Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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A Case of Acute Pulmonary Thromboembolism after Taking Tadalafil

  • Lee, Jinwoo (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Lung Institute, Seoul National University College of Medicine) ;
  • Kwon, Ji Hyun (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Lee, Chang-Hoon (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Lung Institute, Seoul National University College of Medicine) ;
  • Lee, Sang-Min (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Lung Institute, Seoul National University College of Medicine) ;
  • Yim, Jae-Joon (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Lung Institute, Seoul National University College of Medicine) ;
  • Yoo, Chuy-Gyu (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Lung Institute, Seoul National University College of Medicine) ;
  • Kim, Young Whan (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Lung Institute, Seoul National University College of Medicine) ;
  • Han, Sung Koo (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Lung Institute, Seoul National University College of Medicine) ;
  • Park, Young Sik (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Lung Institute, Seoul National University College of Medicine)
  • Received : 2012.04.10
  • Accepted : 2012.05.24
  • Published : 2012.10.30
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Abstract

Tadalafil is a phosphodiesterase-5 inhibitor (PDE5I), which is widely used to treat erectile dysfunction. Although PDE5Is have excellent safety profiles, and most of the side effects are mild, rare serious adverse events have been reported in association with PDE5Is. Thrombosis is one of those events, and a few previous reports have suggested the association of PDE5Is with thrombosis. We report the case of a 61-year-old male who developed pulmonary embolism combined with pulmonary infarction directly after taking tadalafil. Both the patient and the physician suspected tadalafil as the culprit drug, as the patient was in an otherwise healthy condition. However, after extensive evaluation, we noticed that factor VIII levels were elevated. Prior reports suggesting the association between thrombosis and PDEIs either lack complete information on coagulation factors, or show inconsistencies in their results. Physicians should operate caution prior to accepting the diagnosis of adverse drug reaction.

Keywords

References

  1. Goldstein I, Lue TF, Padma-Nathan H, Rosen RC, Steers WD, Wicker PA. Oral sildenafil in the treatment of erectile dysfunction. Sildenafil Study Group. N Engl J Med 1998;338:1397-404. https://doi.org/10.1056/NEJM199805143382001
  2. Montorsi F, Verheyden B, Meuleman E, Jünemann KP, Moncada I, Valiquette L, et al. Long-term safety and tolerability of tadalafil in the treatment of erectile dysfunction. Eur Urol 2004;45:339-44. https://doi.org/10.1016/j.eururo.2003.11.010
  3. Schwartz BG, Levine LA, Comstock G, Stecher VJ, Kloner RA. Cardiac uses of phosphodiesterase-5 inhibitors. J Am Coll Cardiol 2012;59:9-15. https://doi.org/10.1016/j.jacc.2011.07.051
  4. Rosen RC, Kostis JB. Overview of phosphodiesterase 5 inhibition in erectile dysfunction. Am J Cardiol 2003;92:9M-18M.
  5. Rufa A, Cerase A, Monti L, Dotti MT, Giorgio A, Sicurelli F, et al. Recurrent venous thrombosis including cerebral venous sinus thrombosis in a patient taking sildenafil for erectile dysfunction. J Neurol Sci 2007;260:293-5. https://doi.org/10.1016/j.jns.2007.05.011
  6. Morgan JC, Alhatou M, Oberlies J, Johnston KC. Transient ischemic attack and stroke associated with sildenafil (Viagra) use. Neurology 2001;57:1730-1. https://doi.org/10.1212/WNL.57.9.1730
  7. Chen HC, Wang CS, Chuang SH, Wang CY. Pulmonary embolism after tadalafil ingestion. Pharm World Sci 2008;30:610-2. https://doi.org/10.1007/s11096-008-9229-0
  8. Jackson G, Kloner RA, Costigan TM, Warner MR, Emmick JT. Update on clinical trials of tadalafil demonstrates no increased risk of cardiovascular adverse events. J Sex Med 2004;1:161-7. https://doi.org/10.1111/j.1743-6109.2004.04024.x
  9. Kamphuisen PW, Eikenboom JC, Bertina RM. Elevated factor VIII levels and the risk of thrombosis. Arterioscler Thromb Vasc Biol 2001;21:731-8. https://doi.org/10.1161/01.ATV.21.5.731

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