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Tadalafil: a long-acting PDE5 inhibitor for the management of erectile dysfunction

Allen D. Seftel

Erectile dysfunction is a significant medical condition affecting the total health of patients and their partners. Phosphodiesterase type 5 inhibitors treat erectile dysfunction by selectively inhibiting the nitric oxide–cyclic guanosine monophosphate pathway. Tadalafil is a unique phosphodiesterase type 5 inhibitor that has a long period of responsiveness – up to 36 h. Additionally, the absorption of tadalafil is not affected by a high-fat meal. These characteristics may give couples freedom in timing their sexual activity. Tadalafil is safe and effective for improving erectile function in both general and special populations. The most common treatment-emergent adverse events are generally mild or moderate in severity and include headache, flushing or dyspepsia. Tadalafil may cause mild vasodilation; it should not be given concomitantly with organic nitrates or α-blockers, except for tamsulosin (0.4 mg once daily).