title: An update on pharmacological treatment of erectile dysfunction with phosphodiesterase type 5 inhibitors.
abstract: BACKGROUND
  Phosphodiesterase type 5 inhibitors (PDE5-i) are used for the oral treatment of erectile dysfunction (ED). Since the launch of sildenafil more than 15 years ago, new molecules have become available. At present, in addition to tadalafil and vardenafil, there are three other drugs, udenafil, avanafil and mirodenafil, marketed in some countries which appear to be promising.
  
  
  METHODS
  The clinical pharmacological differences in dosage and side effects of all PDE5-i are evaluated.
  
  
  CONCLUSIONS
  All PDE5-i are equally effective and safe for the treatment of ED. On-demand use of any PDE5-i is also safe for patients with comorbid conditions. Tadalafil seems to be the preferred drug by patients and physicians, probably due to its peculiar pharmacological profile that makes sexual intercourse more spontaneous for the patients. Preliminary data suggest that the use of vardenafil may also be beneficial in cases of ED associated with premature ejaculation. Daily treatment is another option in men with ED and documented vascular or prostate disease. In geriatric or in difficult-to-treat populations, the evaluation of testosterone plasma levels will help to predict the efficacy of any PDE5-i. Remarkably, when such drugs are withdrawn for any reason, ED most often continues to occur because of the presence of an underlying disease.
authors.affiliation: Sapienza University of Rome, Endocrinology and Food and Science Section, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Bruzziches
authors.forename: Davide
authors.initials: D
authors.lastname: Francomano
authors.forename: Pietro
authors.initials: P
authors.lastname: Gareri
authors.forename: Andrea
authors.initials: A
authors.lastname: Lenzi
authors.forename: Antonio
authors.initials: A
authors.lastname: Aversa
mesh_terms: D000368:Aged; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D008297:Male; D058986:Phosphodiesterase 5 Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D058986:Phosphodiesterase 5 Inhibitors