PDE 5 Inhibitors

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Post Uploaded Date : January 27, 2024 Last Updated Date : April 25, 2024
PDE5 inhibitors reduce the activity of the phosphodiesterase 5 enzyme. It is now widely used in the management of erectile dysfunction. Some of the most commonly used PDE5 inhibitors include Sildenafil, Vardenafil, and Tadalafil. 
Apart from treating impotence in men, some PDE5 inhibitors are also used to treat benign prostatic hyperplasia and pulmonary hypertension. 

If you’ve ever searched for information about erectile dysfunction in men, you’ve likely heard about PDE5 inhibitors.

PDE5 inhibitors are medications that treat erectile dysfunction in men by improving blood flow to the penis. 

In this blog, we’ve explained what PDE5 inhibitors are, their working mechanism, and the effective PDE5 inhibitors available on the market.

What Is A PDE 5 Inhibitor?

Phosphodiesterase type 5 inhibitors, or PDE5 inhibitors, are a class of medications that cause blood vessels to widen and relax, improving blood circulation. That makes them useful for treating various medical conditions that will be discussed in the later part of this blog. 

Uses of PDE5 Inhibitors

PDE5 inhibitors have numerous uses. At present, PDE5 inhibitors are approved by the U.S. Food and Drug Administration to treat the following:

Erectile Dysfunction

PDE5 inhibitors are best known for their effectiveness in treating erectile dysfunction. This condition can range in severity from person to person. Some men with ED may find it difficult to get an erection, while others may be able to get an erection but find it difficult to maintain it.

Currently, PDE5 inhibitors are generally viewed by many people as the gold standard for treating impotence. Not only are they powerful, they typically work quickly, last longer, and cause mild side effects. 

Nowadays, PDE5 inhibitors are used by millions of men in the United States and worldwide to treat erectile dysfunction or impotence (inability to sustain and maintain an erection) [1].

Benign Prostatic Hyperplasia (BPH)

Benign Prostatic Hyperplasia or BPH is a condition that results in enlargement of the prostate gland and may cause difficulties with urination. 

In fact, 70% of males in the United States in their 60s and 80% of men in their 70s or older are affected by this condition to some extent [2]. 

Pulmonary Hypertension (PH)

Some types of PDE5 inhibitors are used to treat a condition known as pulmonary hypertension which is a form of high blood pressure affecting the arteries in the lungs. 

Some of the symptoms of this condition include chest pain, tiredness, shortness of breath, and a fast heart rate, and this condition can affect the blood flow throughout the body. 

PDE5 Inhibitors: How They Work To Treat ED

To get an erection, men need good and steady blood flow in the penile area. An enzyme known as cGMP (cyclic guanosine monophosphate) helps relax and widen the blood vessel muscle to allow proper blood flow. In the condition of erectile dysfunction, another enzyme called PDE5 breaks down cGMP due to the fact that proper blood flow into the penis is obstructed.

The role of PDE5 inhibitors is to reduce the action of the PDE5 enzyme. Once the action of PDE5 is inhibited or reduced by the PDE5 inhibitors, cGMP facilitates increased blood flow into the penis, resulting in better, stiffer erections.

More Than Erections: Other PDE5 Inhibitor Uses

While PDE5 inhibitors are best known for allowing proper blood flow into the penis, they can also affect other parts of the body where the PDE5 enzyme is active.

Other areas affected by PDE5 inhibitors in the body include the blood vessels in the lungs and the lower urinary tract.

For pulmonary hypertension, PDE5 inhibitors work by opening the blood vessels that carry blood from the heart to the lungs, allowing for easier blood flow.

For benign prostatic hyperplasia, PDE5 inhibitors work by relaxing the smooth muscles in the bladder and prostate.

Note: It is important to remember that PDE5 inhibitors won’t help you get erections randomly. Instead, they’ll make it easier for you to maintain an erection only when you’re sexually stimulated or aroused. 

Most Effective PDE5 Inhibitors

Below, we’ve listed a few of the most effective and common  PDE5 inhibitors:

Sildenafil (Viagra, Aurogra, Malegra)

Sildenafil Citrate is a well-known PDE5 inhibitor on the market. Millions of men use it worldwide and the FDA first approved it in 1998. It is currently approved for impotence and pulmonary arterial hypertension.

Sildenafil, also known as generic Viagra, was the first medication for erectile dysfunction available to the public.

Sildenafil shows its effects for a period of approximately four hours. For best results, it should be used with or without food about an hour before sexual activity. 

Tadalafil (Vidalista, Cialis)

Tadalafil is a PDE5 inhibitor that is available as a generic drug and is sold under various brand names, such as Cialis and Vidalista. In 2003, the FDA approved tadalafil. It can provide relief from ED for up to 36 hours per dose.

Apart from erectile dysfunction, Tadalafil is also approved by the FDA to treat Benign Prostate Hyperplasia [3].

Its long-lasting effects make this ED medication a good choice for people who prefer to avoid taking multiple tablets to treat ED over the course of several days. 

Vardenafil (Vitara, Vilitra)

Vardenafil is an FDA-approved PDE5 inhibitor that is sold under various brand names, such as Vitara and Vilitra. This medication shows its effects for four to eight hours. One key pro of Vardenafil is that it generally is not affected by food, which means you can take it after a meal without any reduction in its effects. 

Natural PDE5 Inhibitor

natural Inhibitor
Some of the natural PDE5 inhibitors include the following foods and herbs:


In a study, wonderful 100% pomegranate juice was found to be beneficial to men with moderate to mild erectile dysfunction. Although 47% of the people (subjects) reported improvement in erections, more research and trials are needed to reach statistical significance [4]. 


Yohimbe is an evergreen tree native to central and western Africa. This tree contains a compound called yohimbine in its bark, said to be one of many natural PDE5 inhibitors. The bark has been used to enhance sexual performance and is promoted as a treatment for impotence in men [5].

If you’re interested in learning more about foods that can help with erectile dysfunction, check out our detailed guide: “What foods help erectile dysfunction?

PDE5 Inhibitor Side Effects

PDE5 inhibitors are generally well-tolerated medicines if used as directed. However, just like every medicine, PDE5 inhibitors can also cause side effects and interact with other drugs. Most of the side effects are manageable, although some require immediate medical attention and terminating treatment. 

Some common side effects of PDE5 inhibitors include-

  • Headaches
  • Cold-like symptoms
  • Facial flushing 
  • Back or muscle pain
  • Dyspepsia
  • Nasal congestion. 

Some serious side effects of ED pills include priapism ( prolonged, painful erection), 

hearing issues, and vision abnormalities (such as sudden loss of vision in one or both eyes). 

The severity of the side effects can increase depending on the dose. If taken excessively, PDE5 inhibitors can cause a rapid drop in blood pressure and fainting.


ED medications are promising, but the results of these pills may vary from person to person. These medications continue to be the first line of treatment because they have high rates of satisfaction from patients. Your doctor may recommend another option if PDE5 inhibitors do not work for you or if they cause side effects.


Which is the best PDE5 inhibitor?

There is no best PDE5 inhibitor. The effects of different PDE5 inhibitors vary from person to person.

What are the examples of PDE5 drugs?

Some examples of PDE5 inhibitors include Sildenafil, Tadalafil, and Vardenafil.

Is Cialis a PDE5 inhibitor?

Yes, Cialis is a PDE5 inhibitor.

What are PDE5 inhibitors used for?

PDE5 inhibitors are used to treat erectile dysfunction, benign prostatic hyperplasia, and pulmonary hypertension.

What are the side effects of PDE5 inhibitors?

Some of the common side effects of PDE5 inhibitors include facial flushing, dyspepsia, nasal congestion, cold-like symptoms, and back or muscle pain. Some severe side effects include hearing issues, vision abnormalities, and priapism.


  1. PDE5 Inhibitors, Wikipedia
  2. Benign Prostatic Hyperplasia and Male Lower Urinary Tract Symptoms: Epidemiology and Risk Factors, NCBI.
  3. What Are the Most Common PDE5 Inhibitors? healthline.
  4. POM Wonderful 100% Pomegranate Juice may improve erectile dysfunction, eurekalert
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