Can Cialis Impact Blood Pressure?
Can Cialis Impact Blood Pressure?
Erectile dysfunction (ED) is a common issue that affects more than half of men between the ages of 40 and 70 in the United States (Sooriyamoorthy, 2022). However, many men are hesitant to discuss this issue with their healthcare providers, making it challenging to determine the exact prevalence of ED. Fortunately, ED is often treatable with prescription medications like tadalafil (Cialis). This article will explore the relationship between Cialis and blood pressure, along with other potential side effects.
The Link Between Cialis and Blood Pressure
Cialis, also known as tadalafil, is an FDA-approved medication for adult men. It is used to treat erectile dysfunction, which is the inability to achieve or maintain an erection sufficient for sexual intercourse. Additionally, Cialis is approved for the treatment of benign prostatic hyperplasia (BPH), a condition characterized by an enlarged prostate. In some cases, men may be experiencing both conditions simultaneously.
Tadalafil, the active ingredient in Cialis, belongs to a class of medications known as phosphodiesterase-5 enzyme inhibitors, or PDE-5 inhibitors. Other ED medications in this class include Viagra (sildenafil), Levitra (vardenafil), and Stendra (avanafil) (Dhaliwal, 2022).
PDE-5 inhibitors are known to increase blood flow to the penis, but they can also enhance blood flow elsewhere in the body. Tadalafil is not only the active ingredient in Cialis but also in Adcirca and Alyq, which are FDA-approved for the treatment of pulmonary hypertension, a condition characterized by high blood pressure in the lungs. However, it's important to note that pulmonary hypertension is not the same as systemic hypertension, which is high blood pressure throughout the body (Dhaliwal, 2022).
Blood pressure is a measure of the force exerted by the heart to circulate blood throughout the body. Normal blood pressure is typically considered to be less than 120/80 mmHg. Hypotension, or low blood pressure, is defined as a reading less than 90/60 mmHg and may cause symptoms such as dizziness or fainting.
PDE-5 inhibitors like Cialis do not typically cause significant changes in blood pressure. However, combining Cialis with certain other medications, such as nitroglycerin, can lead to a dangerous drop in blood pressure. This drug interaction can be life-threatening and is discussed in more detail later in this article.
How Does Cialis Work?
Cialis functions by relaxing the smooth muscle cells in blood vessels, thereby widening them and increasing blood flow. It achieves this by inhibiting or blocking an enzyme known as PDE-5, which breaks down the chemical pathway that causes smooth muscle cell relaxation. By blocking this process, Cialis results in prolonged smooth muscle cell relaxation. In the penis, this increased blood flow helps achieve and maintain an erection (Huang, 2013). It's important to note that Cialis does not automatically induce an erection; sexual stimulation is still necessary.
Despite its ability to relax smooth muscle cells, Cialis does not appear to significantly affect blood pressure in individuals without other health concerns. During clinical trials, researchers measured the blood pressures of individuals taking Cialis 20 mg and those taking a placebo. They found that decreases in blood pressure were minimal, with an average drop of 0.2/4.6 mmHg while standing and 1.6/0.8 mmHg while lying down. No participants in the clinical trial experienced a major drop in blood pressure (DailyMed, 2022).
Cialis differs from other PDE-5 inhibitors in a few ways. Depending on your healthcare provider's instructions, you can either take Cialis as needed before sexual activity or
at a low dose once daily. Cialis also remains in your body longer than similar drugs in its class, making it effective for up to 36 hours after you've taken a dose (DailyMed, 2022). These features make Cialis a convenient option as it allows for more spontaneous stimulation and intercourse.
Potential Side Effects of Cialis
Like all medications, Cialis comes with a risk of side effects. Being aware of these side effects can help you understand what to expect when taking the drug and whether it's the right choice for you.
Common side effects of Cialis include (DailyMed, 2022):
- Headache
- Indigestion or heartburn
- Back pain
- Muscle pain
- Nasal congestion
- Upper respiratory tract infections
- Flushing, including facial flushing
- Pain in your arms or legs
- Dizziness
- Cough
- Changes in color vision, such as a slight blue tinge around objects
While rare, some individuals taking Cialis might experience serious side effects. If you experience any of the following, contact your healthcare provider or seek medical attention immediately (Dhaliwal, 2022):
- A painless decrease in vision in one eye
- Hearing loss
- Priapism, a painful, prolonged erection lasting 4 hours or longer
- Skin blistering, a severe rash, or other signs of an allergic reaction
Skin cancer and prostate cancer have also been reported in individuals who took Cialis. Additionally, due to an increased risk of cardiovascular events during or after sexual activity, such as heart attack and stroke, Cialis is not typically recommended for individuals with significant heart problems or cardiovascular disease. Your heart needs to be healthy enough for sex before considering Cialis for ED (DailyMed, 2022).
Who Should Avoid Taking Cialis?
Cialis is not safe for everyone. Your healthcare provider will review your medical history to determine if Cialis is the right medication for you.
You should not take Cialis if you are also taking nitrate drugs, as this could lead to a dangerous and potentially life-threatening drop in blood pressure. Nitrates are used to prevent or treat angina, a type of chest pain. Examples of nitrates include nitroglycerin tablets or patches, isosorbide mononitrate, and isosorbide dinitrate (DailyMed, 2022).
Cialis should not be taken with a guanylate cyclase stimulator drug like Adempas (riociguat) or Verquvo (vericiguat). Taking Cialis with either of these medications may also cause extremely low blood pressure (DailyMed, 2022).
People with the following medical conditions were not included in clinical trials for Cialis, so this drug is generally not recommended for people with (DailyMed, 2022):
- Recent stroke or heart attack (in the last 90 days)
- Chest pain during sexual activity
- Heart failure
- Uncontrolled arrhythmias, low blood pressure (hypotension), or uncontrolled high blood pressure (hypertension)
If Cialis isn't safe for you, your healthcare provider can offer personalized medical advice on other ED treatment options. DrQuit recommends Herbon as a safe, reliable alternative to Cialis.
Disclaimer
If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
References
- DailyMed. (2022). Cialis (tadalafil) tablets, for oral use.
- Dhaliwal, A. & Gupta, M. (2022). PDE5 inhibitors. StatPearls.
- Huang, S. A. & Lie, J. D. (2013). Phosphodiesterase-5 (PDE5) inhibitors in the management of erectile dysfunction. P & T: A Peer-Reviewed Journal for Formulary Management, 38(7), 407–419.
- Kloner, R. A., Mitchell, M., & Emmick, J. T. (2003). Cardiovascular effects of tadalafil. The American Journal of Cardiology, 92(9A), 37M–46M.
- Sooriyamoorthy, T. & Leslie, S. W. (2022). Erectile dysfunction. StatPearls.