Complications
Adverse effects include headache, flushing, dyspepsia, nasal congestion, and dizziness. Adverse effects are generally short-lived and self-limiting.
Titrating dose gradually may reduce these effects.
Consider alternative therapy if intolerable.
Persistence of vasodilation, with impaired arterial inflow causing prolonged and painful erection, and potential cavernosal tissue ischaemia.
Inform patients to seek immediate medical attention if erection persists for longer than 3 hours.
For medicine-induced priapism, use of alpha-blockers (e.g., phenylephrine) injected intracorporally is usually effective. Monitor blood pressure while treating priapism.
Consider consulting a urologist for acute management, failed injection, or ongoing therapy.
Titrate subsequent medicine doses downwards.
Persistence of vasodilation, with impaired arterial inflow causing prolonged and painful erection, and potential cavernosal tissue ischaemia.
Inform patients to seek immediate medical attention if erection persists for longer than 3 hours.
For medicine-induced priapism, use of alpha-blockers (e.g., phenylephrine) injected intracorporally until erection subsides is usually effective. Monitor blood pressure while treating priapism.
Consider consulting a urologist for acute management, failed injection, or ongoing therapy.
Relationship is controversial, and may be due to cross-reactivity with phosphodiesterase isoforms in the eye.
Phosphodiesterase-5 (PDE5) inhibitors should be stopped if this occurs.
Consultation with ophthalmologist is indicated.[113]
A careful review of pooled data from clinical trials for all three PDE5 inhibitors yielded no evidence for an increased risk of NAION or other adverse ocular events associated with PDE5 inhibitor use.[114]
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