BJO: Tadalafil increases glaucoma risk by 22%

Scientists have found that long-term use of tadalafil (known under the brand name Cialis) to treat symptoms of an enlarged prostate is associated with a significantly higher risk of glaucoma, a serious eye disease that can lead to vision loss. The study was published in the British Journal of Ophthalmology (BJO).

Tadalafil is widely used not only to treat erectile dysfunction but also to ease urination in men with benign prostatic enlargement. The drug dilates blood vessels, and researchers hypothesized that this could also affect eye pressure.

Researchers led by Yun Xia analyzed data from 73,854 men over the age of 40 between 2012 and 2022, comparing those who took tadalafil with those who did not.

The study found that men taking the drug had a 22% higher risk of glaucoma, a 32% higher risk of elevated intraocular pressure, and a 33% higher risk of primary open-angle glaucoma, the most common form of the disease.

“These findings do not constitute a contraindication to tadalafil use, but they highlight the importance of assessing eye health before starting treatment and conducting regular follow-up, particularly in patients with pre-existing glaucoma,” the authors noted.

In other words, the findings do not mean that patients should stop taking an effective medication, but rather that it should be used under the supervision of an ophthalmologist. Glaucoma is dangerous because it can develop without noticeable symptoms and cause irreversible damage to the optic nerve before any complaints appear, making early detection particularly important. The mechanism underlying the association remains unclear; it may be related to the drug’s effects on blood flow and pressure inside the eye.