Tadalafil Does Not Cause Hypotension in Men With Spinal Cord Injury Above T6: Presented at AUA

By Maria Bishop

BOSTON -- May 19, 2017 -- Tadalafil 20 mg for erectile dysfunction in men with spinal-cord injury above T6 does not cause hypotension, according to research presented here on May 16 at the 2017 Annual Meeting of the American Urological Association (AUA).

In addition, haemodynamic changes that occur 12 to 36 hours after administration are compensated for by elevations in heart rate, noted Karen Ethans, MD, Health Sciences Centre and University of Manitoba, Winnipeg, Manitoba.

Dr. Ethans and colleagues studied 20 men with an American Spinal Injury Association Impairment Scale-A spinal-cord injury between cervical 4 and thoracic 5. Investigators administered either tadalafil or placebo for the first phase of the study and after 1 week, subjects were crossed over.

The team found no differences in systolic blood pressure between the groups, although there was a significant increase in those taking tadalafil at several time points (12 hours, P < .05; 22 hours, P < .05; 29 hours P < .01; and 36 hours, P < .05). There was no change in systolic BP in those receiving placebo.

In 25% of patients, there was a significant increase in the Visual Analogue Scale (VAS) for dizziness (range, 2-6 cm change) after taking tadalafil; all reports of dizziness were at 12 hours or later. A change in VAS of ≥2 cm was considered positive. Subjects receiving placebo did not report dizziness.

The authors suggested that these findings should be investigated with larger sample sizes, focusing on the tetraplegic population, as those without spinal-cord sympathetic outflow may not be able to have adaptations in heart rate to maintain blood pressure.

[Presentation title: A Randomized Double-blind, Placebo-Controlled, Cross-Over Trial Assessing the Effect of Tadalafil (Cialis) on the Cardiovascular Response in Men With Complete Spinal Cord Injury Above the Sixth Thoracic Level. Abstract MP91-20]

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