Tuberc Respir Dis.  2012 Oct;73(4):231-233.

A Case of Acute Pulmonary Thromboembolism after Taking Tadalafil

• Lee J
• Kwon JH
• Lee CH
• Lee SM
• Yim JJ
• Yoo CG
• Kim YW
• Han SK
• Park YS

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.

Keyword

Pulmonary Embolism; Pulmonary Infarction; Tadalafil; Phosphodiesterase 5 Inhibitors; Factor VIII

MeSH Terms

Blood Coagulation Factors
Carbolines
Cyclic Nucleotide Phosphodiesterases, Type 5
Drug Toxicity
Erectile Dysfunction
Factor VIII
Humans
Male
Middle Aged
Phosphodiesterase 5 Inhibitors
Pulmonary Embolism
Pulmonary Infarction
Thrombosis
Tadalafil
Blood Coagulation Factors
Carbolines
Cyclic Nucleotide Phosphodiesterases, Type 5
Factor VIII
Phosphodiesterase 5 Inhibitors

Figure

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  Figure 1 Chest x-ray shows ill-defined density in the right lower lung with blunted costophrenic angle.

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  Figure 2 Chest computed tomography demonstrates filling defect at right ascending and descending subsegmental pulmonary arteries, along with a wedge-shaped lesion in the right lower lobe.

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