Entadfi
Entadfi is a combination of two medications: finasteride (a 5-alpha-reductase inhibitor) and tadalafil (a phosphodiesterase-5 (PDE-5) inhibitor). It's FDA-approved to treat benign prostatic hyperplasia (BPH), also known as an enlarged prostate, in adult males. Entadfi (finasteride / tadalafil) comes as a capsule that's taken by mouth once per day for up to 6 months. Side effects include changes in sex drive and headache. Rarely, this medication can also lower your blood pressure.
What is Entadfi (finasteride / tadalafil)?
What is Entadfi (finasteride / tadalafil) used for?
Enlarged prostate (benign prostatic hyperplasia, or BPH)
How Entadfi (finasteride / tadalafil) works
Entadfi (finasteride / tadalafil) is a combination of two medications that work together to treat the signs and symptoms of BPH.
Finasteride is a 5-alpha-reductase inhibitor. It slows the growth and enlargement of the prostate gland by blocking the body from making a form of testosterone called DHT.
Tadalafil is a phosphodiesterase-5 (PDE-5) inhibitor. The way tadalafil treats BPH isn't well-understood. But it's thought that Entadfi (finasteride / tadalafil) can help relax certain muscles and blood vessels near the bladder and prostate, which can improve blood flow to the prostate gland. It's also suggested that tadalafil helps lower prostate gland inflammation, which helps relieve BPH symptoms.
Drug Facts
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What are the side effects of Entadfi (finasteride / tadalafil)?
Common Side Effects
- Erectile dysfunction or impotence (up to 8%)
- Lower sex drive (up to 6%)
- Abnormal ejaculation (up to 4%)
- Headache (4%)
- Indigestion (2%)
- Back pain (2%)
- Nasal congestion (2%)
Other Side Effects
- Breast enlargement
- Breast tenderness
- Rash
- Muscle aches
- Diarrhea
- Pain in arm or leg
- Dizziness
Serious Side Effects
- Severely low blood pressure: dizziness, lightheadedness, feeling faint
- Heart problems (e.g., heart attack, stroke): chest pain; dizziness; difficulty breathing; sudden numbness in one arm, leg, or one side of the face; confusion; trouble speaking
- Erection lasting longer than 4 hours
- Serious allergic reactions: hives; wheezing; difficulty breathing; swelling of face, mouth, tongue, or throat; rash; peeling or blistering skin
Source: DailyMed
Pros and cons of Entadfi (finasteride / tadalafil)
Pros
Starts to work within a month
Taken once per day
Convenient to take two medications in a single pill
Cons
Can cause dizziness, which might raise the risk for falls
Not a long-term treatment, can take for up to 6 months
Can't take with nitrates, like isosorbide mononitrate (Monoket) or nitroglycerin (Nitrostat), due to risk of severely low blood pressure
Pharmacist tips for Entadfi (finasteride / tadalafil)
Entadfi (finasteride / tadalafil) can lower your blood pressure. If you're taking Entadfi (finasteride / tadalafil) along with other medications that can lower your blood pressure even more, make sure to check your blood pressure regularly. Be very careful getting up from a sitting or lying down position since this can make you feel dizzy and more likely to fall.
Contact your prescriber if you notice any changes in vision or hearing loss while taking Entadfi (finasteride / tadalafil) so they can check for eye or hearing problems. Some people have reported these problems during treatment.
Tadalafil in Entadfi can have serious interactions with some medications. Your prescriber might need to adjust the dose of your medications, including Entadfi (finasteride / tadalafil), while other medications might need to be stopped completely. Tell your care team about all of the medications you're taking, including over-the-counter products and herbal supplements. Don't start taking any new medications without talking to your prescriber or pharmacist first.
It's best to avoid drinking alcohol while taking Entadfi (finasteride / tadalafil). Alcohol can lower your blood pressure. This can lead to dizziness or lightheadedness, which can raise your risk of falls and injury. If you drink alcohol regularly and it's difficult for you to stop, talk with your prescriber about what's a safer amount to drink while taking Entadfi (finasteride / tadalafil).
Females who are able to become pregnant shouldn't handle open or crushed Entadfi (finasteride / tadalafil) capsules because the medication can cause harm to babies.
Frequently asked questions about Entadfi (finasteride / tadalafil)
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What are the risks and warnings for Entadfi (finasteride / tadalafil)?
Entadfi (finasteride / tadalafil) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Not recommended in people with current or past heart problems
Risk factors: Currently have a heart condition | Heart failure or stroke within the past 6 months | Heart attack within the last 3 months | Chest pain during sexual intercourse | Heart rhythm problems | Blood pressure that's not under control | Taking a nitrate medication at the same time
Entadfi (finasteride / tadalafil) isn't recommended for people with certain heart conditions, such as heart failure or stroke within the past 6 months, heart attack within the last 3 months, and uncontrolled irregular heart rhythm. It's not known if Entadfi (finasteride / tadalafil) is safe or works well in people with these heart problems because the medication wasn't studied in them. Talk to your prescriber if you have a heart condition to see if Entadfi (finasteride / tadalafil) is right for you.
Serious medication interaction
Don't take Entadfi (finasteride / tadalafil) if you're taking a nitrate medication, such as nitroglycerin (Nitro-Dur) patch. This is because the tadalafil in Entadfi can interact with nitrate medications, and result in dangerously low blood pressure. If you need to take a nitrate medication for a life-threatening chest pain, you must wait at least 2 days after your last dose of Entadfi (finasteride / tadalafil) before you can do so. If you experience chest pain, call for medical help right away and let your medical team know when you last took Entadfi (finasteride / tadalafil).
Low blood pressure
Risk factors: Taking alpha blockers | Taking medications for high blood pressure or chest pain (angina) | Drinking alcohol
Entadfi (finasteride / tadalafil) can lower your blood pressure. Taking Entadfi (finasteride / tadalafil) with other medications) that can also do so can cause your blood pressure to drop even more and lead to fainting. It's recommended to avoid taking Entadfi (finasteride / tadalafil) together with blood pressure medications or alpha blockers, such as prazosin (Minipress), doxazosin (Cardura), and terazosin. If you're taking an alpha blocker for BPH, stop taking the alpha blocker at least 1 day before you start Entadfi (finasteride / tadalafil). Also avoid drinking a lot of alcohol while taking this medication. Additionally, it's important that you don't take Entadfi (finasteride / tadalafil) together with nitrates or guanylate cyclase stimulators due to the risk of a severe and life-threatening drop in blood pressure.
Risk of prostate cancer
Risk factors: Males aged 55 years and older | Prostate surface antigen (PSA) level less than or equal to 3 ng/mL
Taking medications with finasteride, including Entadfi, might raise your risk of prostate cancer. The risk might be higher for people older than 55 years of age and older and with a prostate-specific antigen (PSA) level at 3 ng/mL or lower. Your prescriber will screen you for prostate cancer before and during therapy with
Entadfi (finasteride / tadalafil).
Harm to unborn male babies
Pregnant females shouldn't handle crushed or opened Entadfi (finasteride / tadalafil) capsules due to potential exposure and risk to unborn male babies (i.e., abnormal development of reproductive organs). If a pregnant female comes into contact with crushed or broken contents of Entadfi (finasteride / tadalafil) capsules, have them wash the contact area immediately with soap and water and contact their obstetrician-gynecologist right away.
Prolonged erection
Risk factors: Peyronie's disease | Penile fibrosis | Sickle cell anemia | Certain cancers (e.g., multiple myeloma, leukemia)
Though rare, it's possible for you to have an erection lasting more than 4 hours (called priapism) while taking Entadfi (finasteride / tadalafil). This can sometimes be painful and can potentially cause long-lasting damage to your penis, including permanent erectile dysfunction. Get medical help right away if this happens.
Vision changes
Get medical help right away if you suddenly notice changes in your vision in one or both eyes because this can cause permanent eye damage. If you have a history of eye problems, talk to your prescriber before starting Entadfi (finasteride / tadalafil) to make sure it's safe for you.
Hearing loss
Some people taking Entadfi (finasteride / tadalafil) have reported developing sudden hearing loss. This can happen along with ringing in the ears (tinnitus) and dizziness. Get medical help if you notice changes in your hearing in one or both ears.
Entadfi (finasteride / tadalafil) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 5mg/5mg | 30 capsules | $553.20 | $18.44 |
Typical dosing for Entadfi (finasteride / tadalafil)
Each capsule of Entadfi contains 5 mg of finasteride and 5 mg of tadalafil.
The typical dose is 1 capsule by mouth once daily around the same time each day, for up to 6 months.
How much does Entadfi (finasteride / tadalafil) cost?
Entadfi (finasteride / tadalafil) contraindications
Taking Entadfi (finasteride / tadalafil) together with nitrates or guanylate cyclase stimulators
Pregnancy (not approved for use in females)
What are alternatives to Entadfi (finasteride / tadalafil)?
Enlarged prostate (benign prostatic hyperplasia, or BPH)
Difficulty urinating caused by an enlarged prostate (benign prostatic hyperplasia, BPH)
High blood pressure
Enlarged prostate (benign prostatic hyperplasia, BPH)
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References
Best studies we foundPeixoto, C. A., et al. (2015). The role of phosphodiesterase-5 inhibitors in prostatic inflammation: A review. Journal of Inflammation.
Veru Inc. (2023). Entadfi- finasteride and tadalafil capsule [package insert]. DailyMed.
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