A large comparative study published in the British Journal of Ophthalmology has found that long-term use of tadalafil (Cialis), a phosphodiesterase type 5 inhibitor (PDE5i) commonly prescribed for erectile dysfunction and urinary symptoms associated with an enlarged prostate, may be associated with a higher risk of glaucoma. The study, which analyzed anonymized health information from 73,854 men aged 40 or older, revealed that men prescribed tadalafil were 22% more likely to develop glaucoma compared to those who had not received the medication. Additionally, the study found increased incidences of ocular hypertension (32% more common) and primary open-angle glaucoma (33% more likely), as well as a 33% higher likelihood of initiating glaucoma treatment among tadalafil users.
The researchers caution that the observational nature of the study means it cannot establish a direct causal link between tadalafil and glaucoma. Several limitations were noted, including the inability to account for changes in medication prescriptions over time, tracking of additional health conditions, and the predominantly White participant demographic, which may limit the generalizability of the findings. Despite these limitations, the researchers recommend that patients using tadalafil for extended periods, particularly those with pre-existing glaucoma risk factors such as a family history of the disease, ocular hypertension, high myopia, or the need for long-term therapy, should undergo baseline ophthalmic assessments and regular follow-up monitoring. The study underscores the importance of further investigation into the potential ocular effects of long-term PDE5i use. [Source: https://www.sciencedaily.com/releases/2026/09/260906170134.htm]