title: The effects of the combined use of a PDE5 inhibitor and medications for hypertension, lower urinary tract symptoms and dyslipidemia on corporal tissue tone.
abstract: ED is closely associated with its comorbidities (hypertension, dyslipidemia and lower urinary tract symptoms (LUTS)). Therefore, several drugs have been prescribed simultaneously with PDE5 inhibitors. If a specific medication for ED comorbidities has enhancing effects on PDE5 inhibitors, it offers alternative combination therapy in nonresponders to monotherapy with PDE5 inhibitors and allows clinicians to treat ED and its comorbidities simultaneously. To establish theoretical basis of choosing an appropriate medication for ED and concomitant disease, we examined the effects combining a PDE5 inhibitor with representative drugs for hypertension, dyslipidemia and LUTS on relaxing the corpus cavernosum of rabbits using the organ-bath technique. The effect of mirodenafil on relaxing phenylephrine-induced cavernosal contractions was significantly enhanced by the presence of 10(-4) M losartan, 10(-6) M nifedipine, 10(-6) M amlodipine, 10(-7) M doxazosin and 10(-9) M tamsulosin (P<0.05). The maximum relaxation effects were 47.2±3.8%, 57.6±2.6%, 64.0±3.7%, 76.1±5.7% and 71.7±5.4%, respectively. Enalapril and simvastatin had no enhancing effects. The relaxation induced by sodium nitroprusside alone (39.0±4.0%) was significantly enhanced in the presence of the 10(-4) M losartan (66.0±6.0%, P<0.05). Tetraethylammonium (1 mM) significantly inhibited the enhancement effects of tamsulosin and doxazosin on mirodenafil-induced relaxation (doxazosin: 76.1±5.7% vs 45.3±2.3%; tamsulosin: 71.7±5.4% vs 48.1±3.5%). On the basis of these findings, losartan seemed to induce synergistic effects through an interaction with nitric oxide. In addition, K(+) channel activation could be one of the mechanisms for the synergistic effect of combining mirodenafil with doxazosin or tamsulosin. We believe that the combination of a PDE5 inhibitor with losartan, nifedipine, amlodipine, doxazosin or tamsulosin could be a pharmacologic strategy for simultaneously treating ED and its comorbidities and increasing response rates to PDE5 inhibitors.
authors: Genitourinary Disease Oriented Translational Research, Seoul, Korea.
authors: J H
authors: JH
authors: Lee
authors: M R
authors: MR
authors: Chae
authors: J K
authors: JK
authors: Park
authors: J H
authors: JH
authors: Jeon
authors: S W
authors: SW
authors: Lee
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000494:pharmacology* / Q000627:therapeutic use; D017311:Amlodipine / Q000494:pharmacology / Q000627:therapeutic use; D000818:Animals; D000959:Antihypertensive Agents / Q000494:pharmacology* / Q000627:therapeutic use; D017292:Doxazosin / Q000494:pharmacology / Q000627:therapeutic use; D050171:Dyslipidemias / Q000188:drug therapy; D007172:Erectile Dysfunction / Q000188:drug therapy; D006973:Hypertension / Q000188:drug therapy; D019808:Losartan / Q000494:pharmacology / Q000627:therapeutic use; D059411:Lower Urinary Tract Symptoms / Q000188:drug therapy; D008297:Male; D009119:Muscle Contraction / Q000187:drug effects*; D009131:Muscle, Smooth, Vascular / Q000187:drug effects*; D009543:Nifedipine / Q000494:pharmacology / Q000627:therapeutic use; D010413:Penis / Q000098:blood supply / Q000187:drug effects*; D058986:Phosphodiesterase 5 Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D011817:Rabbits; D013449:Sulfonamides / Q000494:pharmacology / Q000627:therapeutic use; D000077409:Tamsulosin
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D000959:Antihypertensive Agents; D058986:Phosphodiesterase 5 Inhibitors; D013449:Sulfonamides; D017311:Amlodipine; D000077409:Tamsulosin; D009543:Nifedipine; D019808:Losartan; D017292:Doxazosin