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Oral PDE5 Inhibitors rarely cause priapism, finds study
USA: Phosphodiesterase type 5 inhibitor (PDE5i)-induced priapism is a rare event, according to a recent study published in the Journal of Sexual Medicine. The study suggests that PDE5i-induced priapism occurs but is less common than suspected. Drug-induced priapism should be attributed to a wider spectrum of medications that can cause this condition.
Priapism is an adverse drug reaction (ADR) associated with phosphodiesterase type 5 inhibitors (PDE5is) in the treatment of erectile dysfunction.
Michael E. Rezaee and Martin S. Gross from Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA, conducted the study with an aim to identify the true data about PDE5i-associated priapism to properly counsel patients.
The researchers queried the U.S. Food and Drug Administration (FDA) Adverse Reporting System Public Dashboard to identify cases of drug-induced priapism among medications commonly associated with priapism. Then they carried out a systematic review and analysis of publications describing cases of drug-induced priapism.
The main outcome of this study was the incidence of PDE5i-induced priapism.
Key findings of the study include:
- The researchers found 411 cases of drug-induced priapism secondary to Viagra, Cialis, or Levitra reported to the Food and Drug Administration since 1998.
- Compared with PDE5is, drug-induced priapism was 2.6 (n = 1,065) and 2.0 times (n = 817) more commonly reported for second-generation antipsychotics and the antidepressant/sleep aid trazodone, respectively.
- A total of 240 manuscripts describing cases of drug-induced priapism in patients with non-sickle cell disease were identified. PDE5i-induced priapism accounted for only 2.9% (n = 7) of drug-induced priapism cases.
- Second-generation antipsychotics (33.8%), a group of "other" medications (11.3%), and alpha-adrenergic antagonists (8.8%) accounted for the greatest percentage of published drug-induced priapism cases.
"Extensive counseling about priapism as an ADR for PDE5i for the routine treatment of erectile dysfunction is likely unnecessary," wrote the authors.
"PDE5i-induced priapism is a rare event. Drug-induced priapism should be attributed to a wider spectrum of medications that can cause this condition," they concluded.
The study, "Are We Overstating the Risk of Priapism With Oral Phosphodiesterase Type 5 Inhibitors?" is published in the Journal of Sexual Medicine.
MSc. Biotechnology
Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at  editorial@medicaldialogues.in. Contact no. 011-43720751
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751