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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. In studies of Cialis cialis soft tab rss feed 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. A causal relationship of these events to Cialis is uncertain. Because these reactions are reported voluntarily cialis soft tab rss feed 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. In the 1-year open label extension study, back pain and myalgia were reported in 5.5% and 1.3% of patients, respectively. Excluded from this list are those events that were minor, those with no plausible relation to drug use, and reports too imprecise to be meaningful:
Body as a whole — asthenia, cialis soft tab rss feed edema, fatigue, pain
Cardiovascular — angina pectoris, chest pain, hypotension, myocardial infarction, postural hypotension, palpitations, syncope, tachycardia
Digestive — abnormal liver function tests, dry mouth, dysphagia, esophagitis, gastritis, GGTP increased, loose stools, nausea, upper abdominal pain, vomiting
Musculoskeletal — arthralgia, neck pain
Nervous cialis soft tab rss feed dizziness, hypesthesia, insomnia, paresthesia, somnolence, vertigo
Respiratory — dyspnea, epistaxis, pharyngitis
Skin and Appendages — pruritus, rash, sweating
Ophthalmologic — blurred vision, changes in color vision, conjunctivitis (including conjunctival hyperemia), eye pain, lacrimation increase, swelling of eyelids
Otologic — sudden decrease or loss of hearing, tinnitus
Urogenital — erection increased, spontaneous penile erection
Postmarketing Experience
The following adverse reactions have been identified during post approval use of Cialis. Postmarketing experience has included seizure and seizure recurrence and transient global amnesia.
Ocular
Ocular side effects have included blurred vision, changes in color vision, cialis soft tab rss feed (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. 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 cialis soft tab rss feed 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 More Frequent on Drug cialis soft tab rss feed 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 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 cialis soft tab rss feed 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. 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. 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. It is not possible to determine whether these events are related cialis soft tab rss feed 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. Excluded from this list are those events that were minor, those with no plausible relation to drug use, and reports too imprecise to be meaningful:
Body as a whole — asthenia, face edema, fatigue, pain
Cardiovascular — angina pectoris, chest pain, hypotension, myocardial infarction, postural hypotension, palpitations, syncope, tachycardia
Digestive — abnormal cialis soft tab rss feed function tests, dry mouth, dysphagia, esophagitis, gastritis, GGTP increased, loose stools, nausea, upper abdominal pain, vomiting
Musculoskeletal — arthralgia, neck pain
Nervous — dizziness, hypesthesia, insomnia, paresthesia, somnolence, vertigo
Respiratory — dyspnea, epistaxis, pharyngitis
Skin and Appendages — pruritus, rash, sweating
Ophthalmologic — blurred vision, changes in color vision, conjunctivitis (including conjunctival hyperemia), eye pain, lacrimation increase, swelling of eyelids
Otologic — sudden decrease or loss of hearing, tinnitus
Urogenital — erection increased, cialis soft tab rss feed penile erection
Postmarketing Experience
The following adverse reactions have been identified during post approval use of Cialis. In tadalafil clinical pharmacology trials, back pain or myalgia generally occurred 12 to 24 hours after dosing and typically resolved within 48 hours. 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.
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Most, but not all, of these patients had underlying anatomic or vascular risk factors for development of NAION, including but not necessarily limited to: low cup to cialis soft tab rss feed ratio (“crowded disc”), age over 50, diabetes, hypertension, coronary artery disease, hyperlipidemia, and smoking. 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. In many cases, medical follow-up information was limited. Incidence rates for Cialis for once daily use are described in Table 2.
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