How to get? Kaeberlein mentioned
It seems like it could be way cheaper
My Urologist suggested it to me. Any General Practice Physician can give you a prescripton.
On it for 3 + years.
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Cheap from US pharmacies if you see a doctor and get a prescription:
Or cheap from the regular Indian pharmacies if you donāt want to see a doctor:
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You can get it from Amazon health telehealth without insurance for cheap.
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For longevity, neurodegenerative decline, Iāve favored Tadalafil, mostly due to those indications theoretically wanting a continuous serum/brain level. Tadalafil has the advantage of a 18 hr half life - so once a day dosing will provide excellent coverage for that goal - whereas Sildenafil has a 4 hr half life - so youād need to be very frequently dosing to achieve a good level 24/7.
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āTadalafil has the advantage of a 18 hr half life - so once a day dosing will provide excellent coverage for that goalā
I agree, but I am going to be very pi$$ed if the molecular difference between tadalafil and sildenafil favors sildenafil as a life extender. There is currently more evidence for sildenafil and we are just speculating that tadalafil may have the same or better results.
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I agree that we have some information in that area. Iām going to be doing my research and write up on that topic on my blog in another couple of weeks, with a focus on neurocognitive decline. Iāve not thoroughly reviewed the evidence yet, but absolutely agree that there are some indicators of sildenafil having advantages. I however would think the main issue is nitric oxide generation and neuroinflammation reduction. This should be a drug class effect, not an affect of the molecular makeup of the drug - should be on drug activity.
Going to dig in on this in a couple of weeks and sort out where I think the best middle ground is.
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Is there any research that indicates whether similar potential longevity/neuroprotective benefits may also apply to women using Taladafil?
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Its interestingā¦ the studies Iāve seen so far have all been population-based retrospective association studies. Obviously, since Tadalafil is a ED drug, not too many women are in that sample. I suspect specific studies looking at this issue would need to be conducted.
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I wouldnāt anticipate that for neurodegenerative disease that things that work for men wouldnāt work for women. As much as we donāt have great data on that, for the present time, Iām not making any delineation on what I offer patients in this area based on gender (except type of HRT).
Yes - itāll likely go as a no evidence zone - but on a risk/benefit, I offer it to such patients currently.
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Thank you very much for the helpful response, Dr.Fraser. Do you also prescribe it to patients that donāt experience neurodegenerative disease or (noticeable) cognitive decline, and from what age?
Iām wondering what doses are we should be looking at in such situations, and whether we should adjust dose based on age.
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As a general principle - not as advice for you in particular ā¦ once you have disease, much more difficult to reverse or stabilize than avoiding disease.
I guess, with no evidence at all, Iām going to go with Dr. Greenās approach with ApoE status and Rapa start time ā¦ but furthermore, looking at the graph showing other ApoE subtypes and likelihood of not having Alz Dementia ā¦ Iām more in line with everyone considering treatment - possibly with ApoE2/E2 less prioritized.
Individuals considering speculative treatment certainly need to be consented to risk/benefit and the lack of certainty.
I donāt think Iād start the combination of therapy for decreasing risk of neurocognitive decline for someone in their 30ās (maybe an ApoE4/E4 who was super worried at age 35), but at 40 years old, might be a reasonable timing.
Anyone looking at this should consider a consult or be very up to date on the options, pros-cons, etc. Preferably see a specialist who offers these options and reviews everything properly.
Thatās my current thinking. It is a work in progress for sure.
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Thank you very much. Definitely food for thought.
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My cardiologist prescribed Tidalafil to me without hesitation.
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I recently read somewhere, and I canāt remember where, that regular Tadalafil use can adversely affect the field of vision. I had this vision test coming up, so I stopped taking Tadalafil (2.5 mg/day) for the time being Does anyone know about this possible side effect?
Quote from a good review on this:
The most common visual symptoms that have been linked to PDE5 inhibitors include changes in color perception characterized by a blue tinge to the environment and changes in brightness perception, usually in the form of increased sensitivity to light 3, 13, 18, 19. These symptoms occur in 3ā11% of men taking sildenafil 25ā100 mg [13], 0.3ā2% of vardenafil 20, 21, and 0.1% of tadalafil users [22]. These symptoms are mild, doseādependent, and completely reversible.
So only 1 in 1,000 tadalafil users ā¦ and fully reversible with cessation.
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Thank you for the reply and the article link. I will carefully read the article.
@AlexKChen Iād imagine Hims is the easiest route. Thatās where I get my finasteride, and I also got fluoxetine from there once (no longevity evidence for that one, I just wanted to experiment with it). You literally just answer a few questions on their website, and boom, youāve got a prescription.
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I got a prescription for 5mg daily cialis from my urologist no problems
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Dr. Green, who I think is one of the best readers of the research Iāve ever been around, suggests tadalafil. I asked him specifically which was more effective, Cialis or Viagra, and he said that he thinks Cialis is better.
Take that for what itās worth, but Alan Green and Matt Kaeberlein are the people in this space I trust the most. Also Dr Green has patients he is treating and monitoring so itās not just a hypothetical for him.
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