The efficacy and safety of tadalafil: an update

BJU Int. 2004 Jun;93(9):1276-81. doi: 10.1111/j.1464-410X.2004.04819.x.


Objective: To provide an update on the efficacy and safety of tadalafil, a phosphodiesterase-5 inhibitor, in the treatment of erectile dysfunction (ED).

Patients and methods: In all, 2102 men (mean age 56 years) with mild-to-severe ED of various causes were randomized to placebo or tadalafil, taken as needed with no food restrictions, at fixed 'on-demand' doses of 10 or 20 mg in 11 randomized, double-blind, placebo-controlled trials lasting 12 weeks. The three co-primary outcomes were changes from baseline in the erectile function domain of the International Index of Erectile Function (IIEF) and the proportion of 'yes' responses to questions 2 and 3 of the Sexual Encounter Profile (SEP). Additional efficacy instruments included a Global Assessment Question (GAQ).

Results: Compared with placebo, tadalafil gave significantly better outcomes. Patients receiving either dose of tadalafil had a significant mean improvement of 6.5 and 8.6, respectively, in the IIEF erectile function domain score from baseline (P < 0.001 vs placebo). At both doses the mean success rate for intercourse attempts (SEP-Q3) was 58% and 68%, respectively, compared with 31% in the placebo group (P < 0.001), and 71% and 84% reported improved erections at the endpoint (GAQ), vs 33% on placebo (P < 0.001). Tadalafil was effective up to 36 h after dosing and was effective regardless of disease severity and causes, and in patients of all ages. The most frequent adverse events were headache, dyspepsia, back pain and myalgia.

Conclusion: Tadalafil was an effective and well-tolerated treatment for ED.

Publication types

  • Clinical Trial
  • Meta-Analysis
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carbolines / administration & dosage*
  • Carbolines / adverse effects
  • Coitus
  • Double-Blind Method
  • Erectile Dysfunction / drug therapy*
  • Humans
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Phosphodiesterase Inhibitors / administration & dosage*
  • Phosphodiesterase Inhibitors / adverse effects
  • Randomized Controlled Trials as Topic
  • Tadalafil
  • Treatment Outcome


  • Carbolines
  • Phosphodiesterase Inhibitors
  • Tadalafil