- A new study suggests that people who take the erectile dysfunction drug Cialis for urinary tract issues may have a higher risk of glaucoma, a vision-threatening eye disease.
- Men who take tadalafil and have glaucoma risk factors should receive regular eye exams, the researchers say.
- The overall risk of eye disease from occasional use of Cialis to treat erectile dysfunction is low.
A commonly prescribed erectile dysfunction drug may raise the risk of glaucoma for males with an enlarged prostate who take the medication, according to a new study.
Researchers say that long-term use of the medication tadalafil, sold under the brand name Cialis, to treat urinary urgency and frequency from an enlarged prostate may have a higher risk of developing glaucoma, a vision-threatening eye disease.
The researchers say that those taking tadalafil daily over the long-term should receive regular eye exams, particularly if they already have glaucoma risk factors. These include a family history of the disease or already having ocular hypertension, a condition that causes elevated pressure inside the eye.
Experts not involved in the study told Healthline that the overall risk of glaucoma from long-term Cialis use is low.
S. Adam Ramin, MD, a urologist, urologic oncologist, and medical director of Urology Cancer Specialists in Los Angeles, noted that Cialis has been prescribed for years to treat urinary tract issues.
“The risk is relatively small, but it’s important to discuss this with patients,” Ramin said. He added that men who occasionally take Cialis to treat erectile dysfunction shouldn’t be concerned because they aren’t using the medication on a daily basis.
“It’s important to note that the absolute risk was less than 1% greater with daily tadalafil,” added Craig Comiter, MD, a professor of urology at Stanford University.
“For certain, someone with a family history or pre-existing glaucoma or other risk factors should be monitored with ophthalmologic care,” Comiter said. “It’s not obvious that taking this drug changes the required monitoring.”
Eli Lilly and Company, the manufacturer of Cialis, couldn’t be reached for comment.
For their new study, researchers analyzed medical records from the TriNetX Analytics Network of more than 70,000 males ages 40 and older. None of the participants had a history of glaucoma.
Between January 2012 and December 2022, half of the subjects received tadalafil for urinary tract symptoms for up to 5 years. The other participants were taking the drug.
The researchers compared the two groups over five years, examining the likelihood of the participants developing glaucoma or ocular hypertension, or if they began treatment for glaucoma.
The analysis found that males who were prescribed tadalafil were 22% more likely to develop glaucoma than those who had not received the drug.
Males who took tadalafil were also 32% more likely to develop ocular hypertension, 33% more likely to develop primary open-angle glaucoma, and 33% more likely to begin glaucoma treatment.
The researchers noted that most of the study participants were white, which might limit how confidently the findings can be applied to men from other ethnic backgrounds.
They added that their research was observational, so it cannot demonstrate that tadalafil itself caused the increased eye risks.
Ramin said that the risks to any individual patient are relatively small, especially for someone who doesn’t use tadalafil for extended periods.
He added that are medications that aren’t PDESi drugs that can be used to treat urinary tract issues.
“There are alternatives,” Ramin said.
“There are multiple treatments for lower urinary tract symptoms associated with benign prostatic enlargement,” added Comiter. “All patients should be treated with behavioral modification and, if indicated, can try different classes of pharmacotherapy.”
“Each of these medications has their own side effect profile and, based on a patient’s history and risk factors for concomitant disease, the patient and physician should exercise shared decision-making and figuring out the best pharmacologic treatment,” he said.
“If pharmacologic treatment is either unsuccessful or contraindicated, surgical intervention is often successful,” Comiter noted.
The pressure can cause damage to the optic nerve, in particular eroding optic nerve tissue. That erosion can lead to vision loss and even blindness.
There are usually no symptoms in the early stages of this type of glaucoma except for a gradual loss of vision.
The vision loss, in fact, may occur so slowly that a person may not experience any other symptoms or signs of this damage before it becomes permanent and vision loss cannot be restored.
More than
About 80 million people worldwide have glaucoma. It is a leading cause of blindness globally.
However, in the United States, blindness rarely occurs from glaucoma due to early detection and advanced treatments.
Glaucoma can affect people of any age, but people over the age of 60 are at higher risk. So are African-Americans, people with diabetes, and people with severe nearsightedness.
There is no cure for glaucoma, but treatments can slow or even halt the progression of the condition. Treatments for glaucoma include:
- medications, including tablets and eye drops
- laser treatment to reduce eye pressure
- surgery to help drain fluid buildup behind the eye
Ramin said it’s important for people to get regular eye exams so they can have their eye pressure tested for signs of glaucoma.
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