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June 6, 2026The Journal of Sexual Medicine

(782) Combined Use of Tadalafil and Vardenafil in Men with Erectile Dysfunction Non-Responsive to Monotherapy With a Single PDE5 Inhibitor: Clinical Rationale and Preliminary Outcomes

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Authors

IAI ArianNicolae Testemițanu State University of Medicine and PharmacyIDI I DumbraveanuNicolae Testemițanu State University of Medicine and PharmacyMCM CreciunNicolae Testemițanu State University of Medicine and Pharmacy

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Implication

Randomized trial evaluates efficacy and safety of dual PDE5i therapy in men with ED, suggesting a new treatment strategy.

Key Points

  • To evaluate the efficacy, safety, and patient satisfaction of combined tadalafil and vardenafil therapy in men with erectile dysfunction unresponsive to single PDE5 inhibitor treatment.
  • Pilot study involving 62 men previously unresponsive to ≥8 attempts of either tadalafil or vardenafil monotherapy
  • Patients received tadalafil 5 mg daily and vardenafil 10 mg on-demand for 12 weeks
  • Clinical evaluations included the IIEF-5 questionnaire and Erection Hardness Score at baseline and after 4 and 12 weeks
  • Mean IIEF-5 increased from 11.2 to 18.9 after 12 weeks (p < 0.001)
  • Erection Hardness Score improved from 2.1 to 3.4 (p < 0.01)
  • 74% of patients achieved IIEF-5 gain ≥5 points, with 84% reporting improved satisfaction

Cite This Study

Arian et al. (2026) studied this question.

synapsesocial.com/papers/6a23bb4471a5da9775e76d08https://doi.org/10.1093/jsxmed/qdag118.681
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1(187) Efficiency and Safety of Combining Long-Acting and Short-Acting PDE5 Inhibitors2024
  2. 2Vardenafil in the multidisciplinary management of erectile dysfunction: a narrative review on multidimensional outcomes and clinical integration2026
  3. 3(260) Combination Tadalafil and Tamsulosin Therapy Versus Monotherapy for Lower Urinary Tract Symptoms and Erectile Dysfunction: A Randomized Trial2026
  4. 4A comparative evaluation of on-demand phosphodiesterase-5 inhibitor efficacy in erectile dysfunction treatment: a systematic review and network meta-analysis of double-blind, placebo-controlled, randomized trials2026 · 1 citations
  5. 5Oral drug treatments of erectile dysfunction: a AFU/SFMS systematic review2025 · 1 citations