I have been diagnosed with smoldering multiple myeloma for about four years now and am considered low risk. My numbers have gone up slightly, but I am considered stable at this point.
My urologist recently informed me I have an enlarged prostate gland, somewhat normal for a person 67 years old. He referred to my condition as "benign prostatic hypertrophy" (BPH). He prescribed tadalafil (Cialis) 5 mg and to take one pill every other day, for treatment. I informed him I had smoldering multiple myeloma and he really did not have any reaction.
I looked up tadalafil and it has a warning if you have multiple myeloma and to check with your doctor. Does anyone have knowledge regarding this drug or why there is a concern about taking the drug if I have smoldering multiple myeloma.
I am scheduled to have my 90 day CBC in about four weeks and will seeing my myeloma specialist at that time. I probably should wait and check this out with him before proceeding to take the drug.
Your opinions would be appreciated.
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Re: Is tadalafil safe if you have smoldering myeloma?
Dear friend,
I was searching on Google for something else, but accidentally was drawn to your post, and thought I would post a response that might be of help.
I am a hematologist, though my practice does not focus on multiple myeloma necessarily. Of course, I recommend you ask this question from your myeloma doctor, if s/he is really a "myeloma specialist", but if s/he is a hematologist without specific focus on myeloma, likely s/he will not be able to provide more specific answer.
Nevertheless, as best as I can tell, this is why there is a safety concern with Cialis in myeloma:
In active multiple myeloma as you know there are abnormal proteins in the blood that are filtered through kidneys, and these proteins can damage the kidneys. Patients with multiple myeloma, even if their kidney function appears normal on blood tests, are at risk of developing kidney damage with any insult that may not affect normal kidneys. For example, if a person experiences a brief period of low blood pressure for any reason, there will be a brief diminished blood circulation to the kidneys, which is an insult to the kidneys. People with normal kidneys, without abnormal proteins around, can tolerate this well and their kidneys will not have damage. But if somebody has abnormal proteins around, kidneys are kind of irritated and more vulnerable to damage with any insult, even if kidneys look normal on blood tests. Cialis is a vasodilator, meaning, it dilates (opens up) blood vessels. This can cause some mild drop in the blood pressure. This mild drop, can temporarily reduce circulation to the kidneys, and that can affect/insult the kidneys if kidneys are already irritated by abnormal proteins.
Now for you, since you have smoldering myeloma, it means you do not have an obvious kidney dysfunction. May you have some kidney irritation from proteins or not, I cannot tell, that depends on how much abnormal proteins you have in your blood, what type of proteins you have (light chains or heavy chains, etc), and how much of these proteins are going into your kidneys. These are questions that your myeloma doctor can answer. In general if the burden of proteins is small, particularly if there is not much light chains, and if there is no abnormal proteins in your urine, then Cialis would likely not be unsafe to take ... You need to check these things with your myeloma doctor. Also, I think it's good idea to monitor your kidney function if you end up taking Cialis, just to make sure.
I hope it helps. Please do not respond to me or ask more questions because I do not think I will be back to this website again!
Good luck
I was searching on Google for something else, but accidentally was drawn to your post, and thought I would post a response that might be of help.
I am a hematologist, though my practice does not focus on multiple myeloma necessarily. Of course, I recommend you ask this question from your myeloma doctor, if s/he is really a "myeloma specialist", but if s/he is a hematologist without specific focus on myeloma, likely s/he will not be able to provide more specific answer.
Nevertheless, as best as I can tell, this is why there is a safety concern with Cialis in myeloma:
In active multiple myeloma as you know there are abnormal proteins in the blood that are filtered through kidneys, and these proteins can damage the kidneys. Patients with multiple myeloma, even if their kidney function appears normal on blood tests, are at risk of developing kidney damage with any insult that may not affect normal kidneys. For example, if a person experiences a brief period of low blood pressure for any reason, there will be a brief diminished blood circulation to the kidneys, which is an insult to the kidneys. People with normal kidneys, without abnormal proteins around, can tolerate this well and their kidneys will not have damage. But if somebody has abnormal proteins around, kidneys are kind of irritated and more vulnerable to damage with any insult, even if kidneys look normal on blood tests. Cialis is a vasodilator, meaning, it dilates (opens up) blood vessels. This can cause some mild drop in the blood pressure. This mild drop, can temporarily reduce circulation to the kidneys, and that can affect/insult the kidneys if kidneys are already irritated by abnormal proteins.
Now for you, since you have smoldering myeloma, it means you do not have an obvious kidney dysfunction. May you have some kidney irritation from proteins or not, I cannot tell, that depends on how much abnormal proteins you have in your blood, what type of proteins you have (light chains or heavy chains, etc), and how much of these proteins are going into your kidneys. These are questions that your myeloma doctor can answer. In general if the burden of proteins is small, particularly if there is not much light chains, and if there is no abnormal proteins in your urine, then Cialis would likely not be unsafe to take ... You need to check these things with your myeloma doctor. Also, I think it's good idea to monitor your kidney function if you end up taking Cialis, just to make sure.
I hope it helps. Please do not respond to me or ask more questions because I do not think I will be back to this website again!
Good luck
-
Hematologist
Re: Is tadalafil safe if you have smoldering myeloma?
Baily05,
I do not know where you are located, but if you are in the Washington, D.C. / Baltimore area, it may be of interest to you that at Johns Hopkins they are running a clinical trial for myeloma patients, one arm of which involves tadalafil. The trial is for both male and female patients. The tadalafil arm of the trial is just a small portion of the investigation, but I believe it is a follow up to prior research with respect to myeloma and tadalafil. A few other cancer centers are also involved, but I cannot recall their names.
I do not know where you are located, but if you are in the Washington, D.C. / Baltimore area, it may be of interest to you that at Johns Hopkins they are running a clinical trial for myeloma patients, one arm of which involves tadalafil. The trial is for both male and female patients. The tadalafil arm of the trial is just a small portion of the investigation, but I believe it is a follow up to prior research with respect to myeloma and tadalafil. A few other cancer centers are also involved, but I cannot recall their names.
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