Chronic PDE-5 inhibition in patients with erectile dysfunction - a treatment approach using tadalafil once-daily

Tadalafil distinguishes itself from other available phosphodiesterase type 5 (PDE-5) inhibitors by its half-life of ∼ 17.5 h, which results in erectile responsiveness for up to 36 h after a single dose. Most clinical experience has been reported with on-demand use of PDE-5 inhibitors, but several studies have been able to demonstrate that tadalafil, given once-daily in low doses, is both highly effective and well tolerated.

This paper reviews the current evidence for efficacy and safety of tadalafil, as well as the rationale for offering low-dose tadalafil once-daily to patients with erectile dysfunction as an alternative to on-demand treatment.

Tadalafil once-daily provides efficacy comparable to on-demand dosing regimens with PDE-5 inhibitors, is well tolerated and allows patients and their partners to disconnect the administration of medication from sexual activity, thereby enabling them to return to the sex-life they had before the onset of erectile dysfunction.