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Cialis ® (tadalafil)
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Cialis® (tadalafil): Undesirable effects
The most commonly reported adverse reactions were headache, dyspepsia, back pain and myalgia, in which the incidences increase with increasing dose of Cialis.
Summary of the safety profile
The most commonly reported adverse reactions in patients taking Cialis for the treatment of erectile dysfunction or benign prostatic hyperplasia were headache, dyspepsia, back pain and myalgia, in which the incidences increase with increasing dose of Cialis. The adverse reactions reported were transient, and generally mild or moderate. The majority of headaches reported with Cialis once-a-day dosing are experienced within the first 10 to 30 days of starting treatment.
Tabulated summary of adverse reactions
The table below lists the adverse reactions observed from spontaneous reporting and in placebo-controlled clinical trials (comprising a total of 8022 patients on Cialis and 4422 patients on placebo) for on-demand and once-a-day treatment of erectile dysfunction and the once-a-day treatment of benign prostatic hyperplasia.
Frequency convention: Very common (≥1/10), Common (≥1/100 to <1/10), Uncommon (≥1/1,000 to <1/100), Rare (≥1/10,000 to <1/1,000), Very Rare (<1/10,000) and Not known (cannot be estimated from the available data).
Very common |
Common |
Uncommon |
Rare |
Not known
|
Immune system disorders |
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Hypersensitivity reactions |
Angioedema2 |
|
Nervous system disorders |
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Headache |
Dizziness |
Stroke1 (including haemorrhagic events), Syncope, Transient ischaemic attacks1, Migraine2, Seizures2, Transient amnesia |
|
Eye disorders |
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Blurred vision, Sensations described as eye pain |
Visual field defect, Swelling of eyelids, Conjunctival hyperaemia, Non- arteritic anterior ischaemic optic neuropathy (NAION)2, Retinal vascular occlusion2 |
Central serous chorioretinopathy
|
Ear and labyrinth disorders |
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Tinnitus |
Sudden hearing loss |
|
Very common |
Common |
Uncommon |
Rare |
Not known
|
Cardiac disorders1 |
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Tachycardia, Palpitations |
Myocardial infarction, Unstable angina pectoris2, Ventricular arrhythmia2 |
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Vascular disorders |
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Flushing |
Hypotension3, Hypertension |
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Respiratory, thoracic and mediastinal disorders |
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Nasal congestion |
Dyspnoea, Epistaxis |
|
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Gastrointestinal disorders |
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Dyspepsia |
Abdominal pain, Vomiting, Nausea, Gastro-oesophageal reflux |
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Skin and subcutaneous tissue disorders |
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Rash |
Urticaria, Stevens-Johnson syndrome2, Exfoliative dermatitis2, Hyperhydrosis (sweating) |
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Musculoskeletal, connective tissue and bone disorders |
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Back pain, Myalgia, Pain in extremity |
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Renal and urinary disorders |
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Haematuria |
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Reproductive system and breast disorders |
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Prolonged erections |
Priapism, Penile haemorrhage, Haematospermia |
|
General disorders and administration site conditions |
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Chest pain1, Peripheral oedema, Fatigue |
Facial oedema2, Sudden cardiac death1,2 |
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(1) Most of the patients had pre-existing cardiovascular risk factors.
(2) Postmarketing surveillance reported adverse reactions not observed in placebo-controlled clinical trials.
(3) More commonly reported when tadalafil is given to patients who are already taking antihypertensive medicinal products.
Description of selected adverse reactions
A slightly higher incidence of ECG abnormalities, primarily sinus bradycardia has been reported in patients treated with tadalafil once a day as compared with placebo. Most of these ECG abnormalities were not associated with adverse reactions.
Other special populations
Data in patients over 65 years of age receiving tadalafil in clinical trials, either for the treatment of erectile dysfunction or the treatment of benign prostatic hyperplasia, are limited. In clinical trials with tadalafil taken on demand for the treatment of erectile dysfunction, diarrhoea was reported more frequently in patients over 65 years of age. In clinical trials with tadalafil 5 mg taken once a day for the treatment of benign prostatic hyperplasia, dizziness and diarrhoea were reported more frequently in patients over 75 years of age.
REFERENCE
Cialis [Summary of Product Characteristics]. Utrecht, The Netherlands: Eli Lilly Nederland B.V.
Date of Last Review: 12 September 2023