Tadalafil / Testosterone Mini-Troche

Daily Use (Ship Cold)

Available Dosage Strengths

2 mg /1 mg | 5 mg /2 mg

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Disclaimer: Images are for reference only; actual products may vary.

Product Overview

Description

Tadalafil^1,2

Tadalafil, a phosphodiesterase type 5 (PDE5) inhibitor, has a mean terminal half-life of over 17 hours. This half-life is much longer than other PDE-5 inhibitors (sildenafil, vardenafil). This half-life allows for once-daily or on-demand dosing. The drug is indicated for the treatment of pulmonary arterial hypertension (PAH), erectile dysfunction (ED), benign prostatic hypertrophy (BPH), or the concurrent treatment of ED and BPH.

Testosterone^3-6

Micronized testosterone (natural) is derived from plants, most commonly, yams. This starting material undergoes a synthetic process to bioidentical testosterone. Unlike injectable testosterone, free testosterone is metabolized rapidly after absorption, requiring more frequent administration opposed to the weekly-monthly injections (cypionate, enanthate etc…). It is used commonly to treat male

Mechanism of Action

Tadalafil^1-2,7

Phosphodiesterase (PDE) has many isoforms and is an enzyme that has many functions in the body including degrading the effect of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP). PDE5 is an enzyme that is found in many parts of the body including in the smooth muscle of the corpus cavernosum, prostate, bladder, the vascular and visceral smooth muscle, skeletal muscle, urethra, platelets, kidney, lung, cerebellum, heart, liver, testis, seminal vesicle, and pancreas. Tadalafil is a selective inhibitor of PDE5, the enzyme responsible for the degradation of cGMP. The drug has selective activity on PDE5 than other phosphodiesterase isoforms. Tadalafil activity on PDE5 is more than 10,000-fold more than for PDE1, PDE2, PDE4, and PDE7 enzymes. Increased cGMP leads to smooth muscle relaxation in the corpus cavernosum which can help in maintaining an erection.

Testosterone^3-6

Testosterone binds to androgen receptors in various tissues, exerting anabolic and androgenic effects. These effects include the development and maintenance of male secondary sexual characteristics, stimulation of muscle and bone growth, and regulation of libido and mood in both men and women.

Adverse Reactions

Common

Tadalafil^1,2

Headache
Dyspepsia
Flushing
Back pain and myalgia (typically delayed onset, resolving within 48 hours)
Nasal congestion
Pain in limbs

Testosterone³

Acne
Hypertension
Mood swings or irritability
Increased or decreased libido
Gynecomastia

Contraindications & Precautions

Contraindications^1,2,4,5

Known hypersensitivity to tadalafil or testosterone or excipients used
Use of nitrates and guanylate cyclase (GC) stimulators therapy, such as riociguat due to risk of life-threatening hypotension
Males with carcinoma of the breast or known or suspected carcinoma of the prostate
Pregnant or breastfeeding women
Patients with serious cardiac, hepatic, or renal disease

Precautions^1,2,4,5

Use with caution in patients with:
Severe hepatic impairment (Child-Pugh Class C)
Severe renal impairment (creatinine clearance <30 mL/min)
Retinitis pigmentosa (rare inherited retinal disorder)
History of NAION (non-arteritic anterior ischemic optic neuropathy)
Recent history of myocardial infarction, stroke, or unstable angina
Monitor hematocrit and hemoglobin levels
Regularly assess liver function tests
Evaluate lipid profiles periodically

Storage

Store at 20°C to 25°C (68°F to 77°F). Protect from light, moisture, and heat.

References

Tadalafil Prescribing Information – Eli Lilly. www.accessdata.fda.gov/drugsatfda_docs/label/2011/021368s20s21lbl.pdf Revised October 2011. Accessed May 31, 2025
Clinical Pharmacology Tadalafil clinical monograph 2025 https://www.clinicalkey.com/pharmacology/
Clinical Pharmacology Testosterone clinical monograph accessed June 17 2025 ; https://www.clinicalkey.com/pharmacology/monograph/595?n=Testosterone
Tauchen J, Jurášek M, Huml L, Rimpelová S. Medicinal Use of Testosterone and Related Steroids Revisited. Molecules. 2021 Feb 15;26(4):1032. doi: 10.3390/molecules26041032. PMID: 33672087; PMCID: PMC7919692.
AndroGel (testosterone gel 1.62% for topical use) [package insert] AbbVie US LLC , revised May 2013, accessed June 2025 through: https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/021015s036lbl.pdf https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/085635s040lbl.pdf
Clayton AH, Goldstein I, Kim NN, Althof SE, Faubion SS, Faught BM, Parish SJ, Simon JA, Vignozzi L, Christiansen K, Davis SR, Freedman MA, Kingsberg SA, Kirana PS, Larkin L, McCabe M, Sadovsky R. The International Society for the Study of Women’s Sexual Health Process of Care for Management of Hypoactive Sexual Desire Disorder in Women. Mayo Clin Proc. 2018 Apr;93(4):467-487. doi: 10.1016/j.mayocp.2017.11.002. Epub 2018 Mar 12. PMID: 29545008.
Padda IS, Tripp J. Phosphodiesterase Inhibitors. [Updated 2023 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025

Disclaimer

This sheet is a summary. It may not cover all possible drug information about this product. Call your doctor for medical advice and/or about side effects. You may report side effects to the FDA at 1-800-FDA-1088. A Wells Pharmacy Network pharmacist will be happy to answer any questions. For consultation, please call 1-800-622-4510.