The question of the PDE-5 inhibitor selection: efficacy and safety

Both patients and physicians are considering the possibility of using PDE- 5 inhibitors (iPDE-5) for erectile dysfunction (ED) very carefully. We can now even witness the situation, when only 36.9% patients, who were referred to a physician, receive a proper ED treatment. The concerns are related more to a safety than to an efficacy. It is being told that these medications have severe cardiovascular consequences and carry a risk of addiction. In this work autors have analyzed the usage of the most popular PDE-5 inhibitors, namely sildenafil, vardenafil and tadalafil. Published studies show high efficacy of iPDE-5: intake of the medication improves erectile function to a mean increment of 75% estimated by IIEF scale, which is enough in two thirds of the patients to successfully carry out the sexual contact. The duration of the effect is 3-4 hours for sildenafil, up to 18 hours for tadalafil. Among the side effects which refer to IPDE-5 group are critical: headache, blood flushes to a face and digestion disturbances. All of them are well tolerated and warrant no additional treatment. The duration of the side effects is dependent on the duration of the main effect, so it is minimal for sildenafil and vardenafil. Also it is important to disclaim the risk of the development of more serious side effects, for example, cardiovascular, and the effect of the medication cancellation. As the most evaluated and safe medication comes sildenafil. Dinamico is a sildenafil medication with the special modified release system, showing high efficacy and minimal side effects profile, similar to other medications of this group.