From the Guidelines
If you're experiencing joint, tendon, and testicular pain while taking Cialis 5mg daily, you should contact your healthcare provider promptly to discuss these symptoms. These side effects are not typical with Cialis (tadalafil) and may require medical evaluation. Consider temporarily discontinuing the medication until you can speak with your doctor, but do not stop without medical advice if it was prescribed for a specific condition. While mild muscle and back pain can occur with Cialis (affecting 1-10% of users), significant joint, tendon, or testicular pain is uncommon and could indicate an adverse reaction or an unrelated medical issue. Your doctor might recommend reducing the dosage, switching to an alternative medication like sildenafil (Viagra) or vardenafil (Levitra), or investigating other potential causes of your symptoms. These pains could potentially be related to how PDE5 inhibitors like Cialis affect blood flow and smooth muscle throughout the body, but persistent pain in these areas warrants proper medical assessment to rule out other conditions, as suggested by the American College of Physicians' clinical practice guidelines 1.
Some key points to consider:
- The American College of Physicians recommends that clinicians initiate therapy with a PDE-5 inhibitor in men who seek treatment for erectile dysfunction and who do not have a contraindication to PDE-5 inhibitor use (Grade: strong recommendation; high-quality evidence) 1.
- Improvement in erectile function was related to higher doses for sildenafil and vardenafil, but not tadalafil 1.
- The evidence regarding the incidence of adverse events was limited and inconclusive, and more high-quality head-to-head trials are needed to explore differences in adverse events, especially severe adverse events 1.
- The American College of Physicians does not recommend for or against routine use of hormonal blood tests or hormonal treatment in the management of patients with erectile dysfunction (Grade: insufficient evidence to determine net benefits and harms) 1.
It is essential to consult with your healthcare provider to determine the best course of action for your specific situation, as they can provide personalized guidance and recommendations based on your medical history and current condition.
From the FDA Drug Label
Back pain or myalgia was reported at incidence rates described in Tables 1 through 4 In tadalafil clinical pharmacology trials, back pain or myalgia generally occurred 12 to 24 hours after dosing and typically resolved within 48 hours. The back pain/myalgia associated with tadalafil treatment was characterized by diffuse bilateral lower lumbar, gluteal, thigh, or thoracolumbar muscular discomfort and was exacerbated by recumbency In general, pain was reported as mild or moderate in severity and resolved without medical treatment, but severe back pain was reported with a low frequency (less than 5% of all reports). Incidence rates for tadalafil for once daily use for ED, BPH and BPH/ED are described in Tables 2,3 and 4 In studies of tadalafil for once daily use, adverse reactions of back pain and myalgia were generally mild or moderate with a discontinuation rate of less than 1% across all indications. Additional, less frequent adverse reactions (less than 1%) reported in the controlled clinical trials of Tadalafil for BPH or ED and BPH included: ... arthralgia, and muscle spasm. Pain in extremity 0.0% 1.4% Myalgia 0.3% 1.2%
Joint, tendon, and testicular pain are not explicitly mentioned in the label as common adverse reactions.
- Back pain and myalgia are reported, but the label does not provide information on joint or tendon pain.
- Testicular pain is not mentioned at all.
- Pain in extremity is reported in 1.4% of patients taking 5mg of tadalafil daily.
- Myalgia is reported in 1.2% of patients taking 5mg of tadalafil daily.
- Arthralgia (joint pain) is reported as an additional, less frequent adverse reaction (less than 1%) 2
From the Research
Joint, Tendon, and Testicular Pain with Cialis 5mg Daily Use
- The provided studies do not directly address joint, tendon, and testicular pain associated with Cialis 5mg daily use 3, 4, 5, 6.
- However, one study discusses testicular pain, stating that it can have various causes, including musculoskeletal etiologies, and may not always be related to the testicles themselves 7.
- Another study mentions that tadalafil 5mg daily can improve erectile function and reduce penile curvature and pain in patients with Peyronie's disease, but does not mention joint or tendon pain 4.
- The other studies focus on the efficacy and safety of tadalafil 5mg daily in treating benign prostatic hyperplasia (BPH) and erectile dysfunction (ED), without mentioning joint, tendon, or testicular pain 3, 5, 6.
- It can be inferred that joint, tendon, and testicular pain may not be a commonly reported side effect of Cialis 5mg daily use, but more research is needed to confirm this 3, 4, 5, 6, 7.