Skip Navigation

This Article
Right arrow Abstract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Request Permissions
Google Scholar
Right arrow Articles by Giuliano, F.
Right arrow Articles by Varanese, L.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Giuliano, F.
Right arrow Articles by Varanese, L.
Social Bookmarking
 Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?


Tadalafil: a novel treatment for erectile dysfunction

F. Giuliano*,1 and L. Varanese2

a Department of Urology, AP-HP, Centre Hospitalier Universitaire de Bicêtre, Le Kremlin-Bicêtre, France
b Eli Lilly and Company Ltd, Lilly Research Centre, Erl Wood Manor, Windlesham Surrey, U.K.

* Correspondence: François Giuliano, MD, PhD, Department of Urology, CHU de Bicêtre, 78 rue du Général Leclerc, 94270 Le Kremlin-Bicêtre Cedex, France.

Abstract

Tadalafil, a potent, selective and reversible inhibitor of phosphodiesterase type 5 that is under review as an oral therapy for erectile dysfunction, has a time to maximum concentration of 2 h and a half-life of 17·5 h. Systemic tadalafil exposure was not clinically significantly altered by age or diabetes. Food did not alter the rate and extent of absorption of tadalafil, and no restrictions regarding food or alcohol intake were imposed on patients in tadalafil clinical trials. Furthermore, the time of dosing had no significant effect on the systemic distribution of tadalafil. Integrated analyses of data from five phase III trials demonstrated that tadalafil at doses from 5 mg to 20 mg significantly improved erectile function (vs placebo) by all efficacy measures. Tadalafil was safe and well tolerated in the phase III studies, with headache and dyspepsia being the most frequent adverse events. Additionally, in a separate study of patients with erectile dysfunction and diabetes, tadalafil 10 mg and 20 mg significantly improved all efficacy measures as compared with placebo.

Key Words: Diabetes • efficacy • erectile dysfunction • pharmacodynamics • pharmacokinetics • safety • tadalafil

References

  1. Andersson KE, Wagner G. Physiology of penile erection. Physiol Rev. 1995;75:191–236[Free Full Text]
  2. Ignarro LJ, Bush PA, Buga GM, Wood KS, Fukuto JM, Rajfer J. Nitric oxide and cyclic GMP formation upon electrical field stimulation cause relaxation of corpus cavernosum smooth muscle. Biochem Biophys Res Commun. 1990;170:843–850[CrossRef][ISI][Medline]
  3. Rajfer J, Aronson WJ, Bush PA, Dorey FJ, Ignarro LJ. Nitric oxide as a mediator of relaxation of the corpus cavernosum in response to nonadrenergic, noncholinergic neurotransmission. N Engl J Med. 1992;326:90–94[Abstract]
  4. Trigo-Rocha F, Aronson WJ, Hohenfellner M, Ignarro LJ, Rajfer J, Lue TF. Nitric oxide and cGMP: mediators of pelvic nerve-stimulated erection in dogs. Am J Physiol. 1993;264:H419–H422[Medline]
  5. Boolell M, Allen MJ, Ballard SA, et al. Sildenafil: an orally active type 5 cyclic GMP-specific phosphodiesterase inhibitor for the treatment of penile erectile dysfunction. Int J Impot Res. 1996;8:47–52[Medline]
  6. Burls A, Gold L, Clark W. Systematic review of randomised controlled trials of sildenafil (Viagra) in the treatment of male erectile dysfunction. Br J Gen Pract. 2001;51:1004–1012[Medline]
  7. Langtry HD, Markham A. Sildenafil: a review of its use in erectile dysfunction. Drugs. 1999;57:967–989[CrossRef][ISI][Medline]
  8. Palumbo F, Bettocchi C, Selvaggi FP, Pryor JP, Ralph DJ. Sildenafil: efficacy and safety in daily clinical experience. Eur Urol. 2001;40:176–180[Medline]
  9. Virag R. Indications and early results of sildenafil (Viagra) in erectile dysfunction. Urology. 1999;54:1073–1077[CrossRef][ISI][Medline]
  10. Padma-Nathan H, McMurray JG, Pullman WE, et al. On-demand IC351 (CialisTM) enhances erectile function in patients with erectile dysfunction. Int J Impot Res. 2001;13:2–9[CrossRef][ISI][Medline]
  11. Padma-Nathan H, Giuliano F. Oral drug therapy for erectile dysfunction. Urol Clin North Am. 2001;28:321–334[CrossRef][ISI][Medline]
  12. Porst H, Rosen R, Padma-Nathan H, et al. The efficacy and tolerability of vardenafil, a new, oral, selective phosphodiesterase type 5 inhibitor, in patients with erectile dysfunction: the first at-home clinical trial. Int J Impot Res. 2001;13:192–199[CrossRef][ISI][Medline]
  13. Noto T, Inoue H, Ikeo T, Kikkawa K. Potentiation of penile tumescence by T-1032, a new potent and specific phosphodiesterase type V inhibitor, in dogs. J Pharmacol Exp Ther. 2000;294:870–875[Abstract/Free Full Text]
  14. Oh TY, Kang KK, Ahn BO, Yoo M, Kim WB. Erectogenic effect of the selective phosphodiesterase type 5 inhibitor, DA-8159. Arch Pharm Res. 2000;23:471–476[Medline]
  15. Rotella DP, Sun Z, Zhu Y, et al. N-3-substituted imidazoquinazolinones: potent and selective PDE5 inhibitors as potential agents for treatment of erectile dysfunction. J Med Chem. 2000;43:1257–1263[CrossRef][Medline]
  16. Takagi M, Mochida H, Noto T, et al. Pharmacological profile of T-1032, a novel specific phosphodiesterase type 5 inhibitor, in isolated rat aorta and rabbit corpus cavernosum. Eur J Pharmacol. 2001;411:161–168[Medline]
  17. Patterson B, Bedding A, Jewell H, Payne C, Mitchell M. Dose-normalized pharmacokinetics of single-dose tadalafil (IC351) in healthy volunteers. [abstract 14]Int J Impot Res. 2001;13(suppl 5):S63
  18. Patterson B, Bedding A, Jewell H, Payne C, Mitchell MI. The effect of intrinsic and extrinsic factors on the pharmacokinetic properties of tadalafil (IC351). [abstract 16]Int J Impot Res. 2001;13(suppl 5):S62
  19. Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The International Index of Erectile Function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology. 1997;49:822–830[CrossRef][ISI][Medline]
  20. Brock GE, McMahon CG, Chen KK, et al. Efficacy and safety of tadalafil in the treatment of erectile dysfunction: results of integrated analyses. J Urol. 2002;168:1322–1326
  21. Cappelleri JC, Rosen RC, Smith MD, Mishra A, Osterloh IH. Diagnostic evaluation of the erectile function domain of the International Index of Erectile Function. Urology. 1999;54:346–351[CrossRef][ISI][Medline]
  22. Padma-Nathan H, Rosen RC, Shabsigh R, Saikali K, Watkins V. Tadalafil (IC351) provides prompt and extended period of response for the treatment of men with ED. [abstract 20]Int J Impot Res. 2001;13(suppl 5):S64
  23. Porst H, Rosen RC, Padma-Nathan H, Varanese L, Anglin G. Tadalafil allows men with erectile dysfunction to have successful intercourse up to 36 hours postdose. [abstract 709]J Urol. 2002;167:177 (suppl)[CrossRef][ISI][Medline]
  24. Lewis R, Hatzichristou D, Laumann E, McKinlay J. Epidemiology and Natural History of Erectile Dysfunction. Jardin A, Wagner G, Khoury S, et al. July 1–3, 1999First International Consultation on Erectile Dysfunction. Plymouth: Health Publications Ltd; 2000. p. 19–52
  25. Romeo JH, Seftel AD, Madhun ZT, Aron DC. Sexual function in men with diabetes type 2: association with glycemic control. J Urol. 2000;163:788–791[CrossRef][ISI][Medline]
  26. Sáenz de Tejada I, Anglin G, Knight J, Emmick J. Effects of tadalafil on erectile dysfunction in men with diabetes. Diabetes Care. 2002;: (in press)

Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?



This Article
Right arrow Abstract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Request Permissions
Google Scholar
Right arrow Articles by Giuliano, F.
Right arrow Articles by Varanese, L.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Giuliano, F.
Right arrow Articles by Varanese, L.
Social Bookmarking
 Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?