PDE5 Inhibitors: How They Work, Types, Side Effects & Preventions

PDE5 Inhibitors: How They Work, Types, Side Effects & Preventions

pde5 inhibitors

phosphodiesterase 5 (PDE5) inhibitors or PDE5 Inhibitors belong to a group of medicines that are often used in treating Hypertension and Erectile Dysfunction. It can alter blood supply and cell communication in the body. There are several available PDE5 inhibitors: sildenafil, Vardenafil, Tadalafil, and Avanafil, which are FDA-approved; lodenafil, udenafil, and mirodenafil are the other non-FDA commercially available drugs. Several foods and supplements may include PDE5 inhibitors as well.

What Are PDE5 Inhibitors?

A medication known as a PDE5 inhibitor is most often used to treat erectile dysfunction (ED). PDE5 is an enzyme found in blood vessel walls. The blood flow and cell signalling throughout the body impact and PDE5 inhibitors stop the PDE5 enzyme from functioning. The blood arteries relax by this constriction, which boosts blood flow. Researchers were looking at their possible usage for hypertension and angina when they unintentionally found that they may help with ED problems.

Most frequently, PDE5 inhibitors are a family of medicines used to treat erectile dysfunction (ED). An enzyme called PDE5 is present in blood vessel walls. PDE5 inhibitors prevent the PDE5 enzyme from working, influencing blood flow and cell communication throughout the body. This constriction causes the blood vessels to relax, increasing blood flow. When looking at their potential use for angina and hypertension, researchers were unaware that they could also be helpful for ED issues.

ED is among the most prevalent kind of erectile dysfunction in males, and its prevalence rises with age. So for those with ED brought on by inadequate blood supply to the genitals, Phosphodiesterase type 5 inhibitors are the first line of therapy.

Age is a factor in the occurrence of ED, one of the most common types of erectile dysfunction in men. Phosphodiesterase type 5 inhibitors are the first line of treatment for people with ED caused by a lack of blood flow to the genitalia. It is an easy way to increase blood flow to penis.

PDE5 inhibitors may potentially be useful in the treatment of diabetes, cancer, and heart disease, according to research.

Furthermore, PDE5 is now being investigated to see whether it may help address dementia and other cognitive problems.

Read more about erectile dysfunction in hindi

Types of PDE5 Inhibitor Drugs

PDE5 inhibitors are only helpful in treating erectile dysfunction induced by physiological causes.

The psychological ED causes, for instance, stress or worry, can be treated with psychotherapy or counselling

Treatment with PDE5 inhibitors is only effective for erectile dysfunction brought on by physiological factors.
Psychotherapy or counselling can alleviate the psychological effects of ED, such as tension or concern.

The four most common types of phosphodiesterase 5 inhibitors are:

pde5 inhibitors drugs

1. Sildenafil (Viagra)

Sildenafil was the initial PDE5 inhibitor to undergo substantial research, and the FDA authorized it in 1998 under the brand name Viagra to address erectile dysfunction in males. So it is often effective within an hour. Additionally, like other PDE5 inhibitors, you will only get an erection when sexually stimulated.

Viagra’s effects typically last approximately four hours but may last up to twelve. Furthermore, the typical daily dosages range between 25 and 100 milligrams (mg). The 50 mg pack costs somewhere around INR 140.

2. Tadalafil (Cialis)

Tadalafil treats erectile dysfunction and received authorization in 2003. It typically takes 20 minutes to take action, and one must take at least 30 minutes before sexual activity.

Additionally, Tadalafil has FDA approval for treating benign prostate hyperplasia (BPH).

Tadalafil’s 24- to 36-hour duration of action is the highest of any PDE5 inhibitor now marketed. A standard daily dosage is between 2.5 and 20 mg. The 20 mg pack costs INR 650.

3. Vardenafil (Levitra or Staxyn)

Since 2003, Vardenafil has received FDA approval for ED treatment. It has the quickest impact of any PDE5 inhibitor, beginning to work within 10 minutes.

Vardenafil typically lasts between 5 and 7 hours. However, it may last for 12 hours. Vardenafil’s average daily dosage is 5 to 20 mg.

4. Avanafil

Since 2012, Avanafil has been accessible as the most recent PDE5 inhibitor. It often takes 30 to 45 minutes to act.

Avanafil seems to have a half-life of about 5 hours, which is greater than Vardenafil and sildenafil but lower than Tadalafil. Furthermore, Avanafil’s daily dosage is between 50 and 200 mg daily.

PDE5 Inhibitors Uses

So the PDE5 inhibitors can help treat various disorders that impact body parts where the PDE5 enzyme regulates blood flow. Currently, the FDA authorizes Phosphodiesterase 5 inhibitors to address the following conditions:

1. Pulmonary Hypertension

The treatment of Pulmonary hypertension, a kind of hypertension that impacts the arteries in the lungs, is possible with some PDE5 inhibitor drugs.

Breathlessness, chest discomfort, fatigue, and a rapid heartbeat are just indications of pulmonary hypertension, which may disrupt blood circulation across your body. Further, it may weaken the heart gradually and lead to heart failure.

PDE5 inhibitors can help treat pulmonary hypertension in patients by:

  • regulating blood flow of the arteries in the lungs
  • boosting the lungs’ blood flow
  • bringing down blood pressure

PDE5 inhibitors ease blood flow by widening the blood arteries that deliver blood from the heart to the lungs, treating pulmonary hypertension.

Currently, Tadalafil (marketed as Adcirca®) and sildenafil (sold as Revatio® when recommended for PH) are used for this condition.

2. Erectile Dysfunction

PDE5 inhibitors are most well-known for their impact on erectile dysfunction (ED). Furthermore, prominent prescription ED medications enhance blood flow to the genitals by blocking the PDE5 effects.

These medications are available as tablets, making it simple to take them before your planned sexual activity.

The degree of erectile dysfunction might vary. Further, some can acquire an erection but struggle to maintain one that is strong or persistent enough for vaginal penetration. However, others find it challenging to achieve an erection at any time.

PDE5 inhibitors are now standard for treating erectile dysfunction. In addition to being quite effective, they often start to act fast, last for a short while up to a day, and typically only result in moderate, temporary adverse effects.

Since these medications are accessible as pills, using them before your intended sexual activity is straightforward.
Erectile dysfunction can range in severity. In addition, some men can get an erection but find it challenging to keep it strong or consistent enough to allow vaginal penetration. Others, however, find it challenging to get an erection at any moment.

Nowadays, PDE5 inhibitors are used to treat erectile dysfunction. In addition to being extremely powerful, they frequently begin to work quickly, last for only a short time, up to a day, and generally only have mild transient adverse effects.

3. Benign Prostatic Hyperplasia

Benign prostatic hyperplasia, often known as prostate enlargement, is a prevalent condition that typically affects older men.

BPH symptoms include an immediate desire to urinate often, leaking after urination, need for urinating throughout the night, and discomfort following ejaculation or even during urination. Further, long-term BPH is associated with urinary tract infections (UTIs) and kidney impairment.

So Cialis (Tadalafil) is the only FDA-approved PDE5 inhibitor for treating the clinical manifestations of benign prostatic hyperplasia.


How Do PDE5 Inhibitors Work For Erections?

PDE5 inhibitors have a vasodilatory impact on the penis, dilating blood vessels and enhancing blood circulation.

Getting an erection is a complex operation. In response to sexual arousal, the parasympathetic nervous system stimulates. So this neuronal activity induces the release of nitric oxide (NO), enabling cyclic GMP creation.

Cyclic GMP relaxes the muscles within the penis’s blood arteries and multiplies blood circulation by 20 to 40 times.

PDE5 is an enzyme that degrades cyclic GMP and inhibits the erection mechanism. Yet,  PDE5 inhibitors are structurally identical to cyclic GMP and attach to PDE5 to prevent this degradation. So this action boosts NO’s effectiveness and promotes blood flow.

Side Effects Of Phosphodiesterase 5 Inhibitors

When taken as recommended, PDE5 inhibitors are typically safe and effective drugs. However, as with other medicines, phosphodiesterase five inhibitors may produce harmful effects and interfere with other medications.

Most adverse effects of PDE5 inhibitor drugs are moderate and transient. However, when one misuses PDE5 inhibitors or uses them with other Medication, or when used by persons with significant health issues, they may cause serious adverse effects.
PDE5 inhibitors are generally safe and reliable medications when used as directed. Phosphodiesterase 5 inhibitors can have harmful side effects and interact with other drugs, just like other medications might.

The majority of PDE5 inhibitor side effects are mild and temporary. PDE5 inhibitors can potentially have substantial adverse effects when misused, in combination with other medications, or by people with severe health conditions.

  • Headaches
  • Redness of the face
  • Dyspepsia (indigestion)
  • Sinus congestion
  • Cold-like symptoms
  • Visual abnormalities
  • Back or muscle discomfort

phosphodiesterase type 5 inhibitors

It is unusual for PDE5 inhibitors to have severe adverse effects, but they can occur. Infrequent but significant negative effects of phosphodiesterase five inhibitors are:

  • Priapism. This painful, long-lasting erection may damage penis tissue. This unusual side effect needs immediate medical intervention.
  • Hearing problems. Few men on PDE5 inhibitors like sildenafil suffer acute sensorineural hearing loss (SSHL). Like priapism, this rare side effect needs medical treatment.
  • Defective vision. PDE5 inhibitors might cause abrupt vision problems in one or both eyes. Furthermore, this is a severe side effect that requires medical treatment.

Precaution and who should avoid using pde5 inhibitor

Protection in the following cardiovascular categories applies to all PDE5 inhibitors:

  • Myocardial infarction, stroke, or life-threatening arrhythmia within the previous six months.
  • Resting hypotension (BP 90/50 mmHg) or hypertension (BP >170/100 mmHg).
  • Unstable angina, angina during sexual activity, or congestive heart failure is classified as Class IV by the New York Heart Association.

Foods That Contain PDE5 inhibitors

Some herbs may have naturally occurring Phosphodiesterase 5 inhibitors, and they are as follows:

  • Horny goat weed is a traditional Chinese herbal remedy for nerve discomfort, weariness, atherosclerosis, hay fever, osteoporosis, and erectile dysfunction. Furthermore, Horny goat weed includes icariin, a chemical molecule that is efficient as a PDE5 inhibitor. You can take benefits of Horny goat weed by consuming the Ohman Herb Tablets.
  • Thai ginger or black ginger possesses PDE5 inhibitors. According to scientific research, Thai ginger may considerably boost handgrip strength and sexual erogenous sensations.
  • Yohimbe includes yohimbine within the bark, one of the several natural PDE5.

Which Are The Best PDE5 Inhibitors?

There is no best PDE5 inhibitor. In general, NIH’s research indicates that the three most often recommended PDE5, including Sildenafil, Tadalafil, and Vardenafil — are similarly efficient in treating erectile dysfunction.

The optimal PDE5 inhibitor is not known. According to an NIH study, the three PDE5 medications that are most frequently prescribed, Sildenafil, Tadalafil, and Vardenafil, appear to be equally effective in treating erectile dysfunction.


Erectile dysfunction is a prevalent condition that may affect men of any age. The best part is that the majority of occurrences of erectile dysfunction are possible to treat with the combination of healthy practices and PDE5 inhibitors, such as those mentioned above.
Men of any age might be affected by the common ailment known as erectile dysfunction. The most excellent news is that PDE5 inhibitors like those indicated above may be used in conjunction with good habits to treat the majority of cases of erectile dysfunction.

Erectile dysfunction is a prevalent condition that may affect men of any age. The best part is that the majority of occurrences of erectile dysfunction are possible to treat with the combination of healthy practices and PDE5 inhibitors, such as those mentioned above. At Ohman, we provide a variety of FDA-Approved ED Medicines online following doctor consultations. You can also buy some of the popular and FDA approved medicines like


If ED medications aren’t effective or you have other health conditions that don’t permit you to consume these medications, Ohman offers a range of other ED Treatments. So these include penile injections and vacuum device for men for helping you getting a strong erection.

Frequently Asked Question

1. Are pde5 inhibitors safe
When taken as prescribed, PDE5 inhibitors are often safe and efficient drugs. PDE5 inhibitors, including sildenafil, Tadalafil, Vardenafil, and Avanafil, can potentially cause harmful effects and interact with other medicines, much like other pharmaceuticals.

2. Is coffee a PDES inhibitor?
In vivo and in vitro studies have shown that coffee strongly inhibits cAMP phosphodiesterases (PDEs), which has been regarded as another beneficial impact of coffee consumption.

3. Is there anything better than sildenafil?
Due to the biochemical potency of Vardenafil (Levitra) being almost ten times more than that of sildenafil, a lesser dosage may be required to get the same benefits. The drug’s selectivity refers to its capacity to bind to the particular PDE 5 enzyme in penile tissues.

4. Is there a natural herb for erectile dysfunction?
In one study, Panax ginseng improved erectile dysfunction in men. For early ejaculation, a cream mixture is employed. Many active components can be found in Panax ginseng. Short-term usage seems to be safe while using it.

5. Does PDES increase with age?
About 20–30% of adult males experience an age-related fall in serum T, known as late-onset hypogonadism (LOH). Erectile dysfunction (ED) and hypoactive sexual drive are symptoms of this decrease, which is more common in the elderly (up to 60%).

6. Can you drink coffee when taking Viagra?
Although coffee and Viagra don’t appear to mix, minor adverse effects might still happen. Whether you use Viagra, ask your doctor if there are any foods or liquids you should avoid.

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