ATC G04 — Urologicals

Alprostadil is the prostaglandin E1 used for erectile dysfunction when oral PDE5 inhibitors are ineffective or contraindicated. It is administered as intracavernosal injection (Caverject, Edex) or as a urethral pellet (Muse), producing reliable erection within minutes through direct vasodilation.

Sildenafil citrate is a selective PDE5 inhibitor used in adult men for erectile dysfunction. It supports erections by raising cyclic GMP levels in penile tissue during sexual stimulation. Available under brand and generic names.

Tadalafil is a long-acting selective PDE5 inhibitor used for erectile dysfunction, benign prostatic hyperplasia and pulmonary arterial hypertension. Its 17-hour half-life supports an effect window of up to 36 hours. Available under brand and generic names.

Vardenafil is a selective PDE5 inhibitor used in adult men for erectile dysfunction. Its onset and effect window are similar to sildenafil, with a half-life of 4 to 5 hours. Marketed by Bayer as Levitra and as authorised generics.

Avanafil is the newest PDE5 inhibitor approved for erectile dysfunction (FDA 2012, marketed as Stendra in the US and Spedra in Europe). It offers faster onset and shorter duration than sildenafil or tadalafil, with a more selective enzyme profile that may reduce some side effects.

Dapoxetine is a short-acting selective serotonin reuptake inhibitor designed specifically for on-demand treatment of premature ejaculation in adult men. Unlike other SSRIs, it has rapid onset and short duration suitable for as-needed use.

Finasteride is a selective 5-alpha-reductase type II inhibitor used in male pattern hair loss (1mg) and benign prostatic hyperplasia (5mg). It reduces dihydrotestosterone production, slowing or partially reversing androgen-driven hair loss in men.

Dutasteride is a dual 5α-reductase inhibitor that blocks both type 1 and type 2 isoenzymes, reducing dihydrotestosterone (DHT) more completely than finasteride. It is used for benign prostatic hyperplasia and off-label for androgenetic alopecia.