Tadalafil's Effect on PSA Levels

Introduction to Tadalafil and PSA

• The American Urological Association recommends continuing routine PSA screening in men taking tadalafil without any adjustment to the measured value 3
• The European Association of Urology suggests that PSA testing should still be offered annually to men over 50 with a life expectancy of more than 10 years who are on tadalafil, as the medication does not interfere with cancer detection 3, 4

Comparison with 5-Alpha Reductase Inhibitors

• 5-alpha reductase inhibitors, such as finasteride and dutasteride, reduce PSA levels by approximately 50% after 6-12 months of treatment, requiring clinicians to double the measured PSA value to interpret results accurately 1, 2

Clinical Implications for Men with BPH

• When tadalafil is used for BPH symptoms, PSA monitoring remains unchanged from standard BPH management protocols, according to the American Urological Association 6
• In men with BPH taking tadalafil 5 mg daily, approximately 25% may have elevated PSA levels due to the BPH itself, not the medication, and should be evaluated according to standard protocols 6, 3