The Potential of Once-Daily Tadalafil in Enhancing Erectile Dysfunction Recovery in Patients with Diabetes Mellitus: An Updated Review

I Made Oka Negara; Bagus Komang Satriyasa

doi:10.55927/fjst.v4i7.172

Authors

I Made Oka Negara Udayana University
Bagus Komang Satriyasa Udayana University

DOI:

https://doi.org/10.55927/fjst.v4i7.172

Keywords:

Tadalafil Once a Day, Erectile Dysfunction, Diabetes Mellitus, PDE5 Inhibitor, Daily Therapy

Abstract

Erectile dysfunction (ED) is a common chronic complication in men with diabetes mellitus (DM), with a prevalence significantly higher than in the general population. A literature review was conducted using PubMed, ScienceDirect, Cochrane Library, and Google Scholar, focusing on articles from 2013–2024. Inclusion criteria were clinical studies, meta-analyses, and systematic reviews discussing daily tadalafil use in diabetic men with ED. Most studies show that tadalafil once a day significantly improves IIEF scores, sexual satisfaction, and is well tolerated. Some studies also report long-term vascular benefits and improved endothelial function. Daily tadalafil offers potential as a sustainable and effective ED treatment in DM patients, with possible vascular advantages. Further long-term randomized studies are needed to support its inclusion in clinical guidelines.

References

American Diabetes Association. Standards of Medical Care in Diabetes—2024. Diabetes Care. 2024; 47(Suppl 1):S1–S210.

BPJS Kesehatan. National Formulary of Drugs 2024. Jakarta: Ministry of Health of the Republic of Indonesia; 2024.

Burnett AL, Nehra A, Breau RH, et al. Erectile dysfunction: AUA guideline. J Urol. 2018; 200(3):633–41.

Carson CC, Rajfer J, Eardley I, et al. The efficacy and safety of tadalafil: An update. BJU Int. 2004; 93(9):1276–81.

Chiu YW, Chen CK, Wan GH, et al. Treatment satisfaction with daily tadalafil in patients with erectile dysfunction and diabetes mellitus. J Sex Med. 2010; 7(4 Pt 1):1460–9.

Corona G, Rastrelli G, Isidori AM, et al. PDE5 inhibitors improve glucose metabolism. A systematic review and meta-analysis. Andrology. 2016; 4(3):404–11.

Esposito K, Giugliano D. Lifestyle factors and erectile dysfunction: A natural history perspective. J Sex Med. 2014; 11(1):143–6.

European Association of Urology (EAU). Guidelines on Sexual and Reproductive Health 2024.

Giuliano F, Ückert S, Maggi M, Birder L. The mechanism of action of PDE5 inhibitors in the lower urinary tract. Eur Urol. 2013; 63(3):443–7.

Goldstein I, McCullough AR, Jones LA, et al. A randomized controlled trial of tadalafil for daily use in men with erectile dysfunction. J Urol. 2008; 179(2):843–9.

Hackett G. The burden and extent of comorbid conditions in patients with erectile dysfunction. Int J Clin Pract. 2009; 63(8):1205–13.

Huang SA, Lie JD. Phosphodiesterase-5 (PDE5) inhibitors in the management of erectile dysfunction. P T. 2013; 38(7):407–19.

Kendirci M, Salem E, Hellstrom WJ. Efficacy of sildenafil and tadalafil in diabetic men with erectile dysfunction. Curr Med Res Opin. 2007; 23(12):2529–37.

Kloner RA, Jackson G, Emmick JT, et al. Effects of tadalafil on erectile dysfunction in men with diabetes. Int J Impot Res. 2004; 16(6):450–5.

Kostis JB, Dobrzynski JM. The effect of daily tadalafil on endothelial function in patients with erectile dysfunction and cardiovascular risk factors. Curr Med Res Opin. 2005; 21(11):1855–63.

Kucuk EV, Ertas K, Kucuk U, et al. Daily tadalafil improves lower urinary tract symptoms and erectile dysfunction in diabetic men. Aging Male. 2017; 20(2):92–6.

Lu Z, Lin G, Reed-Maldonado AB, Wang C, Lue TF. Erectile dysfunction and regeneration: Experimental approaches. Curr Opin Urol. 2016; 26(2):129–35.

McMahon CG. Efficacy of daily tadalafil in the treatment of men with erectile dysfunction. Curr Med Res Opin. 2004; 20(11):1785–94.

Montorsi F, Briganti A, Salonia A, et al. Erectile dysfunction in diabetic patients: What can be done? J Urol. 2004; 172(2):398–403.

Mulhall JP, Burnett AL, Wang R, et al. A critical analysis of the role of testosterone in the treatment of erectile dysfunction. J Sex Med. 2010; 7(10):3561–72.

Park K, Kim SW, Paick JS. Efficacy of daily vs. on-demand tadalafil in diabetic men with erectile dysfunction: A prospective, randomized, crossover study. J Sex Med. 2009; 6(5):1453–9.

Porst H, Giuliano F, Glina S, et al. Evaluation of the efficacy and safety of once-daily tadalafil 5 mg in men with erectile dysfunction and various underlying conditions: A pooled analysis of randomized, double-blind, placebo-controlled trials. Eur Urol. 2014; 65(4):779–88.

Rahardjo HE, Prasetyo H, Susilo D, Widjanarko B. Effectiveness of daily tadalafil therapy in ED patients with DM in an Indonesian andrology clinic. Maj Kedokt Indon. 2023; 73(2):101–8.

Rosen RC, Allen KR, Ni X, Araujo AB. Minimal clinically important differences in the erectile function domain of the International Index of Erectile Function scale. Eur Urol. 2011; 60(5):1010–6.

Saenz de Tejada I, Anglin G, Knight JR, Emmick JT. Effects of tadalafil on erectile dysfunction in men with diabetes. Diabetes Care. 2002; 25(12):2159–64.

Santi D, Granata AR, Guidi A, et al. Six months of daily treatment with tadalafil improves endothelium-dependent vasodilation in patients with erectile dysfunction. Int J Impot Res. 2016; 28(5):193–9.

Srilestari A, Winarni S, Budiman I. Description of erectile dysfunction in men with type 2 diabetes mellitus in Indonesia. J Androl Indonesia. 2022; 22(1):11–8.

Steers WD, Guay AT, Leriche A, Denes BS. Tadalafil in the treatment of erectile dysfunction: A critical review. Clin Interv Aging. 2005; 1(3):229–44.

Vlachopoulos C, Jackson G, Stefanadis C, Montorsi F. Erectile dysfunction in the cardiovascular patient. Eur Heart J. 2013; 34(27):2034–46.

Yamanaka D, Nishimura M, Nakagawa T, et al. Daily tadalafil improves endothelial function in patients with erectile dysfunction. Int J Urol. 2017; 24(2):142–7.