WEDNESDAY, Aug. 5, 2026 (HealthDay News) -- For men with lower urinary tract symptoms (LUTS), tadalafil is associated with an increased risk for glaucoma compared with a non-phosphodiesterase type 5 inhibitor (non-PDE5i), according to a study published online Aug. 4 in the British Journal of Ophthalmology.
Yun Hsia, M.D., from the National Taiwan University Hospital in Taipei, and colleagues conducted a multinational, retrospective cohort study involving men aged 40 years and older with a history of LUTS who were enrolled between 2012 and 2022. Participants were classified into the tadalafil group and the non-PDE5i group; age, race, comorbidities, renal function, and concomitant medications were balanced in propensity score matching.
Overall, 36,927 tadalafil users and 36,927 matched non-PDE5i users were included in the cohort. The researchers found that compared with non-PDE5i use, tadalafil use was associated with an increased risk for glaucoma up to five years (hazard ratio, 1.22). Risks were elevated for ocular hypertension, primary open-angle glaucoma, and initiation of glaucoma treatment (hazard ratios, 1.32, 1.33, and 1.33, respectively). For low-tension or primary angle-closure glaucoma, there were no significant associations observed. A higher five-year cumulative incidence was seen for tadalafil users versus nonusers (3.93 versus 3.16 percent), with consistent risk in men older than 50 years, in Whites, and across comorbidities, remaining robust at lag times of one, three, and six months.
"These findings do not contraindicate tadalafil use but highlight the importance of baseline ophthalmic assessment and regular follow-up, particularly in patients with preexisting glaucoma, ocular hypertension, a family history of glaucoma, high myopia, or those requiring long-term therapy," the authors write.
