Refeel

Quick links to important sections

Refeel

Medically reviewed

Marina Burgos

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Refeel

Property Description
Active ingredient Tadalafil (INN)
Form Film-coated tablet
Pharmacological class Selective Phosphodiesterase type 5 (PDE5) inhibitor
General purpose To promote localized smooth muscle relaxation and enhanced blood flow
Origin Synthetic compound

Refeel: Identity, Active Composition, and Classification

Refeel is a prescription-only medication whose pharmacological activity comes from its single active substance, Tadalafil (INN). Tadalafil is a fully synthetic compound derived from the pyrazinopiperazinone chemical structure. It belongs to the therapeutic group of selective Phosphodiesterase type 5 (PDE5) inhibitors, a classification that defines its fundamental role in influencing blood vessel dynamics.

A characteristic of Tadalafil is its notably prolonged elimination half-life, which dictates a more sustained period of physiological activity compared to other agents in the same class.

Drug Form and General Purpose

Refeel is manufactured as a film-coated tablet designed for oral administration, utilizing solid pharmaceutical excipients to deliver the precise dose of Tadalafil. Its composition is defined by the sole active ingredient, focusing on the systemic delivery of the agent. The general purpose of Refeel is linked directly to its physiological action: promoting smooth muscle relaxation within blood vessel walls. This selective action serves to improve localized blood flow and tissue perfusion, an effect recognized for addressing conditions where enhanced circulation is required.

What side effects are possible with Refeel?

Possible Side Effects and Safety Information

Refeel, containing Tadalafil, has a documented safety profile established by regulatory agencies. The following information, including adverse reactions and official safety constraints, is based strictly on governmental regulatory sources and their approved prescribing information.


Officially Documented Adverse Reactions

The most frequently reported adverse effects are often related to the medication’s physiological action. Side effects are classified by frequency and associated System-Organ Class (SOC) groupings found in regulatory documents.

Frequency Classification Common Adverse Reactions (Selected Examples) Affected System-Organ Class (SOC)
Very Common (≥ 1/10) Headache Nervous System Disorders
Common (≥ 1/100 to < 1/10) Flushing, Dyspepsia, Back pain, Myalgia, Nasal congestion Vascular, Gastrointestinal, Musculoskeletal
Uncommon (≥ 1/1,000 to < 1/100) Hypersensitivity reactions, Dizziness, Palpitations, Blurred vision Immune System, Nervous System, Cardiac, Eye

Serious Adverse Reactions and Regulatory Constraints

Specific serious risks and safety constraints are highlighted in official labeling:

  • Serious Adverse Reactions: Rare events documented include Priapism (prolonged erection), Non-arteritic Anterior Ischemic Optic Neuropathy (NAION) (sudden vision loss), sudden decrease or loss of hearing, and serious cardiovascular events such as Myocardial Infarction and Stroke.
  • Contraindications: Use is strictly contraindicated in patients concurrently using any form of organic nitrate or guanylate cyclase (GC) stimulators (e.g., riociguat). The medicine is also contraindicated for patients with specific severe, recent cardiovascular events.
  • Population Safety: Use is not recommended for patients with severe renal impairment or severe hepatic impairment due to potential increases in drug exposure. Caution is advised for patients with conditions predisposing them to Priapism (e.g., sickle cell anemia) or with anatomical deformation of the penis.

Overdose and Emergency Response

Overdose from Refeel (Tadalafil) is officially documented as resulting from the exaggeration of known adverse events. Clinical manifestations observed in trials involving high single doses were similar to those at therapeutic levels but occurred with increased frequency and severity. Documented symptoms include severe headache, myalgia (muscle pain), dyspepsia (indigestion), nasal congestion, and pronounced flushing. The drug’s potent vasodilatory action also poses a risk for transient decreases in blood pressure (hypotension).

Certain manifestations require immediate regulatory-mandated action. If an erection lasts four hours or more (priapism), the official label requires users to seek immediate medical attention or emergency treatment. Failure to do so may result in irreversible damage to the erectile tissue. Furthermore, official prescribing information instructs users to stop the medication and consult a physician immediately upon experiencing sudden loss of vision or sudden decrease or loss of hearing.

Management procedures stated in regulatory documents confirm that treatment relies on standard supportive measures. Due to Tadalafil's pharmacokinetic profile, hemodialysis contributes negligibly to its elimination. Patients with pre-existing severe renal or severe hepatic impairment are noted to be at a heightened risk of increased drug exposure, which is an important consideration in an overdose scenario.

Therapeutic Uses of Refeel

What Refeel Treats: Main Uses and Benefits

Refeel (Tadalafil) is commonly used in situations involving certain distressing symptoms across multiple therapeutic domains, primarily focusing on conditions where functional stability may be affected. In various clinical settings, the medication is applied across domains where additional symptomatic support is needed.

Enhanced Functional Support for Erectile Impairment

The medication is commonly used to help manage symptoms related to physical discomfort and functional impairment, specifically the inability to get or keep an erection. The therapeutic benefit supports the handling of distressing manifestations, which provides support that may help maintain a sense of stability for adult men.


Symptomatic Relief for Lower Urinary Tract Discomfort

Refeel is considered relevant for easing symptom clusters associated with prostate enlargement, such as difficulty urinating and increased nocturnal frequency. It can contribute to improved comfort during symptomatic periods by addressing symptoms linked to organ-specific functional stress.


Improving Exercise Capacity in Pulmonary Conditions

The medication is applied for Pulmonary Arterial Hypertension (PAH) to address systemic imbalance and symptoms that interfere with daily functioning, such as breathlessness, providing supportive relief that helps patients cope more steadily with symptom fluctuations.


Quick Fact: Addressing Symptoms of Functional Limitations Refeel is commonly used in settings where short-term symptom stabilization is important, and may assist with maintaining functional stability and providing supportive relief when symptoms interfere with routine activities.

Regulatory References

  1. NIH MedlinePlus Drug Information

Eligibility and Restrictions for Use

Refeel's eligibility is determined by specific exclusions and restrictions defined in official government regulatory documents. It is permitted for use in adult males for all labeled indications and in adult males and females for the treatment of Pulmonary Arterial Hypertension (PAH).

Absolute Contraindications (Must Not Use)

Refeel is strictly contraindicated (prohibited) for patients with the following conditions or co-administered drugs, due to potential for severe reactions:

  • Patients taking any form of organic nitrate (e.g., nitroglycerin).
  • Patients using a Guanylate Cyclase (GC) Stimulator (e.g., riociguat).
  • Patients who have experienced Non-arteritic Anterior Ischaemic Optic Neuropathy (NAION), resulting in vision loss.
  • Patients with specific recent or unstable cardiovascular events, including Myocardial Infarction within the last 90 days or Stroke within the last 6 months.
  • Patients with uncontrolled hypotension (low blood pressure) or uncontrolled hypertension (high blood pressure).

Age and Physiological Restrictions

Population Group Eligibility Status (Regulatory Label)
Pediatric Patients (Under 18) Use is not indicated; safety and effectiveness not established.
Geriatric Patients (Over 65) Generally eligible; no dose adjustment required based on age alone.
Severe Hepatic Impairment Use not recommended due to insufficient data.
Severe Renal Impairment Use not recommended for once-daily dosing.
Pregnancy/Lactation Avoid use; not indicated for use by women for male-specific conditions.

What should I know about interactions with other medicines?

Refeel Interactions with other medicines and products

The interaction profile of Refeel (Tadalafil) is defined by its potential for pharmacodynamic potentiation and its metabolism via the CYP3A4 enzyme system.

Classification Interaction Type / Entity
Contraindicated Combinations Organic Nitrates, Guanylate Cyclase (GC) Stimulators.
Pharmacokinetic Alteration CYP3A4 Inhibitors (Increase Tadalafil exposure); CYP3A4 Inducers (Decrease Tadalafil exposure).
Pharmacodynamic Potentiation Alpha-Blockers, Antihypertensives, substantial Alcohol consumption (ge 5 units).

Official regulatory documents establish two classes of prohibited combinations due to the risk of additive hypotensive effects. Co-administration with any form of Organic Nitrates is strictly forbidden; administration of nitrates must be avoided for at least 48 hours following the last dose of Tadalafil. Similarly, co-use with GC Stimulators such as riociguat is contraindicated.

Substances that inhibit the CYP3A4 metabolic pathway, such as ketoconazole and ritonavir, increase Tadalafil's systemic exposure (AUC), while CYP3A4 inducers like rifampicin decrease exposure. Furthermore, co-administration with Alpha-Blockers (e.g., doxazosin) or other antihypertensives may result in an additive blood pressure lowering effect. The potential for orthostatic symptoms is increased with the consumption of substantial amounts of alcohol. Increased exposure to Tadalafil is observed in individuals with severe renal or hepatic impairment, which heightens the risk for interaction-related effects.

Mechanism of Action

Refeel (Tadalafil) acts at the molecular level as a selective inhibitor of the Phosphodiesterase type 5 ( PDE5) enzyme. This key action prevents the enzyme from hydrolyzing the crucial second messenger molecule, cyclic Guanosine Monophosphate ( cGMP), thereby preserving its concentration within the targeted cells.

This mechanism is integrated into the native Nitric Oxide ( NO) - cGMP signaling pathway, operating as an enhancer rather than an initiator. By preventing cGMP degradation, Refeel amplifies this natural physiological signal, sustaining a cascade that results in the activation of Protein Kinase G ( PKG).

Activated PKG facilitates the reduction of intracellular Ca^2+ availability and the dephosphorylation of myosin light chains. This cellular event directly causes the relaxation of vascular smooth muscle cells. The resulting physiological change, known as vasodilation, is the mechanism for adjustment of local blood flow distribution and increased localized tissue perfusion.

Dosage and Administration Information

How to Use Refeel: Official Administration Guidelines

Refeel (Tadalafil) is administered through the oral route as a film-coated tablet, following standardized dosing patterns. The official usage protocol is defined by two primary administration schedules, which dictate the appropriate dose and frequency.


Dosing Regimens and Frequency

The instructions differentiate between continuous, daily use and intermittent, as-needed use:

  • Once-Daily Dosing: This regimen requires a lower dose, starting at 2.5 mg up to a maximum of 5 mg, taken once every day at approximately the same time. This pattern is typically employed for continuous management regimens.
  • As-Needed Dosing: The starting dose is 10 mg, adjustable between 5 mg and a maximum of 20 mg. This higher dosage is intended for intermittent use and must be taken at least 30 minutes prior to the anticipated activity, with the maximum frequency being once per day. This regimen is not intended for continuous, daily administration.

Procedural and Population Constraints

The tablet must be swallowed whole and can be administered with or without food. Specific constraints apply to certain populations and concomitant medications as defined for the pharmaceutical agent:

  • Severe Organ Impairment: Use is generally not recommended in patients with severe hepatic impairment. For severe renal impairment, the maximum as-needed dose is limited to 5 mg every 72 hours; daily use is not recommended.
  • PAH Regimen: The dose for Pulmonary Arterial Hypertension (40 mg) must be taken as a single dose and is not to be divided over the course of the day.

These instructions detail the standardized procedures for administration, ensuring the medicine is used according to precise specifications.

Recent Clinical Evidence

Research Evidence / Overview of Studies for Refeel

Research evidence concerning Refeel (Tadalafil) includes data derived from randomized, placebo-controlled clinical trials, systematic reviews, and meta-analyses. This evidence contributes to understanding the agent's influence across three distinct areas, focusing on how symptoms and functional capacity were observed to change during the study periods.


Evidence for Functional Support in Erectile Impairment

Research examined the agent in adult men experiencing the inability to achieve or keep an erection. These evaluations were primarily conducted as short-term, randomized, double-blind, placebo-controlled trials. These studies monitored outcomes related to changes in functional status, which were measured using patient-reported scores describing functional metrics, such as scores from the International Index of Erectile Function (IIEF) and records of attempts at sexual activity.

Evidence for Symptomatic Relief in Lower Urinary Tract Discomfort

Refeel was studied for its application in adult men experiencing urinary symptoms (LUTS) related to prostate enlargement (BPH). Research examined the agent's application through intermediate-term, randomized, placebo-controlled trials. Studies used the International Prostate Symptom Score (IPSS) to assess whether changes in symptoms reflecting daily functioning were observed. Trials reported that administration of the active agent was associated with observed differences in the IPSS total score relative to placebo.


Evidence for Improving Exercise Capacity in Pulmonary Conditions

Refeel was evaluated in trials involving adult patients (men and women) with Pulmonary Arterial Hypertension (PAH), focusing on conditions marked by functional limitations. The primary outcome measured was the 6-Minute Walk Distance (6MWD), a standardized functional measure used in research settings. Studies reported measured differences in the 6MWD in the active treatment groups compared to placebo.

What is Still Uncertain About Refeel

Current evidence provides context but not individual predictions, and certain questions about the research remain open. Key limitations include the generally limited long-term data focusing on the durability of the agent's observed effects across all three indications. Comparative evidence is lacking for direct head-to-head comparisons against all alternative treatments in both PAH and BPH-LUTS. The evidence quality varies across studies, and findings for certain secondary endpoints or specific populations remain uncertain. Long-term outcomes regarding measures like survival are not fully established in the research.

Key Studies & References

  1. NICE Guideline NG121: Chronic heart failure in adults: diagnosis and management (relevant for PAH context and functional capacity)

Frequently Asked Questions (FAQ)

Common questions about Refeel (FAQ)


Q: How long does it usually take for Refeel to start working?

Peak concentrations in the blood are generally reached around two hours after administration. Official prescribing guidelines indicate that the medicine, when taken as needed, should be administered at least 30 minutes before anticipated activity.


Q: Do I need to stop taking Refeel suddenly or do I need to taper off?

Discontinuing the medicine suddenly is advised against in regulatory guidance for patients taking it for the Pulmonary Arterial Hypertension (PAH) indication. There is a documented potential for the condition's symptoms to worsen if the medicine is abruptly stopped.


Q: Does Refeel work differently for men versus women?

The regulatory license for this medicine differs for men and women based on the condition being treated. It is approved for male-specific conditions like Erectile Dysfunction and Benign Prostatic Hyperplasia in men, but it is approved for Pulmonary Arterial Hypertension in both men and women.


Q: Can Refeel be used during pregnancy or while breastfeeding?

For the male-specific indications, official regulatory information advises against the use of this medicine during pregnancy or while breastfeeding. For women using the medicine for Pulmonary Arterial Hypertension, use is generally not indicated or recommended during these periods due to insufficient safety data.


Q: What are the long-term effects of taking Refeel?

Official regulatory information lists all known adverse reactions, which include serious but rare events such as sudden vision or hearing loss. Regulatory documents indicate that the research base has generally limited long-term data focusing on the durability of observed effects over many years.


Q: Is Refeel considered a common treatment for its main condition?

Regulatory-based medical information describes the active ingredient of this medicine as a widely used pharmacological option for its main conditions, Erectile Dysfunction and the symptoms of Benign Prostatic Hyperplasia (BPH).


Q: Can Refeel affect my ability to drive or operate machinery?

Official prescribing information advises that this medicine can occasionally cause dizziness. If dizziness occurs, operating machinery or driving should be avoided until the feeling has passed.


Q: Is Refeel available in generic form?

The active substance in this medicine, Tadalafil, is widely available in a generic form. The generic product is approved by relevant health authorities and is subject to the same strict regulatory standards as the branded medicine.


Q: Does Refeel interact with birth control pills?

Based on available regulatory information, this medicine is not known to affect or interfere with the effectiveness of hormonal contraceptive pills.


Q: What is the risk of dependence or addiction with Refeel?

This medicine is classified as a Phosphodiesterase type 5 ( PDE5) inhibitor. Official government regulatory documents do not describe this medication as having a potential for abuse or dependence.


Q: Can Refeel affect my mood or energy levels?

Official labeling documents side effects that can affect your energy and nervous system. These include feeling fatigued or tired, as well as somnolence, which is a state of drowsiness.


Q: Is Refeel a treatment I take only when I feel symptoms?

Official administration guidelines describe two primary dosing schedules: one for continuous, daily use, and a separate schedule for intermittent, as-needed use before activity.


Q: Are there any common reasons why Refeel might not be suitable for someone?

Official regulatory warnings list conditions that are considered contraindications (prohibitions for use). These include severe heart, liver, or kidney impairment, or conditions that increase the risk of a prolonged erection (Priapism).


Q: What if I stop Refeel suddenly?

Regulatory information advises against sudden discontinuation, particularly for patients taking the medicine for the Pulmonary Arterial Hypertension (PAH) indication, due to the documented potential for the condition's symptoms to worsen.


Q: Does Refeel interact with common cold or flu medications?

This medicine has documented interactions with substances that affect blood pressure and those metabolized by the CYP3A4 enzyme system. Components found in some cold and flu medications can fall into these categories, which means there is a potential for interaction based on the official pharmacodynamic and metabolic profiles.


Q: Is Refeel generally well-tolerated?

Official regulatory data classifies adverse effects by frequency. The data shows that the most frequently reported adverse effect (Very Common) is headache, and Common adverse effects include flushing and indigestion.


Q: Are there different strengths or formulations of Refeel available?

This medicine is available as an oral film-coated tablet in multiple strengths. These include 2.5 mg, 5 mg, 10 mg, 20 mg, and 40 mg doses.


Q: What are the main things I should know before starting Refeel?

Key warnings in the official prescribing information state that the medicine must not be used concurrently with organic nitrates or guanylate cyclase stimulators. Patients should also be aware of rare but serious risks, such as sudden vision or hearing loss, which are listed in the safety information.


Q: Is Refeel used to treat conditions other than the main one listed?

Yes, this medicine is officially approved for three separate conditions. These include treating Erectile Dysfunction, providing symptomatic relief for Lower Urinary Tract Symptoms (LUTS) associated with BPH, and improving exercise capacity in Pulmonary Arterial Hypertension (PAH).


Q: Does Refeel need special storage conditions?

The tablets must be stored at a controlled room temperature, protected from both moisture and light. It is required that the medicine be kept in its original, tightly closed container and stored out of the sight and reach of children.


Q: Is Refeel an antidepressant (or similar class) medication?

No, this medicine is classified as a Selective Phosphodiesterase type 5 ( PDE5) inhibitor. It does not belong to the class of antidepressant or similar central nervous system medications.


Q: Do people typically have to adjust their Refeel use after surgery?

Regulatory guidance addresses the perioperative use of this medicine. It notes that specialist evaluation is required due to potential risks such as hypotension (low blood pressure) or loss of pulmonary pressure control for patients taking it for PAH.


Q: Why does the packaging say Refeel is only for specific patient populations?

Official labeling restricts the use of this medicine to adult patients. This is primarily because the safety and effectiveness for those under 18 years of age have not been established in clinical trials reviewed by regulatory authorities.


Q: Does Refeel show up on drug tests?

This medicine will not typically affect or cause false positive results on standard 10-panel urine drug screens. Its detection is generally not included in standard drug screen panels.


Q: What kind of studies were done to get Refeel approved?

The evidence supporting the medicine is based on data from several types of research studies. These include randomized, double-blind, placebo-controlled clinical trials, as well as systematic reviews and meta-analyses.


Q: How soon after starting Refeel do side effects usually appear?

Many of the most commonly reported adverse effects, such as headache and flushing, are typically transient, meaning they are temporary. These effects are often experienced acutely when a patient first starts the medicine.


Q: How long does the effect of Refeel last after I take it?

Due to its prolonged elimination half-life, the physiological activity has been observed to be sustained for a longer period compared to other agents in the same class, with activity reported up to 36 hours.

How should Refeel be stored and disposed of?

How to Store and Dispose of Refeel (Tadalafil)

Refeel must be stored and disposed of strictly according to official regulatory guidelines to maintain its stability and ensure safety.

Storage Requirements

The tablets must be kept at a controlled room temperature, specifically between 20 C and 25 C, and must not be frozen. Storage requires protection from both moisture and light. The tablets must remain in their original container, which must be kept tightly closed when not in use. A mandatory instruction is to keep this medicine out of the sight and reach of children.

Disposal Instructions

Expired or unused Refeel should not be disposed of via wastewater or general household trash. Official regulatory documents direct that the product should be discarded through an authorized medicine take-back program or according to local regulations, consulting a pharmacist or local waste disposal service.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

Available in countries:

Equivalent of Refeel found in:

A-Z Index: