Practical Approaches to Treat ED in PDE5i Nonresponders

Cai Zhonglin, Song Xiaoqing, Zhang Jianzhong, Yang Bin, Li Hongjun

Table 1 Direct evidence of rescue treatment in PDE5i nonresponders.

Approaches for rescue treatment in PDE5i nonresponders PDE5i nonresponse Rescue therapy with/without PDE5is Ref. PDE5i Dosage Dosing regimen PDE5i Dosage Dosing regimen Other therapeutic approaches Salvage success rate Increased PDE5i doses Sildenafil 100 mg On demand Sildenafil 150 or 200 mg On demand NA 24.1% 38 Different dosing regimens Tadalafil 20 mg On demand Tadalafil Flexible doses of 10 and 20 mg Once daily NA 58.0% 46 Different dosing regimens Vardenafil 20 mg On demand Vardenafil 10 mg Once daily NA 38.8% 47 Different PDE5is Sildenafil 100 mg On demand Vardenafil Flexible doses of 10 and 20 mg On demand NA 12.0% 48 Different PDE5is Sildenafil ≤100 mg On demand Vardenafil Flexible doses of 5, 10 and 20 mg On demand NA 53.0% 49 Non-drug therapeutic approaches with or without PDE5is At least one PDE5i (20 mg for tadalafil or vardenafil hydrochloride, 100 mg for sildenafil) Taking the same PDE5i as PDE5i nonresponse VED 70.0% 59 Non-drug therapeutic approaches with or without PDE5is Tadalafil 5?mg Once daily NA NA NA LiSWT 41.7% 62 Non-drug therapeutic approaches with or without PDE5is PDE5is (unclear in detail) NA NA NA LiSWT 60.0% 63 Non-drug therapeutic approaches with or without PDE5is Sildenafil (100 mg), tadalafil (20 mg), and vardenafil (20 mg) as needed or tadalafil (5 mg) daily Taking the same PDE5i as PDE5i nonresponse LiSWT 67.3% 64 Attention to psychological factors Sildenafil 100 mg On demand Sildenafil 100 mg On demand Trazodone (50 or 100 mg, once daily) 66.7% 68 PDE5is combined with other non-PDE5i drugs Highest available dosage of sildenafil, tadalafil, or vardenafil therapy Tadalafil 10 mg Once daily Testogel (5 g up to 10 g, once daily) 33.1% 110 PDE5is combined with other non-PDE5i drugs Sildenafil 100 mg On demand Sildenafil 100 mg On demand Oral testosterone undecanoate (Restandol, 80 mg, bid or tid) 34.3% after testosterone replacement only, 37.5% more after combined therapy 111 PDE5is combined with other non-PDE5i drugs Tadalafil 20 mg On demand Tadalafil 20 mg Twice a week Testogel (5 g, once daily) NA (improvement in IIEF-EF) 113 PDE5is combined with other non-PDE5i drugs Sildenafil 100 mg On demand Sildenafil 100 mg On demand Atorvastatin (40 mg, once daily) NA (significant improvements in all IIEF-5 questions and GEQ) 117