From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
For erectile dysfunction (ED) treatment, phosphodiesterase type 5 inhibitors (PDE5Is) are the first-line approach, with medications such as sildenafil, tadalafil, vardenafil, and avanafil being effective in approximately 60-65% of patients, including those with comorbid conditions like hypertension and diabetes mellitus 1.
Key Considerations
- The evaluation of men with ED requires a comprehensive medical and sexual history, as well as a focused clinical examination and laboratory tests, including fasting glucose levels and a fasting lipid profile 1.
- Lifestyle modification and reduction of comorbid vascular risk factors are essential components of ED treatment, in addition to pharmacotherapy and psychosexual therapy 1.
- Patient-administered intracorporal injection therapy using vasodilator drugs like alprostadil is an effective alternative for men who fail to respond to oral PDE5Is 1.
Treatment Options
- PDE5Is, such as sildenafil, tadalafil, vardenafil, and avanafil, are the most widely used and studied treatments for ED, with a high efficacy and tolerability profile 2, 3, 4.
- The choice of PDE5I should be individualized based on the patient's clinical, demographic, and relational factors, as well as their personal preferences and medical history 2.
- Surgical treatment options, such as penile arterial revascularization and venous ligation surgery, are available for men with penile atherosclerotic disease or corporal veno-occlusive dysfunction, although they are associated with relatively poor outcome results 1.
Safety and Efficacy
- PDE5Is have a safe cardiovascular profile when used according to the Princeton III Consensus guidelines, although they may be associated with a small increase in the risk of non-arteritic ischemic optic neuropathy 5.
- The current evidence suggests that PDE5Is do not increase the risk of biochemical recurrence after prostate cancer management, although the association between PDE5I use and melanoma remains uncertain 5.