Clinical Medicine Reviews in Vascular Health

Phosphodiesterase type 5 (PDE5) inhibitors are arguably the gold standard for treatment of erectile dysfunction in men. While all three PDE5 inhibitors approved for use in the U.S. are effective in treating ED, they possess different characteristics. Tadalafil differs from both sildenafil and vardenafil in its long half-life, which makes it ideal for daily dosing. This regimen has been shown to be effective over placebo, and studies suggest that it may be preferable by both partners over on-demand dosing. Side effects are typically mild in nature and infrequently lead to discontinuation of the drug. Once-daily dosing has also shown to be effective in ‘difficult-to-treat’ groups, such as diabetics and non-responders to on-demand therapy. The implementation of once-daily therapy represents a significant advancement in the understanding of male erectile dysfunction.