PDE5 Inhibitors in Men with Spinal Cord Injury

Dosing Considerations

PDE5 inhibitors should be used with caution and at lower initial doses in men with spinal cord injury due to potential delayed metabolism, as recommended by The American Urological Association 1, 2
Proper patient education is essential as incorrect use accounts for many treatment failures, and multiple trials with the medication may be required to establish efficacy, according to The American Urological Association 1, 2

The most common side effects of PDE5 inhibitors in men with spinal cord injury include dyspepsia, headache, flushing, back pain, nasal congestion, myalgia, visual disturbance, and dizziness, as reported by The American Urological Association 1, 2

For men with spinal cord injury who also have testosterone deficiency, combining PDE5 inhibitors with testosterone therapy may be more effective than PDE5 inhibitors alone, as suggested by The American Urological Association 1, 3
The treatment algorithm for erectile dysfunction in men with spinal cord injury should include starting with a PDE5 inhibitor at lower initial doses, considering tadalafil as potentially the most effective option, and ensuring proper patient education about medication use, according to The American Urological Association 1, 2
Consideration of combination therapy with testosterone in patients with testosterone deficiency is also recommended, as stated by The American Urological Association 1, 3