Multiple previous prescriptions for phosphodiesterase type 5 inhibitors (PDE5Is) are associated with poorer overall health in men regardless of their erectile dysfunction (ED) severity, a new study found.

The greater the number of different PDE5Is a man had been prescribed, the more likely he would have a Charlson Comorbidity Index (CCI) of 1 or higher. Compared with men who had never been prescribed PDE5Is, those who were prescribed 1, 2, and 3 different PDE5Is had significant 1.69-, 2.49-, and 2.9-fold odds of having a CCI of 1 or higher, respectively, in multivariable analysis, Davide Oreggia, MD, of the University Vita-Salute San Raffaele in Milan, Italy, and colleagues reported in PLoS One.

The study included 939 men seeking medical help for ED. Of these, 328 (34.9%) had been prescribed PDE5 inhibitors and 611 (65.1%) were not. The PDE5 inhibitor group and PDE5 inhibitor naïve group were similar with respect to age, body mass index, and baseline ED severity. The group prescribed PDE5Is had a higher proportion of men with a CCI of 1 and CCI of 2 or higher than the PDE5I naïve group (15% vs 8% and 18% vs 10%, respectively).

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The investigators concluded that their findings “provide novel evidence of the potential clinical relevance of an indirect user-friendly measure (namely, the number of previous PDE5Is prescriptions) to easily identify patients deserving a more comprehensive medical assessment.”


Oreggia D, Ventimiglia E, Capogrosso P, et al. Multiple PDE5Is use as a marker of decreased overall men’s health: A real life study. PLoS One (2018;13:e0201601).