Cialis linked to higher glaucoma risk in older men
A widely prescribed drug for prostate problems in older men may also raise pressure inside the eye. Elevated eye pressure is a key risk factor for glaucoma, an eye disease that can cause irreversible vision loss.
Tadalafil, sold under the brand name Cialis, is used for erectile dysfunction and for urinary symptoms caused by an enlarged prostate. It works by inhibiting an enzyme (PDE5) that relaxes blood vessels. That mechanism benefits circulation in the pelvic region, but blood vessel regulation also plays a role in controlling intraocular pressure (the pressure inside the eye).
Large study, notable numbers
The study followed nearly 74,000 men prescribed tadalafil for urinary symptoms caused by an enlarged prostate. Over five years, men taking the drug were 22% more likely to be diagnosed with glaucoma, 32% more likely to develop elevated intraocular pressure (ocular hypertension), and 33% more likely to begin glaucoma treatment. These are associations from an observational study, not proof of causation. Confounding factors related to the health profile of the study population may contribute to the findings.
Why this matters for aging
Glaucoma is strongly age-related. Risk rises substantially after age 60, precisely the group most likely to be prescribed tadalafil for prostate issues. Vision damage from glaucoma is generally irreversible, making early detection critical.
The findings do not call for patients to stop tadalafil without consulting a doctor. However, they do suggest that older men on long-term tadalafil may benefit from regular eye pressure monitoring. The researchers emphasize that further studies are needed to clarify the underlying mechanism and the true magnitude of any risk.
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