Phosphodiesterase type 5 inhibitors and erectile dysfunctionFebruary 25, 2019
When a man becomes sexually aroused, the arteries that supply blood to the penis widen, allowing more blood to flow in, while the veins that carry blood away from the penis become compressed, restricting blood from flowing out.
Phosphodiesterase Type 5 Inhibitors (PDE5) such as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) work by increasing blood flow to the penis. After sexual stimulation, these medications prevent the destruction of cyclic guanosine monophosphate (CGMP) by inhibiting phosphodiesterase-5 (PDE5), allowing CGMP to accumulate and persist longer. Nitric oxide, which is released during sexual stimulation, activates the enzyme guanylate cyclase, causing the production of CGMP, which affects the amount of blood that vessels deliver and remove from the penis. Sildenafil and vardenafil work best if taken without food within the last two hours, while tadalafil can be taken without regard to food. Tadalafil has a longer duration of action, up to 24-36 hours, compared to sildenafil and vardenafil, which work from four to 12 hours. Common adverse effects of these medications include headache, flushing, runny nose, stomach pain, back pain (Cialis), indigestion, dizziness, or a sudden drop in blood pressure. |
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