From the Research
Tadalafil and Rebound Hypertension
- There is no direct evidence in the provided studies to suggest that tadalafil (Cialis) causes rebound hypertension 1, 2, 3, 4, 5.
- The studies primarily focus on the safety and efficacy of tadalafil in patients with erectile dysfunction and pulmonary arterial hypertension, as well as its interaction with antihypertensive medications.
- Tadalafil is known to be a mild vasodilator, which can lead to a reduction in blood pressure, but this effect is generally not considered clinically significant 3, 4.
- The risk of hypotensive or cardiovascular outcomes associated with co-possession of tadalafil and anti-hypertensive medications is not increased beyond that observed for patients in possession of anti-hypertensive medications only 2.
- The studies suggest that tadalafil is safe in patients receiving concomitant antihypertensive agents, with no statistically significant differences in blood pressure changes or cardiovascular events compared to placebo 4.
Mechanism of Action
- Tadalafil works by selectively inhibiting phosphodiesterase-5 (PDE-5), leading to nitric oxide-mediated vasodilation in the pulmonary vasculature 1.
- This mechanism of action can result in a decrease in blood pressure, but the effect is typically mild and not likely to be of clinical concern 3, 4.
Clinical Implications
- Patients with erectile dysfunction and hypertension can be treated with tadalafil, but close monitoring of blood pressure is recommended, especially when combined with alpha-blocking agents or nitric oxide donors 3.
- The long-term safety and efficacy of tadalafil in patients with pulmonary arterial hypertension have been demonstrated, with sustained improvements in exercise capacity and delayed clinical worsening 5.