Erectile Dysfunction Treatments
| ERECTILE DYSFUNCTION TREATMENTS | ||||||
|---|---|---|---|---|---|---|
| Generic | Brand & Company | Formulation | Strength | Onset | Duration of Action |
Dosing Considerations |
| PDE-5 INHIBITORS | ||||||
| sildenafil | Viagra
(Pfizer) |
tabs | 25mg
50mg 100mg |
0.5–2 hrs
(1 hr) |
4 hrs |
• Usually 25mg–100mg 1 hr before anticipated sexual activity. • >65 years old: initially 25mg. • Severe renal dysfunction (CrCl<30mL/min): initially 25mg. • Hepatic impairment: initially 25mg. • Ketoconazole, itraconazole, erythromycin, saquinavir: initially 25mg. • Ritonavir: max 25mg every 48 hours. • α-blockers: initially 25 mg. |
| tadalafil | Cialis
(Lilly Icos) |
tabs | 2.5mg
5mg 10mg 20mg |
0.5–6 hrs
(2 hrs) |
36 hrs |
Use as Needed: • Usually 5mg–20mg before anticipated sexual activity. • >65 years old: no adjustment needed. • Moderate renal dysfunction (CrCl 30–50mL/min): initially 5mg; max 10mg per 48 hours. • Severe renal dysfunction (CrCl<30mL/min): max 5mg per 72 hours. • Mild or moderate hepatic impairment: max 10mg daily; severe: not recommended. • Ketoconazole, ritonavir: max 10mg every 72 hours. • α-blockers: lowest recommended dose |
| see literature |
Once–Daily Use: • Initially 2.5mg (taken at same time each day); may increase to 5mg/day. • Severe renal dysfunction (CrCl<30mL/min): not recommended. • Mild or moderate hepatic impairment: use caution; severe: not recommended. • Concomitant potent CYP3A4 inhibitors: max 2.5mg • For ED + BPH: 5mg taken at same time once daily without regard to timing of sexual activity |
|||||
| vardenafil | Levitra
(Bayer & GSK) |
tabs | 2.5mg
5mg 10mg 20mg |
0.5–2 hrs
(1 hr)¹ |
4 hrs |
• Usually 5mg–20mg 1 hour before anticipated sexual activity. • >65 years old: initially 5mg. • Renal dysfunction: no adjustment needed. • Mild hepatic impairment: no adjustment; moderate: max 10mg; severe: not recommended. • Ketoconazole or itraconazole 200mg/day, or erythromycin: max 5mg daily. Ketoconazole or itraconazole 400mg/day, clarithromycin, saquinavir, atazanavir or indinavir: max 2.5mg daily. Ritonavir: max 2.5mg every 72 hours. • α-blockers: initially 5mg. |
| Staxyn
(Bayer & GSK) |
orally disintegrating tabs | 10mg | 0.75–2.5 hrs
(1.5 hr) |
4–6 hrs |
• Take as needed approximately 60min before sexual activity (max: 10mg/day). • Not interchangeable with Levitra 10mg. • Do not take with water. Place on tongue to disintegrate. • Moderate to severe hepatic impairment or renal dialysis: not recommended. • Concomitant moderate-to-potent CYP3A4 inhibitors, α-blockers, or other erectile dysfunction treatments: not recommended. |
|
| PROSTAGLANDIN E1 | ||||||
| alprostadil | Caverject
(Pfizer) |
injection, intracavernous | 5mcg
10mcg 20mcg 40mcg |
5–20 minutes | 1 hr |
• Usually 1.25–60micrograms within 1 hour before anticipated sexual activity. • Max 3 injections per week with a 24-hour period between each injection. |
| Edex
(Actient) |
injection, intracavernous | 10mcg
20mcg 40mcg |
7 minutes | 1 hr |
• Usually 1–40micrograms within 1 hour before anticipated sexual activity. • Max of 3 injections per week with a 24-hour period between each injection. |
|
| Muse
(Vivus) |
suppository, urethral | 125mcg
250mcg 500mcg 1000mcg |
5–10 minutes | 0.5–1 hr |
• Initially 125–250 micrograms. • Max 2 systems per 24 hours. |
|
| α2-BLOCKERS | ||||||
| yohimbine | Yocon
(Glenwood) |
tabs | 5.4mg |
• Must be taken daily for effect. |
||
| NOTES | ||||||
|
¹ A recent placebo–controlled study indicated that
vardenafil may begin to work in as quickly as 10 minutes after dosing in some men.
(Rev. 5/2012) |
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