Long-term tadalafil use linked to 22% higher glaucoma risk in men with urinary symptoms

A large observational study published in the British Journal of Ophthalmology found that men prescribed tadalafil for lower urinary tract symptoms had a higher risk of glaucoma than matched peers who did not use that class of drugs.

Researchers reviewed records for about 74,000 men ages 40 and older and matched roughly 37,000 tadalafil users with a similar group who did not take phosphodiesterase type 5 inhibitors. Follow-up ran up to five years. Fox News reported that tadalafil users were 22% more likely to develop glaucoma, 32% more likely to develop high pressure inside the eye, and 33% more likely to develop primary open-angle glaucoma.

Five-year cumulative incidence of any glaucoma diagnosis was about 3.93% among tadalafil users versus 3.16% among non-users, according to Ophthalmology Times. Absolute rates remained modest. The study does not prove tadalafil causes glaucoma.

Tadalafil, sold for years as Cialis for erectile dysfunction, is also approved to treat signs of benign prostatic hyperplasia. Many older men take a daily dose for urinary urgency and flow. Glaucoma often has few early visual symptoms, which is why routine eye pressure checks matter.

Dr. Valerie Kattouf, an optometrist at the Illinois Eye Institute who was not involved in the study, told Fox News Digital that glaucoma can advance quietly. Men on long-term tadalafil, especially those with family history or other eye risks, should keep scheduled eye exams and report sudden vision changes right away.

The practical step is shared decision-making: review the drug with both the prescribing clinician and an eye doctor rather than quitting cold on the basis of one observational paper.