In the meta- analysis , tadalafil and sildenafil appeared to have similar efficacies and overall adverse event rates .
However , compared with sildenafil , tadalafil significantly improved psychological outcomes .
Furthermore , the patients and their partners preferred tadalafil over sildenafil , and no significant difference was found in the adherence and persistence rates between tadalafil and sildenafil .
Additionally , the myalgia and back pain rates were higher and the flushing rate was lower with tadalafil than with sildenafil .
Conclusion Tadalafil shares a similar efficacy and safety with sildenafil and significantly improves patients ’ sexual confidence .
Furthermore , patients and their partners prefer tadalafil to sildenafil .
Hence , tadalafil may be a better choice for ED treatment
Aims Erectile dysfunction ( ED ) is a major care problem worldwide .
Tadalafil and sildenafil are the two most common phosphodiesterase 5 inhibitors used to treat ED .
This systematic review and meta- analysis were conducted to directly compare tadalafil with sildenafil for the treatment of ED .
Prospective, randomized, open-label, fixed-dose, crossover study to establish preference of patients with erectile dysfunction after taking the three PDE-5 inhibitors.
INTRODUCTION We conducted a prospect i ve , r and omized , open-label , fixed-dose preference study , with a crossover design , using sildenafil , vardenafil , and tadalafil . AIM To assess patient preference for sildenafil ( 100 mg ) , vardenafil ( 20 mg ) , and tadalafil ( 20 mg ) for the treatment of  erectile dysfunction .  Secondary objectives included finding out whether patients would follow treatment with a second or third option , in the event that the preferred drug was not available , and to assess side effects . MAIN OUTCOME MEASURES Patient preference for any treatment , and evaluation of the elements that patients would assess when choosing one of these drugs . MATERIAL AND METHODS Sildenafil ( 100 mg ) , vardenafil ( 20 mg ) , and tadalafil ( 20 mg ) were taken at least six times over a period of 45 - 60 days with a washout period of 7 days . A total of 132 patients were enrolled to achieve a valid sample of 90 cases ( 15 per r and omized group , total of six groups ) . Enrolled patients had mild to moderate erectile function . RESULTS The International Index of Erectile Function ( IIEF ) score improved from baseline and was statistically significant in all cases ( P < 0.0001 ) . When we compared the IIEF scores , we found a statistically significant difference between tadalafil and vardenafil ( P = 0.0002 ) favoring the former ; similar results were obtained with the Erectile Dysfunction Inventory for Treatment Satisfaction ( EDITS ) Question naire ( P = 0.000075 ) . We also found a significant difference ( P = 0.012 ) between tadalafil and sildenafil , again in favor of the former . In assessing drug preference , 25 patients ( 27.77 % ) chose sildenafil , 18 ( 20 % ) vardenafil , and 47 ( 52.22 % ) tadalafil . A total of 94 % of patients would be willing to take another drug if the preferred choice was not available . All drugs were well tolerated . CONCLUSIONS Although this is a preference study based on subjective elements , statistically significant differences comparing the IIEF score and the EDITS Question naire lead us to believe that beyond patients ' subjective preference per se , said preference is probably also based on a genuinely superior response to one drug over another
In the meta- analysis , tadalafil and sildenafil appeared to have similar efficacies and overall adverse event rates .
However , compared with sildenafil , tadalafil significantly improved psychological outcomes .
Furthermore , the patients and their partners preferred tadalafil over sildenafil , and no significant difference was found in the adherence and persistence rates between tadalafil and sildenafil .
Additionally , the myalgia and back pain rates were higher and the flushing rate was lower with tadalafil than with sildenafil .
Conclusion Tadalafil shares a similar efficacy and safety with sildenafil and significantly improves patients ’ sexual confidence .
Furthermore , patients and their partners prefer tadalafil to sildenafil .
Hence , tadalafil may be a better choice for ED treatment
Aims Erectile dysfunction ( ED ) is a major care problem worldwide .
Tadalafil and sildenafil are the two most common phosphodiesterase 5 inhibitors used to treat ED .
This systematic review and meta- analysis were conducted to directly compare tadalafil with sildenafil for the treatment of ED .