Erectile dysfunction is the most commonly encountered form of sexual dysfunction in men and can cause significant distress, impaired quality of life, and have a negative effect on overall selfesteem and intimate relationships. 1 Risk factors for erectile dysfunction include older age, cardiovascular disease, smoking, diabetes, pelvic irradiation or surgery (e.g., radical prostatectomy), hypertension, medications (e.g., antidepressants such as selective serotonin reuptake inhibitors), and psychiatric conditions (e.g., anxiety, depression). 1 There are three oral medications currently on the market in Canada belonging to the phosphodiesterase 5 (PDE-5) inhibitor class: sildenafil, tadalafil, and vardenafil. 2-4 These medications are all approved for use in the treatment of erectile dysfunction. 2-4 Sildenafil, tadalafil and vardenafil, are approved for use to be taken orally on an as needed basis a short period of time prior to intercourse (30 to 60 minutes; referred to as on demand dosing). 2-4 Tadalafil is also approved for once daily administration on a regular basis for the treatment of erectile dysfunction, but at a lower dose (10mg to 20mg for on demand dosing compared to 2.5mg to 5mg for the daily dosing). 4 In addition to its approved indication of the treatment of erectile dysfunction, PDE-5 inhibitors are also used intermittently to treat antidepressan
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