Cialis / Tadalifil muscle ache - any advice?

Same here, I started on 5 mg daily for about six months (post SBRT) and noticed the exact same side effects as you including Some low back pain as well. When I did a trial of discontinuing the drug, the side effects disappeared. I have gone to 5 mg every other day and found that this helped reduce the side effects.(I am 73 years old so expect that my tadaladil half life might be a bit longer due to age.) If the side effects continue, you might consider switching to Viagra or sildenafil 25mg daily. Tadalafil’s PDE 11 effect is the cause of these specific side effects. Sildenafil lacks PDE 11 inhibition. Good luck!

@jheadding Thanks so much! Glad to know I'm not the only one out there. It appears to be one of the rarer side effects. Not much out there on the web about it, but it is known.

I'm starting by switching to taking it in the morning. Apparently, the muscle ache is described in the literature as being typically worse when lying down, so going to see if taking it in the morning vs. night might help.

From there, I'll probably end up talking with my doc whether to switch to other PDE5 med or just alternate dosing. One person tole me that they switched to taking a 10mg Tadalafil every other day and that helped them.

It did really have me confused at first because I've been do vigorous walking on the treadmill with a weight vest to get in better shape pre-surgery....so I was wondering if that was why my thighs/shoulders were hurting so much. So, good news, no, not the treadmill. Bad news-it's the new drug.

We'll get there. Thanks for your help!

I'll be eliminating the 5 mg of tadalafil I've been taking for a while to see what happens. !
Thanks so much for reporting your experience!

I've been experiencing very similar things. I.e. pain in one of my thighs, hip, shoulder. The thigh and hip pain at times can keep me from sleeping. The pains are intermittent and variable. Some times on some days I experience no pain at all.

My first thought was my exercise program. Once I heard that exercise oncologists have discovered that increased muscle mass is directly related to better prostate cancer outcomes for those on ADT, I've never been so religious about aiming to increase my muscle size, almost regardless of pain. Nevertheless, I've had to stop doing certain exercises involving the thighs because the pain was severe enough I thought I must be doing damage. I added stretching and strengthening exercises of the type recommended by physical therapists for hip pain to my daily routine, but some days I wonder if these are making things worse.... I also added periodic rest days. These seem to help. The thing is, I am used to being suddenly subject to dramatic increases in what my body is expected to do and I am familiar with how it feels to experience the pain of muscle overuse and how it feels to recover and come back stronger. These pains I've been experiencing lately are not responding like that.

Another idea I had is that my symptoms were a possible side effect of Orgovyx. Apparently as many as 30% of patients on Orgovyx can experience some sort of "musculoskeletal" pain, This is defined as "myalgia (muscle pain), arthralgia (joint pain), back pain, pain in extremity, bone pain, and musculoskeletal stiffness". Data supporting this also comes from a recent study of the FDA database of adverse events reported since Orgovyx has been in widespread use. https://pmc.ncbi.nlm.nih.gov/articles/PMC11495556/.
However, my medical oncologist asserts that whatever I'm experiencing has nothing to do with his prescription for Orgovyx. I'm not sure why he is so certain. So far I'm not going to experiment with cutting out the Orgovyx for any length of time. I am grateful it is having its intended effect on the cancer.