Tadalafil linked to increased glaucoma risk

A large multinational cohort study published in the British Journal of Ophthalmology found that men taking tadalafil (Cialis) long-term for lower urinary tract symptoms associated with benign prostatic hyperplasia had a significantly higher risk of developing glaucoma and related eye conditions. The study analyzed anonymized data from 73,854 men aged 40 and older from the TriNetX Analytics Network, half of whom had been prescribed tadalafil or another phosphodiesterase type 5 inhibitor for up to five years. After five years, tadalafil users were 22% more likely to develop glaucoma, 32% more likely to develop ocular hypertension, 33% more likely to develop primary open-angle glaucoma, and 33% more likely to start glaucoma treatment. The associations persisted across sensitivity analyses and were consistent in men aged over 50 and those with comorbidities. The researchers, led by National Taiwan University Hospital, emphasized that the findings do not contraindicate tadalafil use but highlight the importance of baseline ophthalmic assessment and regular follow-up, especially for patients with existing risk factors. Experts from the Centre for Eye Research Australia and Westmead Hospital noted the correlation was clear but the absolute risk remained low, and they recommended regular eye checks for long-term users. The study was observational and could not establish causation, and its applicability to non-White populations may be limited.