SUMMARY Background: All three phosphodiesterase-5 (PDE5) inhibitors for the treatment of the erectile dysfunction have similar efficacy and toxicity profiles. Sildenafil and vardenafil have similar molecular structures, but tadalafil is structurally different, which is reflected in its pharmacokinetic profile. These pharmacokinetic differences among the PDE5 inhibitors may underlie patient preference, an important and emerging aspect of ED therapy. Aim: The study is conducted to show and compare efficacy and safety of the three PDE-5 inhibitors and to assess patients preference in the treatment of erectile dysfunction. Its still unknown which of the three PDE-5 inhibitors is used the most. Methods: Study is conducted during two years on 53 patients with erectile dysfunction. Evaluation is done after 8 weeks of initial treatment followed by a 1- week washout period and then continued the therapy with the second and third medicine by the same protocol. Results: After three months of the treatment, patients preference was as follows: 33 patients (62%) choose tadalafil, 13 patients (24%) choose sildenafil and 7 patients (14%) choose vardenafil. Choice of PDE-5 for initial treatment was a significant predictor for substitution from one drug to another. Conclusion: Frequency of sexual intercourse (occasional use or regular therapy) and personal experience will determine the medicine of choice. When choosing medicine, attention should be paid to the beginning of its functioning, duration and possible interaction with food. [Med Arch 2009; 63(5.000): 278-281]
erectile dysfunction, PDE-5 inhibitor, therapeutic response
