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Tadalafil (Cialis; Eli Lilly, Indianapolis, IN), a phosphodiesterase type 5 (PDE5) inhibitor, is used to treat erectile dysfunction in men. The most common adverse effects reported include headache, dizziness, minor visual changes, and ischemic optic neuropathy.1 We describe a patient who developed intracerebral hemorrhage after taking two tablets of tadalafil 20 mg.
Case report.
A 70-year-old man presented to our emergency department with headache, nausea, and vomiting lasting for 4 days. He was anxious and confused, with memory disturbances, but neurologic examination was otherwise normal. His medical history included prostate cancer, erectile dysfunction, and depression. There was no history of hypertension, head trauma, or prior cerebrovascular disease (stroke/TIA), and no underlying vascular or hemostatic risk factors. Blood pressure and pulse measured were 132/65 mm Hg and 78 bpm. A head CT scan without contrast showed an intracerebral hemorrhage (2 × 4 cm in diameter) in …
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