Erectile Dysfunction Treatments- MPR

Erectile Dysfunction Treatments

ERECTILE DYSFUNCTION TREATMENTS
Generic	Brand	Strength	Form	Onset	Half-life	Adult Dose
PDE-5 INHIBITORS
avanafil	Stendra	50mg, 100mg, 200mg	tabs	15–30mins	5hrs	Take 1 dose as needed ~15 mins before sexual activity at frequency of up to once daily. Initially 100mg. May reduce dose to 50mg taken ~30 mins before activity or increase to 200mg taken ~15 mins before activity. Concomitant moderate CYP3A4 inhibitors: max 50mg once every 24hrs. Concomitant α-blockers (patients should be stable on α-blocker therapy before starting): initially 50mg. Concomitant strong CYP3A4 inhibitors: not recommended.
sildenafil	Viagra	25mg, 50mg, 100mg	tabs	0.5–4hrs (1hr)	4hrs	Take 1 dose as needed about 1hr (0.5–4hrs) before sexual activity at frequency of up to once daily. Initially 50mg. May reduce dose to 25mg or increase to max of 100mg. Elderly, hepatic impairment, severe renal impairment, or concomitant strong CYP3A4 inhibitors: consider initial dose of 25mg. Concomitant ritonavir: max 25mg single dose in 48hrs. Concomitant α-blockers (patients should be stable on α-blocker therapy before starting): initially 25mg.
tadalafil	Cialis	2.5mg, 5mg, 10mg, 20mg	tabs	30mins	≤36hrs	As Needed Use: Initially 10mg before sexual activity; range: 5–20mg. Max once daily; effect may last ≤36hrs. Renal impairment: CrCl 30–50mL/min: initially 5mg/day; max 10mg/48hrs; CrCl <30mL/min or hemodialysis: max 5mg/72hrs. Mild-to-moderate hepatic impairment: max 10mg/day. Concomitant potent CYP3A4 inhibitors: max 10mg/72hrs. Once-Daily Use: Initially 2.5mg at same time each day; may increase to 5mg/day. Concomitant potent CYP3A4 inhibitors: max 2.5mg. CrCl<30mL/min or hemodialysis: not recommended. ED/BPH: 5mg once daily at same time each day. Renal impairment: CrCl 30–50mL/min: initially 2.5mg; may increase to 5mg/day; CrCl <30mL/min or hemodialysis: not recommended.
varden– afil	—	2.5mg, 5mg, 10mg, 20mg	tabs	1hr	4hrs	Take once daily as needed, about 1hr before sexual activity. Initially 10mg; range: 5–20mg. Elderly (≥65yrs): initially 5mg. Moderate hepatic impairment: initially 5mg; max 10mg. Concomitant ketoconazole or itraconazole 200mg/day, or erythromycin: max 5mg. Concomitant indinavir, saquinavir, atazanavir, ketoconazole or itraconazole 400mg/day, clarithromycin: max 2.5mg. Concomitant ritonavir, cobicistat: max 2.5mg/72hrs. Concomitant α-blocker: initially 5mg/day.
varden– afil	—	10mg	orally disinte– grating tabs	1hr	4−6hrs	Not interchangeable with vardenafil 10mg film-coated tabs. Take without liquid. Place one tab on tongue ~1hr before sexual activity; max 1 tab/day. Concomitant α-blockers (patients should be stable on α-blocker therapy before starting): use lower doses of vardenafil film-coated tabs as initial therapy.
PROSTAGLANDIN E1
alpros– tadil	Caverject	20mcg, 40mcg	injection, intraca– vernous	5−20min	1hr	Vasculogenic, psychogenic, or mixed etiology: initially 2.5mcg; if partial response, repeat 2.5mcg dose within 1hr; during titration: max 2 doses within 24hrs; if more titration is needed, may give in increments of 5–10mcg at least 24hrs apart until optimal dose is achieved. Usual max: 60mcg. Neurogenic etiology: initially 1.25mcg; if partial response, repeat 1.25mcg dose within 1hr; during titration: max 2 doses within 24hrs; if more titration is needed, may give 5mcg at least 24hrs apart until optimal dose is achieved. Usual max: 60mcg. Maintenance for home use: max 3 injs/week; allow at least 24hrs between doses.
	Edex	10mcg, 20mcg, 40mcg	injection, intraca– vernous	5–20min	1hr	Vasculogenic, psychogenic, or mixed etiology: initially 2.5mcg. If partial response to initial dose, may give 2nd dose of 5mcg and then may increase by increments of 5–10mcg until desired response achieved. If no response to initial dose, may give 2nd dose of 7.5mcg and then may increase by increments of 5–10mcg until desired response achieved. Neurogenic etiology: initially 1.25mcg. May give 2nd dose of 2.5mcg, and 3rd dose of 5mcg, and then may increase by increments of 5mcg until desired response achieved. Max: 40mcg and 3 injs/week; allow at least 24hrs between doses. Reduce dose if erection lasts over 1hr.
	Muse	250mcg, 500mcg, 1000mcg	supposi– tory, urethral	5−10min	0.5−1hr	Initially 125–250mcg inserted in urethra after urination; adjust dose in stepwise manner on separate occasions; max 2 supps/day.
Not an inclusive list of medications and/or official indications. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling. (Rev. 9/2023)

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