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Tdl3.0
Tadalafil Research
Mostly mechanism / observational
110 peer-reviewed studies
What the evidence says
Mostly mechanism / observational
Most Tadalafil studies are mechanism or observational rather than RCTs that measure a clinical effect — keep findings provisional.
Most evidence is from high-quality meta-analyses and randomised trials published 2007–2026 with a typical study size of 185 participants.
Based on 110 studies · 13 meta-analyses · 86 RCTs · 14,498 total participants
Confidence
High confidence
By outcome
Cardiovascular & vascular
Mostly mechanism / observational25 studies
Safety profile
Mostly mechanism / observational8 studies
Mortality (associational)
Mostly mechanism / observational4 studies
Dementia risk (associational)
Mostly mechanism / observational3 studies
Active research area
41 studies in the last 5 years · Latest meta-analysis: 2026
200720162026
1Meta-Analysisn=1,549 · large study2025
In plain English: These findings support further investigation of PDE5 in chronic inflammatory conditions.
Cianciarulo C, Nguyen TH, Zacharias A, Standen N, Tucci J, Irving H. · International journal of molecular sciences (2025)
Long-term treatment was associated with reduced IL-6 (SMD = -0.64, p = 0.002) and P-selectin (SMD = -0.57, p = 0.02), and increased cGMP (SMD = 0.87, p = 0.0003).
Effects on IL-10 and nitric oxide were inconsistent across studies.
In plain English: PDE5is are highly effective, with sildenafil showing a significantly greater efficacy compared with the other PDE5is.
Salonia A et al. · The journal of sexual medicine (2026)
Threshold analysis showed a statistically significant improvement in ED with sildenafil 100 mg [OR 2.20; 95% confidence interval (CI) 1.78-2.63] and 50 mg (OR 2.10; 95% CI 1.69-2.50) compared to placebo.
PDE5is are highly effective, with sildenafil showing a significantly greater efficacy compared with the other PDE5is.
In plain English: The title is "Associations between PDE5is and vascular parameters: A systematic review and meta-analysis" ( https://www.crd.york.ac.uk/
Zhang Y, Peng H, Xin S, Mao J, Zhang J, Li H, Luan Y, Liu X, Wang T, Liu J, Zhang H, Song W. · Systematic reviews (2025)
Mean differences (MDs) with 95% confidence intervals (CIs) were pooled.
However, the effects of PDE5is on the augmentation index, brachial artery diameter and reactive hyperemia index were not statistically significant.
The title is "Associations between PDE5is and vascular parameters: A systematic review and meta-analysis" ( https://www.crd.york.ac.uk/PROSPERO/ ) (Reg.
In plain English: However, it was associated with a higher incidence of adverse effects.
Hashmi TM, Zia R, Ashraf H, Siddiqui M, Haider A, Rumampouw V, Khan MA, Ahmed M, Iqbal J. · World journal of urology (2025)
However, combination therapy resulted in a higher incidence of pain (OR = 5.66, 95% CI 2.56 to 12.52; P < 0.01) and other adverse events (OR = 2.97, 95% CI 1.60 to 5.49; P < 0.01).
Conclusion Combination therapy with tamsulosin and tadalafil demonstrated superior efficacy over tamsulosin monotherapy in reducing LUTS, improving quality of life, and enhancing erectile function.
However, it was associated with a higher incidence of adverse effects.