Robert A Kloner1, Irwin Goldstein2, Michael G Kirby3, John D Parker4, Richard Sadovsky5. 1. Huntington Medical Research Institutes, Pasadena, CA, USA; Division of Cardiovascular Medicine, Department of Medicine, Keck School of Medicine at University of Southern California, Los Angeles, CA, USA. Electronic address: robert.kloner@hmri.org. 2. Sexual Medicine, Alvarado Hospital, San Diego, CA, USA. 3. Prostate Center, London, United Kingdom; University of Hertfordshire, Center for Research in Primary and Community Care, Hatfield, United Kingdom. 4. Division of Cardiology, Department of Medicine, University of Toronto and Mount Sinai Hospital and Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada. 5. Department of Family Medicine, State University of New York Downstate Medical Center, Brooklyn, NY, USA.
Abstract
BACKGROUND: The phosphodiesterase-5 (PDE5) inhibitors that have been available for nearly 20 years are highly effective in treating erectile dysfunction and have been consistently shown to be safe when used according to package insert instructions. AIM: To review the cardiovascular (CV) safety of PDE5 inhibitors used to treat erectile dysfunction. METHODS: PubMed, the Derwent Drug File, and Embase were searched to identify papers published from 1990-2016 presenting CV safety data for PDE5 inhibitors. OUTCOMES: This narrative review focuses mainly on papers published in the last 10 years with CV safety data for sildenafil, tadalafil, or vardenafil. RESULTS: Similar to earlier studies, newer studies demonstrate that PDE5 inhibitors do not show an increased incidence of serious CV adverse events such as cardiac death or myocardial infarction. There are drug-drug interactions with PDE5 inhibitors that for the most part are now commonly known, and PDE5 inhibitors are generally safe to use with other commonly used drugs including antihypertensive agents. CONCLUSION: PDE5 inhibitors are a class of drugs that when used appropriately demonstrate a favorable CV safety profile and present some encouraging signals for new CV indications, which will require additional study. Kloner RA, Goldstein I, Kirby MG, et al. Cardiovascular Safety of Phosphodiesterase Type 5 Inhibitors After Nearly 2 Decades on the Market. Sex Med Rev 2018;6:583-594.
BACKGROUND: The phosphodiesterase-5 (PDE5) inhibitors that have been available for nearly 20 years are highly effective in treating erectile dysfunction and have been consistently shown to be safe when used according to package insert instructions. AIM: To review the cardiovascular (CV) safety of PDE5 inhibitors used to treat erectile dysfunction. METHODS: PubMed, the Derwent Drug File, and Embase were searched to identify papers published from 1990-2016 presenting CV safety data for PDE5 inhibitors. OUTCOMES: This narrative review focuses mainly on papers published in the last 10 years with CV safety data for sildenafil, tadalafil, or vardenafil. RESULTS: Similar to earlier studies, newer studies demonstrate that PDE5 inhibitors do not show an increased incidence of serious CV adverse events such as cardiac death or myocardial infarction. There are drug-drug interactions with PDE5 inhibitors that for the most part are now commonly known, and PDE5 inhibitors are generally safe to use with other commonly used drugs including antihypertensive agents. CONCLUSION:PDE5 inhibitors are a class of drugs that when used appropriately demonstrate a favorable CV safety profile and present some encouraging signals for new CV indications, which will require additional study. Kloner RA, Goldstein I, Kirby MG, et al. Cardiovascular Safety of Phosphodiesterase Type 5 Inhibitors After Nearly 2 Decades on the Market. Sex Med Rev 2018;6:583-594.
Authors: Irwin Goldstein; Annamaria Giraldi; Martine C Maculaitis; Vicky W Li; Rose Hartzell-Cushanick; Tarek A Hassan Journal: Sex Med Date: 2020-06-27 Impact factor: 2.491