Cialis Long-term ?

Calling all friends who went onto 5mg Cialis or generic Tadalafil at least 2 years ago:
I am wondering about the long-term effects, and would appreciate any feedback about complications or complaints.

I am at 2 1/2 years post-op, and anytime I go off it for a "test", I get terrible itchy flushing in the hands and feet and sometimes lower back. (withdrawal effect ??)
(so far, my couple of tests did not bode well for the hydraulics, although I have only ever tested for a week or less)

But more importantly, does anyone have any serious problems from taking this drug ? I cannot find any relevant studies or anything online about this. As far as I know, this therapy is not really meant for +2 years, but my doc says it's fine to continue. Does anyone really know ??

Post Edited (ComebackKid) : 2/6/2019 3:31:50 AM (GMT-7)

I started it (Cialis 5mg) in early 2010 (January, I think??). I did have to stop it during my weekdays while doing RT, as the very minor back pain got in the way of positioning correctly on the table. But I've been on it all along otherwise.

No evidence of anything negative going on.

island time, you didn't mention this, but hopefully you tried the other PDE5s. The are all completely different medicines and affect people in completely different ways. Unfortunately, much like "tuning-in" to blood-pressure medications, it is only by trial-and-error that we encounter the right medication that works for each different individual's unique biology.

Blackjack said...

ComebackKid said...
As far as I know, this therapy is not really meant for +2 years, but my doc says it's fine to continue. Does anyone really know ??

"As far as you know..." What's that based on...a hunch? Intuition? Unknown?

There have been studies of the safety and tolerability of tadalafil in the treatment of erectile dysfunction which have confirmed long-term usage. More interestingly, I think, is that ED meds appear to demonstrate a degree of "protection" from CVD following long-term usage...and the #1 killer of men WITH prostate cancer is CVD. Double-bonus!

Hey Blackjack,
I was referring to only finding studies which looked at efficacy and tolerance up to the 2 year mark, so naturally I am thinking "OK, what then...?" (in fact I already know about intolerance issues, I'm more concerned with what happens to the liver or the kidneys after 10-20 years...and what about other heart effects ?)
Can you link to us the study you found on long-term usage ? Thanks !

Here's the thing: This therapy is relatively new, and more and more guys are having RP at younger ages (I was only 56), so we are talking about potentially 30+ years on Tadalafil. At what point should one reason that it's better to preserve organs and general health than to be sexually active ? That was the idea of RP in the first place: to raise the chances of a long, healthy, carefree life.
Having said all that, without some proof, clinical or anecdotal, there is no reason to be paranoid. But I will be checking.

Yes, interesting you mention about CVD, as I was checking about tadalafil possibly raising the BP, and in fact it is found to actually LOWER it ! So, bonus for guys like me who are boarderline hypertensive. That must be the mechanism for potential CVD protection.

halbert said...
How did the above comments come out white on a gray background? Virtually unreadable?

I know. Weird. I just fixed it. Good thing I understand a little HTML !

No 30-year studies that I'm aware of.

It worked like magic for me during the couple of months before RP, it was truly amazing. Never even caused a twitch for me during the year or so I fooled with it after RP. But even when it was working wonderfully before RP, it gave me terrible heart burn, every time, for 24 hours or more after I would take a dose. That never stopped.

It also gave me frequent nose bleeds, bad enough to one time send me to the ER, as well as trips to the ENT office for cauterization at least every few weeks during that year. Now, I admit that there might have been other causes, who knows what. But no one ever even mentioned to me that there was an association, until I started researching SEs and sure enough, there it was. Caused a "sloughing" of the nasal lining. I found this out about the time I finally quit the drug, and have not had a nose bleed in the several years since.

So, like the majority of prescription drugs, there are down sides. There is a tendency to fix one thing by breaking another. But if it had helped me sexually, like it did before RP, I would probably be taking it still. Or maybe trying something else like Viagra, since the SEs were pretty bad for me. But the pre RP sexual boost was wonderful.

No success with Tadalafil and Viagra even at max doses. No success combining both of them like 50 mg Viagra and 20 mg. Never produced anything more then just slight chubby.

I seem to get bad muscle aches in my legs if I go too many consecutive days. I can get by during the day but at night the aches can keep me awake. Although an advil seems to work well to combat it. I try and take the pill on Thurs and Fri only since my best opportunity for action is usually the weekend. I didn't seem to have many ED issues after surgery but now that I've gone through radiation/ADT too its harder. Or maybe not.

Expert tip: The 20mg tabs of tadalafil are indeed difficult to cut into quarters for daily dosage. Tadalafil has a lengthy therapeutic window and a long half-life...so consider cutting the pill in half and taking a 10mg dose every other day. (Gracias to my PCP for giving this suggestion...probably 8 years ago.)

Post Edited (Blackjack) : 2/7/2019 10:51:48 AM (GMT-7)

MK1965 said...
No success with Tadalafil and Viagra even at max doses. No success combining both of them like 50 mg Viagra and 20 mg. Never produced anything more then just slight chubby.

BTW, MK1965, bad idea.

Even though the two drugs work differently, they both result in the same mechanism--inhibiting the PDE5 enzymes. There is no incremental benefit to the 2nd drug once the enzymes are saturated by the 1st. Taking both is essentially the same as taking a double dose of one brand (ie. overdosing).

No benefit, but there are increased risks from overdosing--both a increased risk of the common side effects (as you reported experiencing), but also increased likelihood of the more rare serious side effects.

You should instead consult with your PCP (or prescribing physician) about adjusting dosages (for example, the 50mg you mentioned is not the optimal/max viagra dosage) or trying the other brands independently; not every brand works for every man. There are many iterations which may need to be "dialed-in" for your unique body physiology. For example, one study of men for whom the "on demand" cialis did not work were switched for a 12-week trial to the "daily" cialis, and half of the men for whom "on demand" did not work effectively were successful with the "daily" version.

I'm not in the habit of giving "medical recommendations" at this site or anywhere, but I'd recommend that you not to experiment with prescription medications on your own.

Post Edited (Blackjack) : 2/7/2019 11:38:26 AM (GMT-7)

Started Cialis after RP, 4/13, 5mg/day as per the URO for less than 6 months. I am one who is not a great fan of pills so I decided to try 5mg when required. This regime has worked for me over the last 5 years with no problems at all.

Dave

Post Edited (slapshot) : 2/7/2019 3:41:24 PM (GMT-7)

Blackjack,
Combining both of them was recommended by my follow up post RP and a friend who is a Pharm D, so it came from trusted sources.
Cialis and Viagra never worked for me after RP. I never tried any PDE5i before RP because I never had any problems with achieving and maintaining erectionsas long as needed.
After I failed at anything I tried ( Cialis, Viagra, VED, TRIMIX, BIMIX) , decided to get penile implantand I was implanted at 22 months post RP.
Waiting for erectionsto come back after RP was equal to UTOPIA.
MK