Prescribing All Phosphodiesterase 5 Inhibitors to a Patient with Erectile Dysfunction—A Realistic and Feasible Option in Everyday Clinical Practice—Outcomes of a Simple Treatment Regime

ObjectiveIn clinical practice, to apply and evaluate outcomes of a treatment regime, in which the patient had the opportunity to try all the available phosphodiesterase 5 (PDE5) inhibitors.MethodsPatients eligible for treatment with PDE5 inhibitors were prescribed 8 tablets with a shorter-acting substance (four tablets sildenafil 100 mg and four tablets vardenafil 20 mg) and eight tablets with a long-acting substance (tadalafil 20 mg). Outcomes of the regime were recorded.ResultsOf the 186 patients, 64 (34%) had not been treated previously (naïve), and 122 (66%) were undergoing treatment for their erectile dysfunction. The overall treatment response was 89% (165 of 186 patients); 78% (n = 145 of 186 patients) tested all three substances. No significant difference in choice between long- and shorter-acting medications in the overall material was observed. Two thirds of the naïve patients (n = 64) preferred a shorter-acting substance (p < 0.01). Every fifth man requested both a shorter- and a long-acting medication to accommodate his need.ConclusionIf patients are given the opportunity in clinical practice to try all three available PDE5 inhibitors, the overall response rate is very high, almost 90%. No significant difference in patient preference between long- and shorter-acting drugs was observed. Treatment choice was based mainly on efficacy or duration of effect.