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Cialis/Tadalafil alongside Zoladex ADT

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User
Posted 20 May 2024 at 16:48

In advance of radiation treatment, I have been started on ADT; daily Bicalutamide tablets so far but I was due to start Zoladex implants very soon, to potentially continue for 2 years. Information from multiple sources online, says that taking low-dose (2.5mg or 5mg) Cialis (generic Tadalifil in the UK) daily thoughout and beyond the ADT is a sensible step to prevent long-term erectile issues. It's also mentioned on this thread here..
https://community.prostatecanceruk.org/posts/t26748-ADT-RT-and-ED

However the NHS refuse to give me anything preventative, and will only give me pills or pumps etc once I already have ED problems. By then it's too late, I want the pills up-front. I do not currently have any ED issues.

I have said that I won't start Zoladex until they can give me Tadalafil alongside it, but I was told that the consultant said that this would be like giving someone anti-biotics who didn't have any infection. I don't agree with this analogy at all. I've also said that I don't mind paying for the drug as from what I've seen on dubious websites, it's not that expensive for the low-dose drug. I've seen that you can get an over-the-counter version of Cialis from Boots, but that's about £5 per 10mg tablet (so maybe £2.50 per day). That seems a bit much, but I suppose not outrageous.

Does anyone else have experience of Cialis alongside ADT or views on its necessity?

User
Posted 20 May 2024 at 17:51

I took Tadalafil during salvage RT with Bicalutamide. I was already on it following my prostatectomy. I would say that post SRT my ED is slightly worse than it was beforehand. So whether the Tadalafil made any difference, it's hard to say.

User
Posted 20 May 2024 at 19:28
I had RT (37 sessions) and Zoladex for 3 yrs (together with 2 yrs abiraterone and enzalutimide on trial). I didn't have any medication related to ' anti ED', didnt know it was a thing. I was 59 when treatment started. Obviously the Zoladex knocked everything out via lack of libido, but once Zoladex finished, allowing for fairly lengthy recovery time, no problems with ED etc, no aids needed.

Peter

User
Posted 20 May 2024 at 20:28

Hi Radical Rob,

I haven't had Radiotherapy or ADT, (only prostatectomy), so I can't comment on how effective Tadalafil would be for you, but in my opinion, it's worth a try.  As for the doctor saying it's like giving you anti-biotics without evidence of an infection, it seems to be par for the course that you will get loss of libido (and presumably E.D.) with Hormone Therapy, so the analogy doesn't seem right to me.

I had to wait for 5 months after my surgery before I actually received a vacuum pump and the consensus seems to be that that is too long to wait before commencing penile rehab.  So why should you wait for E.D. to become an issue?

If it were me, I would buy Tadalafil online.  They are usually cheaper than Boots (whose prices are almost always higher than elsewhere).  For penile rehab., 5 mg. is considered sufficient, so you could split a 20mg. tablet into 4, which would save money.

Best wishes,

JedSee.

User
Posted 20 May 2024 at 22:10

I initially asked my GP for Tadalafil and came away with a prescription for four Viagra tablets. However, he did say that he would prescribe Tadalafil if instructed by my medical team. My nurse specialist kindly wrote to the surgery. I got a repeat prescription for 20 mg Tadalafil (two per week). I was really wanting the 5 mg per day therapeutic dose but 20 mg (which is an event dose) was better than nothing. I used to break the tablets in half and take one every other day. They are film coated tablets so you are not really meant to split them. It has certainly helped with the ED but they do cause me acid reflux. If they do help with ED prevention during RT. It is worth pursuing it.

User
Posted 21 May 2024 at 05:50

It is 2yrs on since my surgery and I have tried everything from the injection to the VED pump and everything else in between. I was prescribed the 20mg Tadalafil, which is more of an event dose at around 6mths post surgery. I also broke it into 4 pieces and tried to take them daily, but did not see an improvement, I must add I was not consistent. On my last visit to the andrologist, I mentioned the possibility of being prescribed the 5mg daily dose, he said he would,sadly nothing was sent to my gp. 

I now order the 5mg dose from UKmeds.com, it costs around £30 for a months supply. I use the 5mg daily and the 20mg dose as required or every 2/3 days.

One thing I have realised on this journey especially as it pertains to recovery, whether it is ED and/or incontinence is being proactive and being on the front foot. The NHS is great, but the wheels can be sometimes slow to turn. Which is why I did not wait until I was issued with a medical grade pump, I went and bought one myself.

2yrs on, I do wake up with a semi-erection, don't get to use it though or test it, but at least it is there.😁😁

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User
Posted 20 May 2024 at 17:51

I took Tadalafil during salvage RT with Bicalutamide. I was already on it following my prostatectomy. I would say that post SRT my ED is slightly worse than it was beforehand. So whether the Tadalafil made any difference, it's hard to say.

User
Posted 20 May 2024 at 19:28
I had RT (37 sessions) and Zoladex for 3 yrs (together with 2 yrs abiraterone and enzalutimide on trial). I didn't have any medication related to ' anti ED', didnt know it was a thing. I was 59 when treatment started. Obviously the Zoladex knocked everything out via lack of libido, but once Zoladex finished, allowing for fairly lengthy recovery time, no problems with ED etc, no aids needed.

Peter

User
Posted 20 May 2024 at 20:28

Hi Radical Rob,

I haven't had Radiotherapy or ADT, (only prostatectomy), so I can't comment on how effective Tadalafil would be for you, but in my opinion, it's worth a try.  As for the doctor saying it's like giving you anti-biotics without evidence of an infection, it seems to be par for the course that you will get loss of libido (and presumably E.D.) with Hormone Therapy, so the analogy doesn't seem right to me.

I had to wait for 5 months after my surgery before I actually received a vacuum pump and the consensus seems to be that that is too long to wait before commencing penile rehab.  So why should you wait for E.D. to become an issue?

If it were me, I would buy Tadalafil online.  They are usually cheaper than Boots (whose prices are almost always higher than elsewhere).  For penile rehab., 5 mg. is considered sufficient, so you could split a 20mg. tablet into 4, which would save money.

Best wishes,

JedSee.

User
Posted 20 May 2024 at 20:49

Originally Posted by: Online Community Member
I had RT (37 sessions) and Zoladex for 3 yrs (together with 2 yrs abiraterone and enzalutimide on trial). I didn't have any medication related to ' anti ED', didnt know it was a thing. I was 59 when treatment started. Obviously the Zoladex knocked everything out via lack of libido, but once Zoladex finished, allowing for fairly lengthy recovery time, no problems with ED etc, no aids needed.
Peter

This is definitely good to know! There's hope 😊

Over 3 years as well. From everything I saw, it said the muscles atrophe if there's nothing going on down there for such a long time, and so it never really recovers. Also the RT affects the blood vessels and the Cialis helps keep everything flowing

User
Posted 20 May 2024 at 20:51

Originally Posted by: Online Community Member

I took Tadalafil during salvage RT with Bicalutamide. I was already on it following my prostatectomy. I would say that post SRT my ED is slightly worse than it was beforehand. So whether the Tadalafil made any difference, it's hard to say.

Sounds like you had a rough time of it, sorry to hear. Yeah I can imagine with so much treatment it would deteriorate, but every little helps and if the Tadalafil is there, why not take the precaution. Were you prescribed it, or had to get it yourself?

User
Posted 20 May 2024 at 20:54

Originally Posted by: Online Community Member

Hi Radical Rob,

I haven't had Radiotherapy or ADT, (only prostatectomy), so I can't comment on how effective Tadalafil would be for you, but in my opinion, it's worth a try.  As for the doctor saying it's like giving you anti-biotics without evidence of an infection, it seems to be par for the course that you will get loss of libido (and presumably E.D.) with Hormone Therapy, so the analogy doesn't seem right to me.

I had to wait for 5 months after my surgery before I actually received a vacuum pump and the consensus seems to be that that is too long to wait before commencing penile rehab.  So why should you wait for E.D. to become an issue?

If it were me, I would buy Tadalafil online.  They are usually cheaper than Boots (whose prices are almost always higher than elsewhere).  For penile rehab., 5 mg. is considered sufficient, so you could split a 20mg. tablet into 4, which would save money.

Best wishes,

JedSee.

Yeah I'd prefer to use anything that might help rather than do nothing, and it's not a dangerous drug in such a low dose and I've got no other conditions or meds.

The Boots version is different to the prescribed version, but I haven't looked into the details yet. When you say "online", the sites I was looking at still have some online doctor signing off on things and sounds like it goes on your medical record. I've no experience with it. Is that the kind of thing you mean?

User
Posted 20 May 2024 at 21:51

Originally Posted by: Online Community Member
Hi Radical Rob,

I haven't had Radiotherapy or ADT, (only prostatectomy), so I can't comment on how effective Tadalafil would be for you, but in my opinion, it's worth a try.  As for the doctor saying it's like giving you anti-biotics without evidence of an infection, it seems to be par for the course that you will get loss of libido (and presumably E.D.) with Hormone Therapy, so the analogy doesn't seem right to me.

 

Yeah I'd prefer to use anything that might help rather than do nothing, and it's not a dangerous drug in such a low dose and I've got no other conditions or meds.

The Boots version is different to the prescribed version, but I haven't looked into the details yet. When you say "online", the sites I was looking at still have some online doctor signing off on things and sounds like it goes on your medical record. I've no experience with it. Is that the kind of thing you mean?

I bought some Spedra from Lloyds Pharmacy Online Doctor last year.  I originally asked for Viagra but the doctor went through my other medication and suggested the Spedra instead.  I was quite impressed with the service and it certainly didn’t appear on my NHS records. I’d be suprised if a private doctor can access your records without permission.

I’m currently 5 weeks post RP.  Immediately after the surgery I was started on 5mg of Tadalafil which resulted in successful morning erections after a couple of weeks.  I was then reduced to 2.5mg due to a potential reaction with other medications and things are now distinctly more flaccid.  I’m going to ask if I can go back to 5mg to try and improve things again.  On the plus side I was sent a vacuum pump only a week or so after surgery. Although the instructions say that you shouldn’t use it until 6 weeks after surgery I couldn’t resist giving it a gentle try.  It is quite effective although all of the rubber cock rings seem very tight and I’m certainly no more than average size at best.

Edited by member 20 May 2024 at 21:59  | Reason: shocking spelling

User
Posted 20 May 2024 at 22:10

I initially asked my GP for Tadalafil and came away with a prescription for four Viagra tablets. However, he did say that he would prescribe Tadalafil if instructed by my medical team. My nurse specialist kindly wrote to the surgery. I got a repeat prescription for 20 mg Tadalafil (two per week). I was really wanting the 5 mg per day therapeutic dose but 20 mg (which is an event dose) was better than nothing. I used to break the tablets in half and take one every other day. They are film coated tablets so you are not really meant to split them. It has certainly helped with the ED but they do cause me acid reflux. If they do help with ED prevention during RT. It is worth pursuing it.

User
Posted 21 May 2024 at 05:50

It is 2yrs on since my surgery and I have tried everything from the injection to the VED pump and everything else in between. I was prescribed the 20mg Tadalafil, which is more of an event dose at around 6mths post surgery. I also broke it into 4 pieces and tried to take them daily, but did not see an improvement, I must add I was not consistent. On my last visit to the andrologist, I mentioned the possibility of being prescribed the 5mg daily dose, he said he would,sadly nothing was sent to my gp. 

I now order the 5mg dose from UKmeds.com, it costs around £30 for a months supply. I use the 5mg daily and the 20mg dose as required or every 2/3 days.

One thing I have realised on this journey especially as it pertains to recovery, whether it is ED and/or incontinence is being proactive and being on the front foot. The NHS is great, but the wheels can be sometimes slow to turn. Which is why I did not wait until I was issued with a medical grade pump, I went and bought one myself.

2yrs on, I do wake up with a semi-erection, don't get to use it though or test it, but at least it is there.😁😁

User
Posted 21 May 2024 at 11:47

Originally Posted by: Online Community Member

It is 2yrs on since my surgery and I have tried everything from the injection to the VED pump and everything else in between. I was prescribed the 20mg Tadalafil, which is more of an event dose at around 6mths post surgery. I also broke it into 4 pieces and tried to take them daily, but did not see an improvement, I must add I was not consistent. On my last visit to the andrologist, I mentioned the possibility of being prescribed the 5mg daily dose, he said he would,sadly nothing was sent to my gp. 

I now order the 5mg dose from UKmeds.com, it costs around £30 for a months supply. I use the 5mg daily and the 20mg dose as required or every 2/3 days.

One thing I have realised on this journey especially as it pertains to recovery, whether it is ED and/or incontinence is being proactive and being on the front foot. The NHS is great, but the wheels can be sometimes slow to turn. Which is why I did not wait until I was issued with a medical grade pump, I went and bought one myself.

2yrs on, I do wake up with a semi-erection, don't get to use it though or test it, but at least it is there.😁😁

Good info, thanks. I have ordered some now via Pharmica. It seemed easy enough but I did tick the box to have it inform my GP. Will see what happens. I only ordered the 2.5mg dose to begin with, I can always double it if/when I think I need more.

 
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