Overview: Priapism, a potential side effect, is linked with the use of phosphodiesterase type 5 inhibitors (PDE5is) for treating erectile dysfunction.
Objective: This research aimed to gather accurate information on priapism related to PDE5i to offer proper guidance to patients.
Procedure: The U.S. Food and Drug Administration (FDA) Adverse Reporting System Public Dashboard was examined to spot instances of medication-caused priapism linked to medicines frequently connected with this side effect. Following this, a comprehensive review and analysis of related publications were conducted.
Primary Finding: The study primarily focused on the occurrence rate of priapism induced by PDE5i.
Findings: Since 1998, 411 instances of medication-induced priapism due to Viagra, Cialis, or Levitra have been reported to the FDA. In comparison, medication-induced priapism was reported 2.6 (n = 1,065) and 2.0 times (n = 817) more for second-generation antipsychotics and the antidepressant/sleep aid trazodone. Out of 240 papers detailing cases of medication-induced priapism in patients without sickle cell disease, only 2.9% (n = 7) were due to PDE5i. The highest percentage of reported cases were attributed to second-generation antipsychotics (33.8%), followed by a category of “other” medicines (11.3%), and alpha-adrenergic blockers (8.8%).
Clinical Takeaway: Intense guidance on priapism as a side effect of PDE5i for regular erectile dysfunction treatment might not be essential.
Strengths & Constraints: The research utilized national data to recognize medication-induced priapism cases. However, the reported and documented cases might signify the more severe and unconventional instances of this side effect, potentially leading to an underestimation of our findings.
Conclusion: Priapism caused by PDE5i is uncommon. It’s crucial to recognize that various other drugs can also lead to this condition. Rezaee ME, Gross MS. “Is the Risk of Priapism with Oral PDE5 Inhibitors Overemphasized?”. J Sex Med 2020;17:1579-1582.
