Chronic Low Dosing of Phosphodiesterase Type 5 Inhibitor for Erectile Dysfunction

Abstract

Oral phosphodiesterase type 5 (PDE5) inhibitors have provided non-invasive, effective, and well-tolerated treatments for patients with erectile dysfunction (ED). However, many patients with ED are unresponsive to 'on-demand' PDE5 inhibitors. In addition, the lack of spontaneity and naturalness of the on-demand regimen could be a reason for decreased compliance with PDE5 inhibitors. Recently, tadalafil and udenafil were approved for low-dose daily administration for the treatment of ED. Since the introduction of the concept of daily administration of PDE5 inhibitors, several reports have supported the potential benefits of this therapy for disease modification, improvement of the treatment response in difficult-to-treat populations, spontaneity, and safety, although further research is needed to better address these hypotheses. In this article, we reviewed the daily administration of PDE5 inhibitors in terms of pharmacokinetics, safety, efficacy, and distinct features.

Effect of low-dose tadalafil once daily on glycemic control in patients with type 2 diabetes and erectile dysfunction: a randomized, double-blind, placebo-controlled pilot study

“…PDE-5 enzymes are present in various tissues; they are present in penile erectile tissues and blood vessels, platelets, and smooth muscle tissues [ 26 ]. Recently accumulated data on chronic usage of low-dose PDE-5 inhibitors indicate that low-dose therapy can provide additional potential benefits in diverse medical conditions, apart from their well-established erectogenic action [ 27 , 28 ]. However, there are limited placebo-controlled data regarding the effects of PDE-5 inhibitors on glycemic control in patients with T2D.…”

Comparison of the efficacy and safety of 5-mg once-daily versus 5-mg alternate-day tadalafil in men with erectile dysfunction and lower urinary tract symptoms

“…17 The use of daily tadalafil (10 or 20 mg) was first described in 2004. 18 One hundred and twelve men, who responded poorly to treatment with 20-mg tadalafil, showed substantial improvement in mean international index of IIEF-EF scores from 10.3 to 14.9 following a 4-week on-demand regimen, and this increased to 23.1 after 12 weeks of daily dose therapy. Favorable responses to SEP3 also increase from 14% (baseline) to 21% after on-demand therapy.…”

Effect of Low-Dose Tadalafil Once Daily On Glycemic Control In Patients With Type 2 Diabetes and Erectile Dysfunction: A Randomized, Double-blind, Placebo-controlled Pilot Study

“…PDE-5 enzymes are present in various tissues; they are present not only in penile erectile tissues but also in blood vessels, platelets, and smooth muscle tissues [26]. Recently accumulated data on chronic use of low-dose PDE-5 inhibitors indicate that low-dose PDE-5 inhibitors can provide additional potential bene ts in diverse medical applications in addition to their famed erectogenic action [27,28]. However, there are limited placebo-controlled data regarding the effects of PDE-5 inhibitors on glycemic control in patients with T2D.…”