From the Guidelines
Tadalafil can cause several side effects, including common mild side effects such as headache, indigestion, back pain, muscle aches, flushing, and nasal congestion, as well as more serious but less common side effects like prolonged erection, sudden vision loss, hearing decrease or loss, and allergic reactions 1.
Side Effects of Tadalafil
The side effects of tadalafil are generally mild and resolve on their own, but it is essential for patients to be aware of them before taking this medication. Some of the common side effects include:
- Headache
- Indigestion
- Back pain
- Muscle aches
- Flushing
- Nasal congestion More serious but less common side effects include:
- Prolonged erection (priapism) lasting more than 4 hours
- Sudden vision loss
- Hearing decrease or loss
- Allergic reactions
Interaction with Other Medications
Tadalafil may also cause a drop in blood pressure, especially when combined with nitrates or alpha-blockers, which can lead to dizziness, fainting, or in severe cases, heart attack or stroke 1. Patients should seek immediate medical attention if they experience chest pain, severe dizziness, or changes in vision or hearing while taking tadalafil.
Dosage and Administration
The standard dose of tadalafil ranges from 2.5 to 20 mg depending on the condition being treated, with lower doses (2.5-5 mg) typically used for daily therapy and higher doses (10-20 mg) for as-needed treatment of erectile dysfunction 1.
Mechanism of Action
These side effects occur because tadalafil works by inhibiting the enzyme phosphodiesterase type 5, which increases blood flow to certain areas of the body, including the penis, but can also affect blood vessels in other parts of the body 1.
From the FDA Drug Label
The most common side effects with tadalafil tablets are: headache, indigestion, back pain, muscle aches, flushing, and stuffy or runny nose. Uncommon side effects include: An erection that won’t go away (priapism). Color vision changes, such as seeing a blue tinge (shade) to objects or having difficulty telling the difference between the colors blue and green. In rare instances, men taking PDE5 inhibitors (oral erectile dysfunction medicines, including tadalafil tablets) reported a sudden decrease or loss of vision in one or both eyes. Sudden loss or decrease in hearing, sometimes with ringing in the ears and dizziness, has been rarely reported in people taking PDE5 inhibitors, including tadalafil tablets
The side effects of Tadalafil (Cialis) include:
- Common side effects:
- Headache
- Indigestion
- Back pain
- Muscle aches
- Flushing
- Stuffy or runny nose
- Uncommon side effects:
- Priapism (an erection that won’t go away)
- Color vision changes
- Sudden decrease or loss of vision
- Sudden loss or decrease in hearing 2
From the Research
Side Effects of Tadalafil (Cialis)
The side effects of Tadalafil (Cialis) have been studied in several clinical trials. Some of the common side effects reported include:
- Facial flushing, which was the most common adverse side effect in a study of 158 patients with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) 3
- Headache, which was reported by 2 men in the same study 3
- Dizziness, which was reported by 2 men in the same study 3
- Back pain, which is listed as a potential adverse drug event in the FDA-approved labeling for tadalafil 4
- Dyspepsia, which is listed as a potential adverse drug event in the FDA-approved labeling for tadalafil 4
- Ejaculatory dysfunction, which was improved with tadalafil treatment in a study of men with LUTS/BPH and erectile dysfunction 5
Less Common Side Effects
Less common side effects of tadalafil include:
- Orthostatic hypotension, which was not observed in a study of 406 patients with ED and BPH-LUTS 6
- Changes in uroflowmetry parameters, which were not observed in the same study 6
- Changes in clinical laboratory parameters, which were not observed in the same study 6
Drug Interactions
Tadalafil can interact with other medications, including: