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It is not possible to determine whether cialis impacting sperm events are related directly to Cialis, to sexual activity, to the patient's underlying cardiovascular disease, to a combination of these factors, or to other factors .
Body as a whole — hypersensitivity reactions including urticaria, cialis impacting sperm syndrome, and exfoliative dermatitis
Nervous — migraine, seizure and seizure recurrence, transient global amnesia
Ophthalmologic — visual field defect, retinal vein occlusion, retinal artery occlusion
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 Cialis. A causal relationship of these events to Cialis is uncertain. It is not possible to determine whether these events are related directly to the use of PDE5 inhibitors, to the patient's underlying vascular risk factors or anatomical defects, to a combination of these factors, or to other factors .
Otologic — Cases of sudden decrease or loss of hearing have been reported postmarketing in temporal association with the use of PDE5 inhibitors, including Cialis. The list does not include adverse events that are reported from clinical trials and that are listed elsewhere in this section.
Cardiovascular and cerebrovascular — Serious cardiovascular events, including myocardial infarction, sudden cardiac death, stroke, chest pain, palpitations, and tachycardia, have been reported postmarketing in temporal association with the use of tadalafil. 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. In some of the cases, medical conditions and other factors were reported that may have also played a role in the otologic adverse events. A causal relationship of these events to Cialis is uncertain. In some cases, medical conditions and other factors were cialis impacting sperm that may have also played a role in the otologic adverse events. 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 as needed. 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). In the 1-year open label extension study, back pain and myalgia were reported in 5.5% and 1.3% of patients, respectively. 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. Because these reactions are reported voluntarily from a population of uncertain size, it is not cialis impacting sperm possible to cialis impacting sperm estimate their frequency or establish a causal relationship to drug exposure. Diagnostic testing, including measures for inflammation, muscle injury, or renal damage revealed no evidence of medically significant underlying pathology. 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 Use (2.5 or 5 mg) and cialis impacting sperm Frequent on Drug than Placebo in the Three Primary Placebo-Controlled Phase cialis impacting sperm 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 cialis impacting sperm 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 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.
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Others were reported to have occurred hours to days after the use of Cialis and sexual activity. The list does not include adverse events that are reported from clinical trials and that are listed elsewhere in this section.
Cardiovascular and cialis impacting sperm — Serious cardiovascular events, including myocardial infarction, sudden cardiac death, stroke, chest pain, palpitations, and tachycardia, have been reported postmarketing in cialis impacting sperm association with the use of tadalafil. In the 1-year open label extension study, back pain and myalgia were reported in 5.5% and 1.3% of patients, respectively. 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 as needed. 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). It is not possible to determine whether these events are related directly to Cialis, to sexual activity, to the patient's underlying cardiovascular disease, to a combination of these factors, or to other factors .
Body cialis impacting sperm a whole — hypersensitivity reactions including urticaria, Stevens-Johnson syndrome, and exfoliative dermatitis
Nervous — migraine, seizure and seizure recurrence, transient global amnesia
Ophthalmologic — visual field defect, retinal vein occlusion, retinal artery occlusion
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 Cialis.
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