The clinical pharmacokinetics of phosphodiesterase-5 inhibitors for erectile dysfunction

J Clin Pharmacol. 2005 Sep;45(9):987-1003. doi: 10.1177/0091270005276847.

Abstract

Differences in the clinical pharmacology of the 3 currently available oral phosphodiesterase-5 (PDE5) inhibitors, sildenafil, vardenafil, and tadalafil, are largely determined by their clinical pharmacokinetics as well as their PDE inhibitory activity profile. This review comparatively discusses the major characteristics of the pharmacokinetic profile of all 3 PDE5 inhibitors, including bioavailability and rate of absorption, Biopharmaceutical Classification System categorization, elimination mechanisms, and metabolic profile including active metabolites, as well as the drug-drug interaction potential and modification of pharmacokinetic properties under selected physiologic and pathophysiologic conditions. The review is aimed at providing comparative clinical pharmacology data to allow for scientifically rational, evidence-based prescribing and dosing decisions regarding the clinical use of these medications for the treatment of erectile dysfunction.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • 3',5'-Cyclic-GMP Phosphodiesterases
  • Animals
  • Biological Availability
  • Carbolines / pharmacokinetics*
  • Cyclic Nucleotide Phosphodiesterases, Type 5
  • Cytochrome P-450 CYP3A / metabolism
  • Drug Interactions
  • Erectile Dysfunction / drug therapy*
  • Erectile Dysfunction / metabolism
  • Humans
  • Imidazoles / pharmacokinetics*
  • Male
  • Metabolic Clearance Rate
  • Phosphodiesterase Inhibitors / pharmacokinetics*
  • Phosphoric Diester Hydrolases / metabolism
  • Piperazines / pharmacokinetics*
  • Purines
  • Sildenafil Citrate
  • Sulfones / pharmacokinetics
  • Tadalafil
  • Triazines / pharmacokinetics
  • Vardenafil Dihydrochloride

Substances

  • Carbolines
  • Imidazoles
  • Phosphodiesterase Inhibitors
  • Piperazines
  • Purines
  • Sulfones
  • Triazines
  • Vardenafil Dihydrochloride
  • Tadalafil
  • Sildenafil Citrate
  • Cytochrome P-450 CYP3A
  • Phosphoric Diester Hydrolases
  • 3',5'-Cyclic-GMP Phosphodiesterases
  • Cyclic Nucleotide Phosphodiesterases, Type 5
  • PDE5A protein, human