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The table below provides essential information regarding contraindications and cautions when prescribing phosphodiesterase-5 (PDE-5) inhibitors for men with erectile dysfunction. It outlines specific conditions and factors that healthcare professionals should consider before recommending these medications, ensuring the safe and appropriate use of PDE-5 inhibitors in clinical practice ( based on recommendations by NICE CKS )
| Contraindications and Cautions for PDE-5 Inhibitors | Description |
|---|---|
| Contraindications ❌ (Do Not Prescribe) | - Unstable angina or angina during sexual intercourse - Regular or intermittent use of nitrates (severe risk of hypotension) - Hypotension (systolic BP < 90 mmHg) - History of non-arteritic anterior ischemic optic neuropathy (NAION) - Recent myocardial infarction (within 90 days for tadalafil) - Recent stroke - Heart failure (mild to severe for tadalafil and avanafil) - Uncontrolled arrhythmias (tadalafil and avanafil). - Uncontrolled hypertension (tadalafil and avanafil). - Severe hepatic impairment (sildenafil, vardenafil, avanafil); moderate-to-severe (vardenafil orodispersible tablets). - Renal impairment (creatinine clearance < 30 mL/min, avanafil). - Hereditary degenerative retinal disorder (e.g., retinitis pigmentosa, sildenafil, vardenafil, avanafil). |
| Cautions (Prescribe with Caution) | - Cardiovascular disease. - Left ventricular outflow obstruction (e.g., aortic stenosis, idiopathic hypertrophic subaortic stenosis). - Anatomical deformity of the penis (e.g., angulation, cavernosal fibrosis, Peyronie's disease). - Predisposition... |
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