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The back pain/myalgia associated with tadalafil treatment was characterized by diffuse bilateral lower lumbar, gluteal, thigh, or thoracolumbar muscular discomfort and was exacerbated by recumbancy. Postmarketing experience has included seizure and seizure recurrence and transient global amnesia.
Ocular
Ocular side effects have included blurred vision, changes in color vision, conjunctivitis (including conjunctival hyperemia), eye pain, increased lacrimation, and swelling of the eyelids.
Non-arteritic anterior ischemic optic neuropathy (NAION), a cause of decreased vision including permanent loss of vision, has been reported rarely postmarketing in temporal association with the use of phosphodiesterase type 5 (PDE5) inhibitors, including tadalafil.
Other
Other side effects have included cases of sudden decrease or loss of hearing reported postmarketing in temporal association with the use of PDE5 cialis and blindness including tadalafil. In studies of Cialis for once daily use, events of back pain and myalgia were generally mild or moderate with a discontinuation rate of 0.3%.
Across all studies with any Cialis dose, reports of changes in color vision were rare (<0.1% of patients).
The following section identifies additional, less frequent events (<2%) reported in controlled clinical trials of Cialis for once daily use or use cialis and blindness needed. Many of these events were reported to occur during or shortly after sexual activity, and a few were reported to occur shortly after the use of Cialis without sexual activity. reported for Cialis for use as needed:
Table 1: Treatment-Emergent Adverse Events Reported by ≥2% of Patients Treated with Cialis (10 or 20 mg) and More Frequent on Drug than Placebo in the Eight Primary Placebo-Controlled Phase 3 Studies (Including a Study in Patients with Diabetes) for Cialis for Use as Needed
a The term flushing includes: facial flushing and flushing
Adverse Event
Placebo
(N=476)
Tadalafil 5 mg
(N=151)
Tadalafil 10 mg
(N=394)
Tadalafil 20 mg
(N=635)
Headache
5%
11%
11%
15%
Dyspepsia
1%
4%
8%
10%
Back pain
3%
3%
5%
6%
Myalgia
1%
1%
4%
3%
Nasal congestion
1%
2%
3%
3%
Flushinga
1%
2%
3%
3%
Pain in limb
1%
1%
3%
3%
Cialis for Once Daily Use
In three placebo-controlled Phase 3 clinical trials of 12 or 24 weeks duration, mean age was 58 years (range 21 to 82) and the discontinuation rate due to adverse events in patients treated with tadalafil was 4.1%, compared to 2.8% in placebo-treated patients.
The following adverse events were reported in clinical trials of 12 weeks duration:
Table 2: Treatment-Emergent Adverse Events Reported by ≥2% of Patients Treated with Cialis for Once Daily cialis and blindness (2.5 or 5 mg) and More Frequent on Drug than Placebo in the Three Primary Placebo-Controlled Phase 3 Studies at 12 weeks (Including a Study in Patients with Diabetes) for Cialis for Once Daily Use
Adverse Event
Placebo
(N=248)
Tadalafil 2.5 mg
(N=196)
Tadalafil 5 mg
(N=304)
Headache
5%
3%
6%
Dyspepsia
2%
3%
5%
Nasopharyngitis
4%
4%
3%
Back pain
1%
3%
3%
Upper respiratory tract infection
1%
3%
3%
Flushing
1%
1%
3%
Influenza
2%
3%
2%
Myalgia
1%
2%
2%
Cough
0%
4%
2%
Diarrhea
0%
1%
2%
Nasal congestion
0%
2%
2%
Pain in extremity
0%
1%
2%
Bronchitis
1%
2%
0%
Urinary tract infection
0%
2%
0%
Gastroesophageal reflux
0%
2%
1%
Abdominal pain
0%
2%
1%
The following cialis and blindness events were reported over 24 weeks treatment duration in one placebo-controlled Phase 3 clinical study:
Table 3: Treatment-Emergent Adverse Events Reported by ≥2% of Patients Treated with Cialis for Once Daily Use (2.5 or 5 mg) and More Frequent on Drug than Placebo in One Placebo-Controlled Phase 3 Study of 24 Weeks Treatment Duration for Cialis for Once Daily Use
Adverse Event
Placebo
(N=94)
Tadalafil 2.5 mg
(N=96)
Tadalafil 5 mg
(N=97)
Nasopharyngitis
5%
6%
6%
Gastroenteritis viral
2%
3%
5%
Influenza
3%
5%
3%
Back Pain
3%
5%
2%
Upper Respiratory Tract Infection
0%
3%
4%
Dyspepsia
1%
4%
1%
Gastroesophageal Reflux Disease
0%
3%
2%
Myalgia
2%
4%
1%
Hypertension
0%
1%
3%
Nasal Congestion
0%
0%
4%
Back pain or myalgia was reported at incidence rates described in Tables 1 and 2. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. When medical treatment was necessary, acetaminophen or non-steroidal anti-inflammatory drugs were generally effective; however, in a small percentage of subjects who required treatment, a mild narcotic (e.g., codeine) was used. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. Postmarketing experience has included seizure and seizure recurrence and transient global amnesia.
Ocular
Ocular side effects have included blurred vision, changes in color vision, conjunctivitis (including conjunctival hyperemia), eye pain, increased lacrimation, and swelling of the eyelids.
Non-arteritic anterior ischemic optic neuropathy (NAION), a cause of decreased vision including permanent loss of vision, has been reported rarely postmarketing in temporal association with the use of phosphodiesterase type 5 (PDE5) inhibitors, including tadalafil.
Other
Other side effects have included cases of sudden decrease or loss of hearing reported postmarketing in temporal association with the use of PDE5 inhibitors, including tadalafil. In general, pain was reported as mild or moderate in severity and resolved without medical treatment, but severe back pain was reported with a low frequency (<5% of all reports). These events have been chosen for inclusion either due to their seriousness, reporting frequency, lack of clear alternative causation, or a combination of these factors. These events have been chosen for cialis and blindness either due to their seriousness, reporting frequency, lack of clear alternative causation, or a combination of these factors. In general, pain was reported as mild or moderate in severity and resolved without medical treatment, but severe back pain was reported with cialis and blindness low frequency (<5% of all reports). It is not possible to determine whether these reported events are related directly to the use of Cialis, to the patient's underlying risk factors for hearing loss, a combination of these factors, or cialis and blindness other factors .
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Side Effects by Body System
Cardiovascular
Cardiovascular side effects have included angina pectoris, chest pain, hypotension, hypertension, myocardial infarction, postural hypotension, palpitations, syncope, and tachycardia.
Dermatologic
Dermatologic side effects have included pruritus, rash, and sweating.
Gastrointestinal
Gastrointestinal side effects have included dyspepsia, diarrhea, dry mouth, dysphagia, esophagitis, gastroesophageal reflux, gastritis, loose stools, nausea, upper abdominal pain, and vomiting.
General
General side effects have included asthenia, face edema, facial flushing, fatigue, and pain in a limb.
Genitourinary
Genitourinary side effects have included increased erection and spontaneous penile erection.
Hepatic
Hepatic side effects have included abnormal liver function tests such as an increased GGTP.
Musculoskeletal
Musculoskeletal side effects have included back pain or myalgia, arthralgia, and neck pain.
Respiratory
Respiratory side effects have included nasal congestion, dyspnea, epistaxis, pharyngitis, nasopharyngitis, upper respiratory tract infection, and bronchitis.
Nervous system
Nervous system side effects have cialis and blindness headache, dizziness, hypesthesia, insomnia, paresthesia, somnolence, migraine and vertigo. In many cases, medical follow-up information was limited. reported for Cialis for use as needed:
Table 1: Treatment-Emergent Adverse Events Reported by ≥2% of Patients Treated with Cialis (10 or 20 mg) and More Frequent on Drug than Placebo in the Eight Primary Placebo-Controlled Phase 3 Studies (Including a Study in cialis and blindness with Diabetes) for Cialis for Use as Needed
a The term flushing includes: facial flushing and flushing
Adverse Event
Placebo
(N=476)
Tadalafil 5 mg
(N=151)
Tadalafil 10 mg
(N=394)
Tadalafil 20 mg
(N=635)
Headache
5%
11%
11%
15%
Dyspepsia
1%
4%
8%
10%
Back pain
3%
3%
5%
6%
Myalgia
1%
1%
4%
3%
Nasal congestion
1%
2%
3%
3%
Flushinga
1%
2%
3%
3%
Pain in limb
1%
1%
3%
3%
Cialis for Once Daily Use
In three placebo-controlled Phase 3 clinical trials of 12 or 24 weeks duration, mean age was 58 years (range 21 to 82) and the discontinuation rate due to adverse events in patients treated with tadalafil was 4.1%, compared to 2.8% in placebo-treated patients.
The following adverse events were reported in clinical trials of 12 weeks duration:
Table 2: Treatment-Emergent Adverse Events Reported by ≥2% of Patients Treated with Cialis for Once Daily Use cialis and blindness or 5 mg) and More Frequent on Drug than Placebo in the Three Primary Placebo-Controlled Phase 3 Studies at 12 weeks (Including a Study in Patients with Diabetes) for Cialis for Once Daily Use
Adverse Event
Placebo
(N=248)
Tadalafil 2.5 mg
(N=196)
Tadalafil 5 mg
(N=304)
Headache
5%
3%
6%
Dyspepsia
2%
3%
5%
Nasopharyngitis
4%
4%
3%
Back cialis and blindness respiratory tract infection
1%
3%
3%
Flushing
1%
1%
3%
Influenza
2%
3%
2%
Myalgia
1%
2%
2%
Cough
0%
4%
2%
Diarrhea
0%
1%
2%
Nasal congestion
0%
2%
2%
Pain in extremity
0%
1%
2%
Bronchitis
1%
2%
0%
Urinary tract infection
0%
2%
0%
Gastroesophageal reflux
0%
2%
1%
Abdominal pain
0%
2%
1%
The following adverse events were reported over 24 weeks treatment duration in one placebo-controlled Phase 3 clinical study:
Table 3: Treatment-Emergent Adverse Events Reported by ≥2% of Patients Treated with Cialis for Once Daily Use (2.5 or 5 mg) and More Frequent on Drug than Placebo in One Placebo-Controlled Phase 3 Study of 24 Weeks Treatment Duration for Cialis for Once Daily Use
Adverse Event
Placebo
(N=94)
Tadalafil 2.5 mg
(N=96)
Tadalafil 5 mg
(N=97)
Nasopharyngitis
5%
6%
6%
Gastroenteritis viral
2%
3%
5%
Influenza
3%
5%
3%
Back Pain
3%
5%
2%
Upper Respiratory Tract cialis and blindness Reflux Disease
0%
3%
2%
Myalgia
2%
4%
1%
Hypertension
0%
1%
3%
Nasal Congestion
0%
0%
4%
Back pain or myalgia was reported at incidence rates described in Tables 1 and 2. Most, but not all, of these patients had preexisting cardiovascular cialis and blindness factors. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. Postmarketing experience has included seizure and seizure recurrence and transient global amnesia.
Ocular
Ocular side effects have included blurred vision, changes in color vision, conjunctivitis (including conjunctival hyperemia), eye pain, increased lacrimation, and swelling of the eyelids.
Non-arteritic anterior ischemic optic neuropathy (NAION), a cause of decreased vision including permanent loss of vision, has been reported rarely postmarketing in temporal association with the use of phosphodiesterase type 5 (PDE5) inhibitors, including tadalafil.
Other
Other side effects have included cases of sudden decrease or loss of hearing reported cialis and blindness in temporal association with the use of PDE5 inhibitors, including tadalafil. Incidence rates for Cialis for once daily use are described in Table 2.
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In studies of Cialis for once daily use, events of back pain and myalgia were generally mild or moderate with a discontinuation cialis and blindness of 0.3%.
Across all studies with any Cialis dose, reports of changes in color vision were rare (<0.1% of patients).
The following section identifies additional, less frequent events (<2%) reported in controlled clinical trials of Cialis for once daily use or use as needed. In many cases, medical follow-up information was limited. Others were reported to have occurred hours to days after the use cialis and blindness Cialis and sexual activity. Overall, approximately 0.5% of all subjects treated with cialis and blindness for on demand use discontinued treatment as a consequence of back pain/myalgia.
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