36-hour window

• A 20 mg dose improved erectile function up to 36 hours after dosing.
• In one trial, 52 percent of men on 20 mg succeeded within 30 minutes.
• On placebo the figure was 35 percent.
• At the 36-hour mark, 64 percent of the 20 mg group succeeded at least once.
• On placebo the figure was 37 percent.
• You do not need to plan sex around the dose within this window.
• Onset speed varies between individuals. Allow time for it to work.
• Any claim of a 5-hour duration is wrong. The figure is 36 hours.

Missed doses

• As-needed use has no schedule, so there is no missed dose.
• Never take two strips to make up for one.
• Never take extra strips to get a stronger effect.
• If you take too much, go to a hospital emergency department.

Precautions

Absolute contraindications (never use)

• Any organic nitrate, in any form, regular or occasional.
• Examples: nitroglycerin, isosorbide mononitrate, isosorbide dinitrate.
• Recreational nitrite ‘poppers’, including amyl nitrite.
• Guanylate cyclase stimulators such as riociguat.
• Known serious allergy to tadalafil, in any brand.
• Known allergy to any flavouring or film ingredient in the strip.
• Men for whom sexual activity is unsafe due to heart disease.
• Severe liver impairment (Child-Pugh C).
• Use in women, or in anyone under 18 years of age.

Conditions to disclose to your doctor

• Heart attack within the last 90 days.
• Unstable angina, or angina that occurs during sexual intercourse.
• Heart failure of NYHA Class 2 or greater in the last 6 months.
• Uncontrolled irregular heartbeat, or uncontrolled high blood pressure.
• Low blood pressure below 90/50 mmHg.
• Stroke within the last 6 months.
• Narrowing of the aortic valve, or other outflow obstruction.
• A curved or deformed penis, such as Peyronie’s disease.
• Any past erection lasting more than 4 hours.
• Sickle cell anaemia, multiple myeloma, or leukaemia.
• Retinitis pigmentosa or other inherited retinal disease.
• Any past severe vision loss, especially NAION.
• Bleeding disorders, or an active stomach ulcer.
• Liver disease, kidney disease, or dialysis treatment.
• Any mouth ulcers or sores, which may affect strip comfort.
• All current medicines, including herbal and over-the-counter products.

Food and drink precautions

• Food does not affect how tadalafil is absorbed.
• You may take the strip with or without a meal.
• Avoid grapefruit and grapefruit juice. It likely raises tadalafil levels.
• Keep alcohol low. Both alcohol and tadalafil widen blood vessels.
• Five or more alcohol units with tadalafil can drop blood pressure.
• This can bring dizziness, headache and a faster heart rate on standing.
• At a lower alcohol dose, this effect was not observed.
• Alcohol also worsens erectile response on its own.
• Avoid recreational drugs, especially nitrite poppers.

Before-use safety checklist

1. Do I hold a valid prescription from a registered doctor?
2. Has my doctor confirmed that 20 mg is the right strength for me?
3. If this is my first time, should I be starting at 10 mg instead?
4. Have I confirmed that I take no nitrate medicine of any kind?
5. Am I free of poppers and of riociguat?
6. Has my doctor confirmed my heart can handle sexual activity?
7. Have I given my doctor a full list of my medicines?
8. Have I declared any liver, kidney, eye or blood conditions?
9. Is the sachet sealed, undamaged, and within its expiry date?
10. Has it been more than 24 hours since my last dose?
11. Do I understand that tadalafil stays active for up to 36 hours?
12. Do I know the emergency warning signs in Section 8?

Side Effects

Common side effects

Rates below are from as-needed tadalafil trials versus placebo.

Side effect	Placebo	Tadalafil 10 mg	Tadalafil 20 mg
Headache	5%	11%	15%
Indigestion (dyspepsia)	1%	8%	10%
Back pain	3%	5%	6%
Muscle pain (myalgia)	1%	4%	3%
Blocked nose	1%	3%	3%
Flushing	1%	3%	3%
Pain in an arm or leg	1%	3%	3%

• Most common effects are mild and settle on their own.
• 3.1% of men on tadalafil stopped due to side effects, versus 1.4% on placebo.
• Headache and indigestion are more common at 20 mg than at 10 mg.
• This is one reason the label starts men at 10 mg.

Understanding the back and muscle pain

• Back pain or muscle pain usually starts 12 to 24 hours after the dose.
• It typically clears within 48 hours.
• It is felt as a diffuse ache in the lower back, buttocks or thighs.
• Lying down tends to make it worse.
• Most reports were mild or moderate. Severe pain was uncommon.
• Paracetamol or an anti-inflammatory usually helped.
• Only about 0.5 percent of men stopped treatment because of it.
• Testing found no muscle, kidney or inflammatory damage behind it.

Less common and rare side effects

Body system	Reported effects
Heart and circulation	Chest pain, palpitations, fast heartbeat, low blood pressure, fainting
Serious cardiovascular (rare)	Heart attack, sudden cardiac death, stroke
Eyes	Blurred vision, colour vision change, eye pain, eyelid swelling, conjunctivitis
Eyes (rare, serious)	NAION, visual field defect, retinal vein or artery occlusion
Ears	Ringing in the ears, sudden decrease or loss of hearing
Nervous system	Dizziness, vertigo, insomnia, numbness, migraine, seizure, transient amnesia
Digestive	Dry mouth, nausea, vomiting, reflux, gastritis, abnormal liver blood tests
Musculoskeletal	Joint pain, neck pain, muscle spasm
Urinary and genital	Prolonged erection, priapism, spontaneous erection, renal impairment
Respiratory	Shortness of breath, nosebleed, sore throat
Skin and allergy	Rash, itching, sweating, hives
Skin (rare, serious)	Stevens-Johnson syndrome, exfoliative dermatitis

Drug Interactions – Avoid With

Risk level	Drug or substance	What happens
NEVER COMBINE	All organic nitrates: nitroglycerin, isosorbide mono/dinitrate	Severe, possibly fatal blood pressure drop
NEVER COMBINE	Nitrite poppers: amyl nitrite	Severe, possibly fatal blood pressure drop
NEVER COMBINE	Riociguat and other guanylate cyclase stimulators	Blood pressure may fall to an unsafe level
NEVER COMBINE	Other PDE-5 inhibitors: sildenafil, vardenafil	No added benefit; blood pressure falls further
NEVER COMBINE	Other tadalafil products, including any lung-pressure brand	Accidental double dosing
DOSE ADJUSTMENT NEEDED	Ketoconazole 400 mg daily	Exposure rises 312%; ceiling is 10 mg per 72 hours
DOSE ADJUSTMENT NEEDED	Ritonavir 200 mg twice daily	Exposure rises 124%; ceiling is 10 mg per 72 hours
DOSE ADJUSTMENT NEEDED	Itraconazole and other potent CYP3A4 inhibitors	Ceiling is 10 mg. Use Tastylia 10 at most.
USE WITH CAUTION	Alpha-blockers: doxazosin, tamsulosin, alfuzosin	Dizziness, fainting, symptomatic low blood pressure
NOT RECOMMENDED	Alpha-blockers, when treating BPH	Combination not adequately studied for BPH
USE WITH CAUTION	Blood pressure medicines and angiotensin II receptor blockers	Additional fall of roughly 8/4 mmHg
USE WITH CAUTION	Alcohol, 5 units or more	Dizziness, headache, orthostatic low blood pressure
REDUCED EFFECT	Bosentan	Tadalafil exposure falls
REDUCED EFFECT	Rifampicin	Tadalafil exposure falls by 88 percent
REDUCED EFFECT	Carbamazepine, phenytoin, phenobarbital	Tadalafil exposure likely falls
MINOR	Antacids	Absorption slows, but total exposure is unchanged
MINOR	Grapefruit juice (raises levels)	May increase side effects

• Tadalafil did not significantly affect warfarin, midazolam or digoxin.
• Tadalafil did not increase the bleeding time caused by aspirin.
• This list is not complete. Show your doctor every medicine you take.

Emergency Warning Signs

Stop the medicine and get emergency medical care if any of these occur:

• An erection lasting more than 4 hours, whether painful or not.
• Untreated priapism can cause irreversible damage to erectile tissue.
• Sudden loss of vision in one or both eyes.
• Sudden decrease or loss of hearing, with or without ringing.
• Chest pain, pressure, or pain spreading to the arm, neck or jaw.
• Chest pain or dizziness during sex. Stop the activity at once.
• Fainting, or severe dizziness on standing.
• Slurred speech, facial droop, or one-sided weakness.
• Swelling of the lips, tongue, face or throat.
• Swelling in the mouth or throat after the strip dissolves.
• A widespread rash with blistering or peeling skin.
• A seizure.

Why Choose Tastylia 20 mg

Handled honestly, separating what holds up from what does not.

What genuinely holds up

• No water needed. The strip dissolves on the tongue.
• A practical option for men who dislike or struggle with swallowing tablets.
• Useful for anyone with a swallowing difficulty.
• Strips are thin, flat and discreet to carry.
• Each strip is pre-measured, so no dose counting is needed.
• 20 mg is the approved maximum for on-demand use, not above it.
• A 10 mg version exists, so the dose can be stepped properly.
• Tadalafil offers the longest action of the common ED medicines.
• Its effect lasts up to 36 hours.
• Food and normal meals do not affect absorption.
• Tadalafil worked across mild, moderate and severe ED.
• It worked in men with diabetes-related ED.
• It worked in men after nerve-sparing radical prostatectomy.
• In one US trial, maintenance of erection rose from 23% to 64%.
• The manufacturer publishes its own product information.

What does not hold up

• The strip does not bypass the stomach. Tadalafil barely dissolves in water.
• It cannot cross the mouth lining in meaningful quantity.
• No published study shows the strip acts faster than a tablet.
• It does not last 5 hours. The approved figure is 36 hours.
• It does not increase penis size or sex drive.
• It is not FDA-approved, though the molecule inside it is.

Storage Instructions

• Store in a cool, dry place, below 30 °C.
• The tadalafil label gives 25 °C, with excursions from 15 to 30 °C.
• Keep each strip in its sealed foil sachet until use.
• Moisture matters more for a strip than for a tablet.
• A strip exposed to humidity may stick, tear or dissolve early.
• Protect from direct sunlight and heat.
• Do not refrigerate and do not freeze.
• Do not store in a bathroom cabinet or a parked car.
• Do not carry a loose strip in a wallet or pocket.
• Keep out of the sight and reach of children.
• A flavoured strip may look appealing to a child. Store it securely.
• Do not use a strip that is torn, damp, discoloured or stuck together.
• Do not use after the printed expiry date.
• Dispose of unused medicine through a pharmacy take-back scheme.
• Never share this medicine with another person.

Medical Disclaimer

• This content is for general information only.
• It does not replace advice from a qualified doctor or pharmacist.
• Tadalafil is a prescription-only medicine.
• Do not self-prescribe or change a dose without medical advice.
• Do not claim the strip bypasses the stomach or acts faster than a tablet.
• Do not claim a 5-hour duration, size increase, or libido effect.
• This product is not approved by the FDA, the EMA or the MHRA.
• Always read the leaflet supplied with the product you receive.