title: A three-part study to investigate the incidence and potential etiologies of tadalafil-associated back pain or myalgia.
abstract: The potential mechanisms underlying back pain and/or myalgia experienced by men taking tadalafil were investigated. An integrated analysis of 10 placebo-controlled tadalafil clinical trials (N=1846) showed that the incidence of back pain and/or myalgia was 9.4% in patients receiving tadalafil 10 mg (N=394), 8.3% in patients receiving tadalafil 20 mg (N=883) and 3.7% in placebo-treated patients (N=569). One (0.3%) patient receiving tadalafil 10 mg, six (0.7%) patients receiving tadalafil 20 mg, and no patients receiving placebo discontinued treatment due to back pain and/or myalgia. In a prospective study in healthy volunteers, no substantial changes were observed in laboratory markers indicative of inflammation or muscle damage, and tadalafil did not affect renal plasma flow nor produce lumbar or gluteal myositis by positron emission tomography scan or magnetic resonance imaging. Although the mechanism of back pain and/or myalgia remains unknown, these events appear to be self-limiting and a general effect of phosphodiesterase 5 inhibition.
authors: Case Western Reserve University, University Hospitals of Cleveland, Cleveland, OH 44106-5046, USA. ads6@po.cwru.edu
authors: A D
authors: AD
authors: Seftel
authors: J
authors: J
authors: Farber
authors: J
authors: J
authors: Fletcher
authors: M C
authors: MC
authors: Deeley
authors: A
authors: A
authors: Elion-Mboussa
authors: A
authors: A
authors: Hoover
authors: A
authors: A
authors: Yu
authors: P
authors: P
authors: Fredlund
mesh_terms: D000293:Adolescent; D000328:Adult; D001416:Back Pain / Q000139:chemically induced* / Q000453:epidemiology / Q000209:etiology; D002243:Carbolines / Q000009:adverse effects*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000139:chemically induced / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008297:Male; D009135:Muscular Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D010726:Phosphodiesterase Inhibitors / Q000009:adverse effects*; D049268:Positron-Emission Tomography; D011868:Radioisotopes; D016032:Randomized Controlled Trials as Topic; D000068581:Tadalafil
chemical_list: D002243:Carbolines; D010726:Phosphodiesterase Inhibitors; D011868:Radioisotopes; D000068581:Tadalafil