Tadalafil use associated with higher risk of glaucoma

Taiwanese researchers have identified a higher risk of glaucoma among patients taking tadalafil on a daily, long-term basis for the treatment of lower urinary tract symptoms.

Tadalafil is a form of phosphodiesterase type 5 inhibitor (PDE5i) – a category of medication that can be used to treat erectile dysfunction.

Writing in the British Journal of Ophthalmology, the researchers highlighted that PDE5is have been associated with a range of adverse ocular events, including optic neuropathy and maculopathy.

“Evidence regarding the potential association between PDE5i and glaucoma remains limited and inconclusive, particularly for tadalafil prescribed for lower urinary tract symptoms, which typically involves long-term daily dosing,” the authors highlighted.

To explore this gap in the evidence, the scientists used the TriNetX database to follow 36,927 tadalafil users and 36,927 matched non-PDE5i users over a period of five years.

They found that those using tadalafil had a 22% higher risk of developing glaucoma over the five-year period compared to the control group who were not taking any form of PDE5i.

The researchers also observed a 32% higher risk of ocular hypertension among those taking the medication over the period.

The researchers highlighted that the findings suggest long-term use of PDE5i may influence ocular physiology – warranting further investigation into the mechanism that causes this to happen.

“Clinically, enhanced ophthalmic monitoring may be considered for patients receiving long-term tadalafil, particularly those with glaucoma risk factors,” the researchers emphasised.