The influence of treatment-emergent adverse reactions on selecting phosphodiesterase type 5 inhibitors

Abstract

Purpose: This study was conducted to determine how treatment-emergent adverse reactions (ARs) of each of the phosphodiesterase type 5 inhibitors (PDE5Is) influenced the patient when selecting a drug. Materials and Methods: For our study, we recruited a total of 123 patients who were suffering with erectile dysfunction and they randomly took 3 different PDE5Is (sildenafil, tadalnafil, and vardenafil), at least 4 times each and then had successful intercourse after using each PDE5I. We investigated the influence of the treatment-emergent ARs on the patients selecting a PDE5I. Results: Sixty eight out of 123 patient s (55.3%) showed more than one AR. Five patients (4.1%) did not select any of the PDE5Is due to their treatment-emergent ARs, and 15 patients (12.2%) did not select the PDE5Is due to the severity and/or duration of the AR. Facial flushing was the most common cause of non-selection; this was followed by headache. Fifteen patients (12.2%) selected one specific PDE5I because they experienced a less severe AR with that drug. The severity and duration of the ARs increased in the group of elderly men and the group of men who took larger doses of the drug. Conclusions: ARs had an impor tant effect on the patients' selection of a PDE5I, although the impact was quite low compared with its overall occurrence rate. The severity and/or duration of the AR were so variable, depending on the patient, that no PDE5I was better than the others in terms of attributing the selection of a PDE5I to its reduced AR.