THURSDAY, Oct. 22 (HealthDay News) -- Doctors should prescribe
oral phosphodiesterase type 5 (PDE-5) inhibitor drugs, such as Viagra,
Cialis and Levitra, for men with erectile dysfunction, unless the patient
is on nitrate therapy, according to a clinical practice guideline issued
by the American College of Physicians.
The type of erectile dysfunction (ED) drug prescribed should be based
on the individual preferences of patients, including cost of medication,
ease of use and types of side effects, the authors noted.
"The evidence is insufficient to compare the effectiveness or adverse
effects of different PDE-5 inhibitors for the treatment of ED because
there were only a few head-to-head trials," guideline lead author Dr. Amir
Qaseem, senior medical associate with the ACP, said in a news release.
Qaseem and colleagues analyzed the findings of 130 studies that
evaluated PDE-5 inhibitors alone or combined. They found that treatment
with the drugs led to statistically significant and clinically relevant
improvements in sexual intercourse and erectile function in men with ED,
regardless of the cause (e.g., diabetes, depression, prostate cancer) or
ED severity at the start of the study.
Overall, PDE-5 inhibitors were relatively well-tolerated and associated
with only mild or moderate side effects, such as headaches, flushing,
upset stomach and runny nose, the authors found.
The guideline is published in the Oct. 20 issue of the journal
Annals of Internal Medicine.
Because there is no conclusive evidence about the effectiveness of
hormonal blood tests or treatment in patients with low testosterone
levels, the ACP doesn't recommend for or against routine use of the tests
in ED patients. The college says doctors should make decisions to measure
hormone levels based on an individual patient's clinical symptoms
(decreased libido, premature ejaculation, fatigue, etc.) and physical
signs (such as testicular or muscle atrophy) that suggest hormone
problems.
More information
The U.S. National Institute of Diabetes and Digestive and Kidney
Diseases has more about erectile dysfunction.
