Regional cerebral blood flow following single-dose and continuous-dose tadalafil after stroke.

Abstract

PURPOSE:

Tadalafil is a potent and selective phosphodiesterase type 5 inhibitor that provides effective treatment for erectile dysfunction (ED). The purpose of this study was to explore the effect of a single on-demand dose of tadalafil compared to low-dose continuous administration on regional cerebral blood flow (rCBF), in patients after stroke.

METHODS:

Thirty consecutive male patients (mean age 58.3 ± 7.9 years) with ED and a history of stroke were included in the study. The baseline single-photon emission computed tomography (SPECT) study was performed 15 min after iv injection of 740 MBq Tc-99m-HMPAO (Ceretec; GE Healthcare Ltd. Chalfont St. Giles, UK). Fifteen randomized patients received a single dose of 20 mg tadalafil in the morning, and a second SPECT study was performed 6 h later. Fifteen other patients received 5 mg of tadalafil each morning for seven consecutive days, and the second SPECT study was performed 6 h after the last dose. The imaging data were evaluated using SPM software (Wellcome Department of Cognitive Neurology, University College, London).

RESULTS:

Associations between any of the risk factors/comorbidities and the perfusion changes were not detected. All patients showed areas of reduced relative rCBF in the affected hemisphere after tadalafil administration compared to baseline (P < 0.001). No significant difference was found between patients on 5 mg tadalafil and 20 mg dose.

CONCLUSION:

Tadalafil administration after cerebral stroke may be associated with diminished blood flow to areas adjacent to the stroke. The alterations in perfusion suggest a need for caution in prescribing tadalafil to patients with a history of stroke, especially with continuous administration that may impose constant stress on the cerebral circulation.

• Authors: M Lorberboym, E Makhline, Y Lampl
• Journal: Acta neurologica Scandinavica (Acta Neurol Scand) Vol. 130 Issue 6 Pg. 380-6 (Dec 2014) ISSN: 1600-0404 [Electronic] Denmark
• PMID: 25208597 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chemical References

• Carbolines
• Radiopharmaceuticals
• Vasodilator Agents
• Technetium Tc 99m Exametazime
• Tadalafil

Topics

• Adult
• Aged
• Carbolines (administration & dosage, adverse effects)
• Cerebrovascular Circulation (drug effects)
• Erectile Dysfunction (drug therapy)
• Female
• Humans
• Male
• Middle Aged
• Radiopharmaceuticals
• Stroke (complications, diagnostic imaging)
• Tadalafil
• Technetium Tc 99m Exametazime
• Tomography, Emission-Computed, Single-Photon (methods)
• Vasodilator Agents (administration & dosage, adverse effects)