From the FDA Drug Label
Tadalafil has not been administered to patients with bleeding disorders or significant active peptic ulceration Although tadalafil has not been shown to increase bleeding times in healthy subjects, use in patients with bleeding disorders or significant active peptic ulceration should be based upon a careful risk-benefit assessment and caution.
Bleeding gums are not directly mentioned in the label, but the label does discuss the potential for bleeding disorders.
- The label states that tadalafil has not been shown to increase bleeding times in healthy subjects.
- However, it also advises caution in patients with bleeding disorders. Since bleeding gums can be a symptom of a bleeding disorder, it is possible that tadalafil could contribute to bleeding gums in susceptible individuals, but this is not directly stated in the label 1.
From the Research
Cialis (tadalafil) can potentially cause bleeding gums as a rare side effect, and patients should be aware of this risk, especially if they are also taking blood thinners or have a history of bleeding disorders. This occurs because Cialis is a phosphodiesterase type 5 (PDE5) inhibitor that works by increasing blood flow throughout the body, not just to the genital area. This vasodilating effect can sometimes lead to increased bleeding tendency in various tissues, including the gums.
Key Points to Consider
- If you notice bleeding gums while taking Cialis, you should contact your healthcare provider, especially if the bleeding is severe or persistent.
- The bleeding risk may be higher if you're also taking blood thinners like warfarin, aspirin, or other antiplatelet medications.
- Good oral hygiene practices, including gentle brushing and regular flossing, may help minimize gum bleeding.
- However, if bleeding continues or worsens, your doctor might need to adjust your medication regimen or recommend alternative treatments for erectile dysfunction that may have fewer effects on your oral health. According to a study published in 2019 2, tadalafil 5 mg/day can decrease systemic inflammation and improve clinical symptoms in patients with erectile dysfunction, but its effect on bleeding gums is not directly addressed. Another study from 2017 3 compared tadalafil with sildenafil for the treatment of erectile dysfunction and found that tadalafil had a similar efficacy and safety profile, but it did not specifically mention bleeding gums as a side effect.
Management of Bleeding Complications
- Patients treated with anticoagulants, including those taking Cialis, have an unavoidable risk of bleeding complications, and management of these complications should follow the same routines as for non-anticoagulated patients 4, 5.
- Reversal of the anticoagulant effect is crucial in life-threatening or massive hemorrhages, and specific antidotes for factor Xa inhibitors are becoming available.
- Supportive care and nonspecific support for hemostasis with antifibrinolytic agents or prothrombin complex concentrates should be kept in mind.