Tadalafil Side Effects: Short-Term, Long-Term & Safety

Tadalafil treats both erectile dysfunction and benign prostatic hyperplasia, though long-term use may cause side effects. Side effects and their long term implications are of considerable concern to patients. How long term side effects may impact the heart, liver, kidneys, vision, and hearing are also of interest.

Most of the studies conducted have been rudimentary and short in duration. Therefore, there is not a lot of evidence confirming the side effects of long-term tadalafil use. Despite the evidence, its use should remain restrictive.

Can You Take Tadalafil Daily and Is Tadalafil Safe?

Tadalafil may be prescribed for daily use. The starting dose of tadalafil for ED is generally 2.5 mg, that dose may be increased to 5 mg if there is therapeutic insufficiency. For the management of BPH, the starting dose is also 5 mg.

Daily tadalafil use has been studied at recommended doses. However, it should only be undertaken with the approval of a healthcare professional, especially if you have a coexisting condition affecting the liver, kidney, or heart, or if you are taking medications that are suspected of interacting with tadalafil.

Typical Daily Cialis Side Effects

The most common side effects of tadalafil include:

• A headache
• Back and limb pain
• Muscle aches
• Congestion of nasal passages
• Flushing
• Abdominal pain

These side effects are common and should resolve with time. The current prescribing information includes these side effects and others in the listing of adverse reactions.

How Common and How Severe?

Long term research has its advantageous uses in measuring frequency. In a 24 month study of 1,173 men, the occurrence of headache was 15.8%, indigestion was 11.8% and back pain was 8.2%. Only 6.3% of study participants stopped because of adverse events.

Serious reactions occur, but chest pain, sudden hearing or vision changes or an erection lasting more than four hours should be addressed by a medical professional.

Long Term Effects of Tadalafil on the Body

Patients will ask if over the years, tadalafil use will begin to have negative effects on the body’s organs. Long term studies have not produced evidence of serious organ toxicity due to the proper use of tadalafil.

Studies on tadalafil use at a dose of 5 mg showed no clinically meaningful effects of the drug on the liver and kidney function as evidenced by laboratory tests or ECG.

Liver and Kidney Function

Tadalafil gets processed in the liver while the kidney plays a role in drug metabolism.

Patients needing therapy for tadalafil and having kidney or liver problems will most likely need a dose adjustment. Severe problems may make certain tadalafil regimens inappropriate.

Long term studies showed no signs of drug induced liver toxicity or kidney problems due to tadalafil in the studied populations.

Hormones, Metabolism, and Brain

Tadalafil does not work the same way as testosterone or hormone replacement therapy.

Long term use of tadalafil is not necessarily harmful to the body. Tadalafil does cause an increase in dizziness and/or headaches, but memory loss and concentration problems are not recognized as normal side effects of the drug.

Eyesight And Hearing

Several cases of eye and hearing issues have been reported with PDE5 inhibitors, particularly tadalafil.

Severe cases include:

• Sudden decrease or loss of vision
• Sudden hearing decrease or loss
• Ringing in the ears or dizziness associated with hearing problems

These issues are rare, but any change in vision or hearing should be immediately addressed by a medical professional.

Cialis Long Term Use: Duration and Stopping

The most common request is how long tadalafil can be safely used.

How Many Years Can You Take Cialis?

There is no defined max period for tadalafil treatment. Doctors evaluate ongoing treatment so long as it remains effective and well tolerated.

Studies have assessed the safety of men using tadalafil daily for up to two years with minimal adverse effects. A separate study looking at tadalafil at 5 mg daily concluded that there were no clinically-significant changes in laboratory values or electrocardiogram results (ECG).

More recent findings from studies involving tadalafil at 5 mg daily report that safety concerns have not increased with longer treatment.

What Happens If You Stop Using Tadalafil?

Tadalafil does not cause withdrawal symptoms. After discontinuation, the medicine leaves the body.

Your erections will return to the level associated with your underlying ED. Should your condition have changed and/or developed over time (diabetes, vascular disease, etc.), your erectile function will also have changed.

Tadalafil Side Effects on Heart and Cardiovascular Safety

ED and cardiovascular disease often co-exist, and therefore heart safety is of importance.

Blood Pressure and Heart Rate

Tadalafil may decrease the patient’s blood pressure due to relaxation of smooth muscles of the vasculature. This is generally not of concern for most of the patients for which it is prescribed.

Large-scale studies have not shown an increased incidence of heart attacks and/or cardiac-related death due to the usage of tadalafil vs. the usage of a placebo.

The primary concern is its usage in conjunction with nitrates. The usage of tadalafil with nitrates may cause a critical drop in blood pressure and should be avoided. The usage of Tadalafil may also interact with alpha-blockers, and antihypertensive medication, and may also interact with the use of alcohol in excessive amounts.

Who Needs Extra Caution?

Talk with a healthcare professional before using tadalafil if you:

• Have heart disease that is unstable or hypertension that is uncontrolled
• Use nitrate medicines
• Take riociguat
• Use alpha-blockers, multiple medicines to decrease blood pressure
• Have severe kidney or liver disease

The presence of stable cardiovascular disease does not necessarily eliminate the use of tadalafil, however it should be considered if you engage in sexual activity.

Minimizing Long Term Side Effects of Tadalafil

The following can help diminish possible effects of tadalafil use:

• Use the lowest effective dose. Daily ED treatment typically starts with a dose of 2.5 mg and may be increased to 5 mg.
• Regularly assess your medications. Interactions may increase exposure to tadalafil, or even decrease blood pressure.
• Attend routine visits. This provides the opportunity to assess the balance of pros and cons, side effects, blood pressure, and other related conditions.
• Support cardiovascular health. This supports both cardiovascular health as well as erectile function. This should include a healthy diet and exercise, adequate sleep, and not smoking.

Final Thoughts

Tadalafil is generally tolerated well, including over prolonged periods of time. Research up to two years has not shown major safety concerns. More commonly, headache, heartburn, and back/muscle pain have been reported. These symptoms can be managed.

Tadalafil should not be taken when suffering from conditions of the heart, kidney, liver, or where nitrates are being used. These patients should be assessed accordingly.

Urgent medical care should be sought for chest pain, vision or hearing loss, and erections lasting more than 4 hours.

Sources

• DailyMed – Tadalafil Prescribing Information
• PubMed – Long-Term Safety and Tolerability of Tadalafil