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La PDE5 è la fosfodiesterasi predominante nei vasi polmonari. L’inibizione della PDE5 da parte di tadalafil aumenta le concentrazioni della cGMP determinando un rilassamento della muscolatura liscia dei vasi polmonari e una vasodilatazione del letto vascolare polmonare.
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Tadalafil (twenty mg) è stato studiato in associazione a four classi di antipertensivi. Nei soggetti che assumevano più antipertensivi, le variazioni della pressione sanguigna controllata ambulatorialmente apparivano correlabili al grado di controllo della pressione sanguigna. Nei soggetti con pressione sanguigna ben controllata, la riduzione della pressione sanguigna era minima e simile a quella osservata nei soggetti sani.
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Il tadalafil può inibire debolmente anche la fosfodiesterasi di tipo 6 (PDE6; seven-hundred volte meno potente sulla PDE6 rispetto alla PDE5) che è un enzima coinvolto nella traduzione del segnale dei fotorecettori e quindi si possono osservare disturbi visivi occur la modifica della percezione dei colori. Si po' avere anche ipoacusia monolaterale.
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