What are the side effects of Tadalafil (Cialis)?

From the Guidelines

Cialis (tadalafil) commonly causes side effects including headache, indigestion, back pain, muscle aches, flushing, and nasal congestion, as reported in the most recent and highest quality study 1. These side effects typically resolve within a few hours after taking the medication. More serious but less common side effects include prolonged erection (priapism) lasting over 4 hours, sudden vision or hearing loss, and allergic reactions. Cialis can also cause a dangerous drop in blood pressure when taken with nitrate medications, making this combination strictly contraindicated. Some users experience dizziness, particularly when standing up quickly. Side effects generally increase with higher doses, and the longer-acting nature of Cialis (up to 36 hours) means side effects may persist longer than with other ED medications. Most side effects occur because tadalafil works by inhibiting PDE5 enzymes, which increases blood flow not only to the penis but also affects blood vessels throughout the body. Key points to consider when prescribing Cialis include:

• The most frequently reported adverse events in men using PDE5i are dyspepsia, headache, flushing, back pain, nasal congestion, myalgia, visual disturbance, and dizziness 1.
• Average rates of these side effects are similar across medications, with the exception of dyspepsia, flushing, and myalgia, which have lower rates with certain medications 1.
• If you experience severe or persistent side effects, seek medical attention immediately. It is essential to inform patients about the potential side effects of Cialis and to monitor them for any adverse reactions, as recommended by the American College of Physicians 1.

From the FDA Drug Label

What Are The Possible Side Effects Of Tadalafil Tablets? 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 possible side effects of Cialis (tadalafil) 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 Cialis

• The most commonly reported adverse effects with sildenafil, a similar medication to Cialis (tadalafil), are headache, flushing, and dyspepsia 3.
• Tadalafil has a longer duration of action than sildenafil and vardenafil, and is similarly effective in the treatment of erectile dysfunction (ED) 3, 4.
• The side effects of tadalafil are not fully discussed in the provided studies, but it is mentioned that all three phosphodiesterase-5 inhibitors (sildenafil, vardenafil, and tadalafil) have similar adverse effects profiles 5.
• Nonarteritic anterior ischaemic neuropathy has been reported in some users of the PDE5 inhibitors, but there is no conclusive evidence that PDE5 inhibitors cause this rare effect 5.
• Tadalafil, like other PDE5 inhibitors, must be used with caution in patients taking alpha(1)-adrenoceptors antagonists for benign prostatic hyperplasia, and is not suitable for use in patients taking nitrates for the treatment of ischaemic heart disease 5.

Comparison of PDE5 Inhibitors

• Sildenafil, vardenafil, and tadalafil have all been shown to be similarly effective in the treatment of men with ED of varying etiologies 4, 5.
• Tadalafil has a longer half-life than sildenafil or vardenafil, and a longer duration of action than sildenafil and vardenafil 5.
• Patient preference studies have shown that tadalafil is often preferred over sildenafil and vardenafil, but the results of these studies are not always consistent and may be limited by bias 6, 7.