Finasteride:

• For Male Pattern Baldness: Take 1 mg daily, with or without food. It may take several months to see noticeable results in hair growth. Consistency is key.
  
  
• For Benign Prostatic Hyperplasia (BPH): Take 5 mg daily, with or without food. This may help improve urinary symptoms over time, such as frequent urination or difficulty urinating.
  
  

Tadalafil:

• For Erectile Dysfunction: Take 10 mg about 30 minutes before sexual activity. Depending on how well you tolerate the medication, your doctor may adjust the dose to 5 mg (for daily use) or 20 mg. Do not take more than one dose per day.
  
  
• For Benign Prostatic Hyperplasia (BPH): Take 5 mg daily, with or without food.
  
  
• For Pulmonary Arterial Hypertension (PAH): Take 40 mg daily (usually split into two doses of 20 mg each).
  
  

General Instructions:

• Follow prescribed dosages: It’s important not to exceed the prescribed dosage of either medication.
  
  
• Regular follow-ups: If you’re using these medications for a prolonged period, your doctor may want to monitor your progress and check for any side effects.
  
  

Finasteride:

Finasteride works by inhibiting the enzyme 5-alpha reductase, which converts testosterone into dihydrotestosterone (DHT). By blocking DHT, Finasteride reduces its harmful effects on the prostate and hair follicles:

• Hair Growth: In the case of male pattern baldness, lower DHT levels prevent the shrinking of hair follicles, which is responsible for thinning and hair loss.
  
  
• Prostate Shrinkage: In BPH, DHT contributes to prostate enlargement. Finasteride helps to shrink the prostate by lowering DHT levels.
  
  

Tadalafil:

Tadalafil works by inhibiting the enzyme phosphodiesterase type 5 (PDE5), which regulates the flow of blood in the penis. When PDE5 is inhibited, nitric oxide (a natural chemical) increases in the body, leading to relaxation of the muscles in the blood vessels, allowing more blood to flow into the penis. This results in an erection when a man is sexually stimulated.

For BPH, tadalafil works by relaxing the muscles of the prostate and bladder, easing the passage of urine.

Finasteride:

While Finasteride is generally well-tolerated, some men may experience side effects:

• Sexual side effects: Reduced libido, erectile dysfunction, and decreased semen volume are the most common side effects. These side effects are usually temporary and resolve after stopping the medication, but they can persist in some cases.
  
  
• Breast changes: Rarely, Finasteride can cause tenderness or enlargement of the breast tissue in men.
  
  
• Depression or mood changes: Some men may experience mood changes, including depression, while on Finasteride.
  
  

Tadalafil:

Tadalafil also has some side effects, though many people tolerate it well:

• Headaches: One of the most common side effects of tadalafil.
  
  
• Indigestion: Tadalafil may cause discomfort or acid reflux.
  
  
• Back pain and muscle aches: Some men report muscle pain, particularly in the back and legs.
  
  
• Dizziness or lightheadedness: Especially when standing up quickly.
  
  
• Vision changes: Rarely, tadalafil can cause changes in vision, such as blurred vision or a blue tint.
  
  

Serious side effects are rare but can include priapism (a prolonged erection) or a sudden loss of vision. Seek immediate medical attention if you experience these symptoms.

• Finasteride: Should not be used by women, especially if pregnant, due to the risk of birth defects. It can be absorbed through the skin, so women should avoid handling crushed or broken tablets.
  
  
• Tadalafil: Should not be taken with nitrates (medications used to treat chest pain) as it can cause a dangerous drop in blood pressure. Additionally, caution is needed in men with cardiovascular issues or those taking blood pressure medications.
  
  

Both: These medications should be used under the supervision of a healthcare provider, especially in older adults or those with other health conditions, to avoid complications.

• Finasteride and Tadalafil generally have no direct interactions with each other, and they can be used together to treat both erectile dysfunction and benign prostatic hyperplasia (BPH).
  
  
• Tadalafil: When used with other medications that lower blood pressure (such as nitrates for heart problems), tadalafil can cause a dangerous drop in blood pressure. Always inform your doctor if you’re taking any blood pressure medication.
  
  
• Finasteride: There are no major interactions with tadalafil, but always inform your doctor if you’re using any other medications for prostate health or hair loss.
  
  

The standard dosage guidelines are as follows:

• Finasteride:
  
  
  • Male pattern baldness: 1 mg once daily.
    
    
  • Benign prostatic hyperplasia (BPH): 5 mg once daily.
    
    
• Tadalafil:
  
  
  • Erectile dysfunction: 10 mg as needed before sexual activity (maximum 20 mg per day).
    
    
  • Benign prostatic hyperplasia (BPH): 5 mg once daily.
    
    

Pulmonary Arterial Hypertension: 40 mg once daily, split into two 20 mg doses.

Both Finasteride and Tadalafil require a prescription from a healthcare provider. Before prescribing these medications, your doctor will evaluate your health condition and determine if they are appropriate for your needs. Be honest about your symptoms and medical history to ensure the best treatment.

• What is Finasteride and Tadalafil used for?
  It is used to treat benign prostatic hyperplasia (BPH) — also known as enlarged prostate — and may improve:

  • Urinary symptoms (difficulty urinating, weak stream, frequent urination)

  • Sexual function, when erectile dysfunction (ED) is also present
    Some men also take this combination for prostate enlargement plus hair loss.

• What are the brand names?

  • Entadfi® — an FDA-approved combination of Finasteride 5 mg and Tadalafil 5 mg in one capsule (for BPH).

  • Finasteride and tadalafil can also be prescribed separately as Proscar® / Propecia® (Finasteride) and Cialis® (Tadalafil).

• What are the active ingredients?

  • Finasteride: a 5-alpha-reductase inhibitor (shrinks prostate).

  • Tadalafil: a phosphodiesterase type-5 (PDE-5) inhibitor (relaxes smooth muscle to improve urine flow and erections).

• How does this combination work?

  • Finasteride reduces DHT (dihydrotestosterone), shrinking the prostate over time.

  • Tadalafil relaxes smooth muscle in the prostate and bladder, improving urinary symptoms more quickly.

  • Together, they address both the size and the function of the prostate, and may help sexual performance.

• What type of medication is it?
  A combination of a hormonal agent (Finasteride) and a PDE-5 inhibitor (Tadalafil) for urinary and sexual health.

• How is Finasteride and Tadalafil taken?

  • Orally, once daily, with or without food.

  • Take at the same time each day, preferably in the evening.

  • Swallow whole — do not crush or chew.

• What are the available strengths?

  • Entadfi capsules: Finasteride 5 mg / Tadalafil 5 mg.

  • Components can also be prescribed separately in various strengths.

• How long does it take to work?

  • Tadalafil: Improves urinary flow and erections within a few days to weeks.

  • Finasteride: Shrinks prostate and relieves BPH symptoms in 3–6 months.

  • Combination: May show noticeable results in 1–3 months, with continued improvement over time.

• What are the common side effects?

  • Headache (from tadalafil)

  • Dizziness

  • Nasal congestion

  • Back or muscle pain

  • Decreased libido or ejaculation changes (from finasteride)

• Are there serious side effects?
  Rare, but possible:

  • Allergic reaction (rash, swelling, trouble breathing)

  • Priapism (erection lasting >4 hours) — emergency condition

  • Vision or hearing changes (sudden)

  • Depression or mood changes (rare)

  • Low blood pressure, especially with nitrates or alpha-blockers

• Who should not take this combination?

  • Women or children (not approved for use).

  • Men taking nitrates or guanylate cyclase stimulators (risk of severe hypotension).

  • Patients with severe liver or kidney disease without doctor supervision.

  • Pregnant women must not handle finasteride tablets — risk of birth defects in male fetuses.

• Can it be used for erectile dysfunction?
  Yes — Tadalafil component helps improve ED, and the combo is ideal for men with BPH + ED.

• Can it be used for hair loss?
  Only Finasteride 1 mg is approved for hair loss.
  Tadalafil is not indicated for this purpose but can be safely taken if prescribed for other reasons.

• Can I drink alcohol while taking it?
  Limit alcohol — excessive use can increase dizziness or worsen erectile dysfunction.

• Can it be used during pregnancy or breastfeeding?

  • Not for use in women.

  • Pregnant women should avoid handling crushed or broken finasteride tablets.

• Does it interact with other medications?
  Yes — especially with:

  • Nitrates (e.g., nitroglycerin) – causes dangerous blood pressure drop.

  • Alpha-blockers (e.g., tamsulosin) – may cause dizziness.

  • Antifungal and antibiotic drugs (ketoconazole, clarithromycin) – increase tadalafil levels.

  • HIV protease inhibitors – may raise tadalafil concentration.

• How should I store it?
  Store at room temperature (20 °C–25 °C / 68 °F–77 °F), away from heat and moisture.

• Is there a generic available?

  • Finasteride and Tadalafil are available generically as separate medications.

  • The combination Entadfi® is brand only (as of now).

• Where can I buy it?
  Available by prescription only at pharmacies.