Dr. Jordan Baye was a postgraduate year 1 resident at the Iowa City VA Health Care System at the time of writing. He current works as a staff pharmacist at Sanford University of South Dakota Medical Center in Sioux Falls, SD.
Review of Therapeutics
Tadalafil: A Phosphodiesterase-5 Inhibitor for Benign Prostatic Hyperplasia
Version of Record online: 25 MAR 2013
© 2013 Pharmacotherapy Publications, Inc
Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy
Volume 33, Issue 6, pages 639–649, June 2013
How to Cite
- Issue online: 4 JUN 2013
- Version of Record online: 25 MAR 2013
- benign prostatic hyperplasia;
- PDE-5 inhibitors;
- lower urinary tract symptoms;
- new FDA indication;
- overflow incontinence
Tadalafil is a phosphodisesterase (PDE)-5 inhibitor recently approved by the United States Food and Drug Administration for lower urinary tracts symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). The mechanism for improved LUTS is thought to be related to three principal theories: alterations in nitric oxide levels, Rho-associated protein kinase deactivation, and reductions in pelvic atherosclerosis. The efficacy of PDE-5 inhibitors for the treatment of LUTS associated with BPH has been demonstrated in several randomized placebo-controlled trials. Tadalafil is thought to be superior based on an extended half-life; however, other PDE-5 inhibitors have positive results in BPH and have not been proved to be inferior to tadalafil. Before administration, concomitant use of medications such as nonselective α-adrenergic antagonists, nitrates, and cytochrome P450 inhibitors should be assessed for possible drug interactions. Potential adverse drug events seen in Food and Drug Administration–approved tadalafil include back pain, dyspepsia, headache, and dizziness. Given the efficacy and safety data currently available, the PDE-5 inhibitor tadalafil represents a reasonable alternative for selected male patients with LUTS associated with BPH, especially with concomitant erectile dysfunction.