From the Guidelines
Tadalafil is the most suitable oral medication for erectile dysfunction (ED) that is less likely to cause gastroesophageal reflux disease (GERD) or heartburn, as it has the lowest rates of dyspepsia compared to other PDE5 inhibitors, according to the 2018 AUA guideline 1. When considering oral medications for ED, it is essential to weigh the benefits and risks, including the potential for gastrointestinal side effects like GERD or heartburn. The available FDA-approved oral phosphodiesterase type 5 inhibitors (PDE5i) include sildenafil, tadalafil, vardenafil, and avanafil.
- Key points to consider:
- Tadalafil has the lowest rates of dyspepsia, making it a better option for those prone to heartburn or GERD 1.
- The dose of PDE5i should be titrated to provide optimal efficacy, and instructions should be provided to maximize benefit/efficacy 1.
- Individual responses to PDE5 inhibitors vary, so switching to another medication might help if one causes heartburn.
- Taking the medication with plenty of water and avoiding large or fatty meals around the time of intake can reduce digestive side effects. The reason some ED medications cause heartburn is that they can relax the lower esophageal sphincter, allowing stomach acid to flow back up. If heartburn persists with any ED medication, it is crucial to consult a healthcare provider, as they may recommend taking an antacid separately or exploring alternative treatments for erectile dysfunction.
From the FDA Drug Label
5 WARNINGS AND PRECAUTIONS 5.1 Cardiovascular Risk 6 ADVERSE REACTIONS 6.1 Clinical Trials Experience 6.2 Postmarketing Experience 17 PATIENT COUNSELING INFORMATION
There is no information in the provided drug label for avanafil that directly addresses the question of whether there is an oral medication for erectile dysfunction (ED) that does not cause gastroesophageal reflux disease (GERD) or heartburn 2.
- Key points:
- The label does not mention GERD or heartburn as potential side effects or warnings.
- It discusses various other potential side effects and warnings, but not GERD or heartburn. The FDA drug label does not answer the question.
From the Research
Oral Medications for Erectile Dysfunction
- There are several oral medications available for the treatment of erectile dysfunction (ED), including phosphodiesterase-5 inhibitors (PDE5Is) such as avanafil, sildenafil, tadalafil, and vardenafil 3, 4, 5, 6, 7.
Avanafil as a Treatment Option
- Avanafil is a rapidly absorbed oral PDE5I with a fast onset of action, making it a potential option for patients with ED 4, 5, 6, 7.
- Avanafil has been shown to be effective and well-tolerated in clinical trials, with a favorable pharmacodynamic and pharmacokinetic profile 4, 5, 6.
Side Effects and Tolerability
- Common side effects of PDE5Is include headache, flushing, and visual disturbances, but avanafil may have a more favorable side-effect profile compared to other PDE5Is 3, 4, 5.
- Avanafil has been found to have a low discontinuation rate due to adverse events, with ≤2% of patients discontinuing treatment in clinical trials 4.
Gastroesophageal Reflux Disease (GERD) and Heartburn
- There is no direct evidence to suggest that avanafil causes GERD or heartburn, but patients with a history of these conditions should be monitored closely while taking the medication.
- The available evidence suggests that avanafil is a safe and effective treatment option for ED, but its potential impact on GERD or heartburn is not well-studied 3, 4, 5, 6, 7.