Tadalafil Effects on Kidneys: What You Should Know and Keep in Mind

Tadalafil (Cialis) is a medication often used to treat erectile dysfunction in men. This article will go over some of the more typical adverse effects of tadalafil medication, as well as some of the more serious issues that might arise from its use. We will especially investigate whether tadalafil has an effect on the kidneys and whether it is safe for persons with renal disease to use.

PDE5 Inhibitors: Erectile dysfunction, BPH (benign prostatic hyperplasia), and PAH medications (pulmonary arterial hypertension)


Tadalafil (Cialis) and sildenafil (Viagra) are examples of drugs known as phosphodiesterase 5 (PDE5) inhibitors. They are frequently prescribed to males suffering from erectile dysfunction (sexual impotence). PDE5 medications function by inhibiting the enzyme PDE5. This medication class enhances blood flow to the penis, assisting in the maintenance of an erection during sexual stimulation. It’s worth mentioning that PDE5 inhibitors like tadalafil and sildenafil require physical stimulation to act.


Tadalafil is also used to treat lower urinary tract symptoms of benign prostatic hyperplasia (BPH) or an enlarged prostate in men. Tadalafil alleviates symptoms such as urinary frequency and urgency, decreased urine flow, and nocturia (getting up at night to urinate).


Adcirca, a brand name of tadalafil, is used in both men and women with pulmonary arterial hypertension (high blood pressure in the major artery that transports blood from the heart to the lungs); as a result, Adcirca can increase exercise capacity. Tadalafil relaxes the blood vessels, increases blood flow to the lungs, and reduces the burden on the heart.

Tadalafil Side Effects

Tadalafil Side Effects

Side effects of tadalafil tablets include heartburn, belching, indigestion, stomach pain, upset stomach, diarrhea, headache, back pain, muscle aches, stuffy nose, and reddish skin (flushing). These adverse effects are usually modest and go away after a while of using tadalafil. If they are severe or persistent, consult your doctor or pharmacist.

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Tadalafil’s more serious adverse effects include:

  • Priapism (a painful erection that does not go away)
  • Vision changes
  • Hearing loss
  • Low blood pressure

If you have any of these significant side effects, you should contact your doctor immediately or seek emergency medical attention.

Can sildenafil damage kidneys?

Sildenafil (Viagra) is deemed kidney-safe and may be provided to persons with renal failure, including men on dialysis who have advanced kidney failure and substantially diminished renal function. According to studies, 75% of men on dialysis may get erections with sildenafil therapy. Men who have diabetes in addition to renal insufficiency have a somewhat reduced success rate.

Having said that, sildenafil should be used with extreme caution in patients who already have kidney disease, since improper dose of sildenafil in these patients can result in catastrophic problems. There have been cases of acute tubular necrosis (ATN) in males with renal disease who took sildenafil in high doses. The danger increases if there are pharmacological interactions, such as nitrates (medications used to treat chest pain). Keeping hydrated while using sildenafil can help reduce the degree of kidney damage and acute renal failure.

Can you take Cialis with kidney disease?

Can you take Cialis with kidney disease?

PDE5 inhibitors, such as tadalafil (Cialis), have been shown in studies to preserve the kidneys.

Can CKD patients take tadalafil?

Several laboratory investigations on rats have looked at the effects of tadalafil on renal tissue. In brief, these are some of the findings:

Serum creatinine and urine protein levels in rats were considerably reduced after 8 weeks of tadalafil usage compared to controls. Tadalafil at high doses improved both renal blood flow and blood pressure. The researchers concluded that both low- and high-dose tadalafil can reduce renal tissue injury in rats with chronic kidney disease.

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Tadalafil has demonstrated encouraging results in rats with chronic renal disease and hypertension caused by excessive salt consumption. PDE5 inhibitors may help retain kidney function and reduce the progression of CKD with hypertension to end-stage renal disease, according to the findings.

Tadalafil significantly reduced acute inflammation and renal damage in rats with sepsis. Tadalafil considerably reduced renal tissue injury caused by inflammation in rats, and the difference was regarded statistically significant. In other words, tadalafil was found to decrease inflammation and protect rat kidney tissues from sepsis-related damage.

According to research, giving tadalafil to rats before generating renal ischemia-reperfusion injury helped reduce the severity of the injury. Tadalafil also aids in the prevention of renal dysfunction and renal damage caused by tubular necrosis.

Though these rat trials are intriguing, more research is needed to gain a better understanding of PDE5 inhibitors’ renoprotective capabilities in CKD patients. In terms of ED medication, PDE5 inhibitors such as tadalafil (Cialis) or sildenafil (Viagra) are routinely used in men with CKD and are effective when administered under the supervision of a physician.

Safe use of tadalafil

This drug is generally safe for men with kidney problems to take. However, when taking tadalafil (Cialis) or other erectile dysfunction medications, it is critical to follow your doctor’s instructions. Here are some pointers for using tadalafil safely:

  • If you have ever had an adverse response to tadalafil or other PDE5 inhibitors, tell your doctor.
  • Tadalafil and other PDE5 inhibitors may be dangerous for some people, such as those with heart condition. If you have risk factors for tadalafil use, talk to your doctor about alternate treatment options for erectile dysfunction.
  • If you are using a nitrate drug (isosorbide mononitrate or isosorbide dinitrate), you should not use Viagra or other PDE5 inhibitors within 7 days. Sublingual pills and oral spray are two further types of nitrates. You should not take Viagra within 24 hours of taking these nitrate dosage forms. Nitrates and PDE5 inhibitors can interact to cause a hazardous reduction in blood pressure.
  • Provide your doctor with a comprehensive list of all medications, including prescription, over-the-counter, and supplements. This can assist to avoid potentially dangerous drug interactions.
  • Take no more than one tadalafil dose in a 24-hour period. An overdose can have major health consequences. If your medication isn’t working, consult your doctor before raising the dose.
  • Do not take two doses of tadalafil to make up for a missed dosage if you are on a regular dosing plan.
  • Drinking grapefruit juice while taking tadalafil can result in increased levels of the medicine in your system, which can create difficulties. While taking tadalafil, avoid eating or drinking grapefruit.
  • Tadalafil therapy improves ED but does not protect against sexually transmitted illnesses. You should engage in safe sex and take necessary precautions, such as using condoms.
  • Tadalafil medication is only effective when sexual excitement is present.
  • Children should not take tadalafil. This drug’s safety and efficacy in youngsters have not been verified.
  • There are no unique concerns for older men using tadalafil. However, elderly patients are more likely to experience negative effects in general. If this is a problem for you, consult with your doctor.
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