The Medical Letter on Drugs and Therapeutics
PDE5 Inhibitors for Erectile Dysfunction
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Sildenafil (Viagra), tadalafil (Cialis) and vardenafil (Levitra, Staxyn) have become the standard treatment for erectile dysfunction.1 Head-to-head comparisons of these agents are still lacking, but some differences between them and new recommendations for their dosing (see Table 2) are worth noting.

PHARMACOKINETICS — The oral bioavailability of phosphodiesterase 5 (PDE5) inhibitors ranges from 15% for vardenafil to 40% for sildenafil. High-fat meals delay the absorption of vardenafil and sildenafil, but not tadalafil. All three agents are metabolized in the liver by CYP3A4.

EFFECTIVENESS — In the absence of randomized controlled trials comparing PDE5 inhibitors with each other, there is no acceptable evidence that one is more effective than another. Their efficacy varies with the etiology of the ... more      

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Title: PDE5 Inhibitors for Erectile Dysfunction
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