PDE-5 inhibitors, also known as phosphodiesterase type 5 inhibitors, are drugs that selectively inhibit phosphodiesterase activity and are mainly used in the treatment of male erectile dysfunction. the introduction of PDE-5 inhibitors has been a revolutionary breakthrough in the treatment of male erectile dysfunction. However, in clinical practice, PDE-5 inhibitors sometimes do not work as well as they should due to various reasons. 1, a large number of start PDE-5 inhibitor application is different from other drugs, should not use the “small dose to start, gradually increase” approach, so that a significant number of patients with poor results, especially long-term treatment is ineffective, the psychological pressure of patients, the first dose of ineffective will destroy the patient’s residual The first dose of PDE-5 inhibitors should be given in full (sildenafil 100mg, tadalafil 20mg, vardenafil 20mg) as long as there are no contraindications and the body can tolerate it. If an effective erection is not achieved with the first dose, a full dose (tadalafil is more suitable) can be administered daily until the patient can obtain an effective erection (grade III or higher hardness) after sexual stimulation. 2.Effective maintenance After the drug is administered until the patient obtains an effective erection, the drug should not be stopped or reduced immediately, but should be maintained until the patient can obtain a satisfactory erection (no less than 80% chance) during regular and moderate sexual intercourse. 3.Satisfactory reduction After the patient obtains satisfactory erection and sexual life, you can consider the dose reduction or gradually lengthen the interval of medication (should not stop immediately), but the speed of reduction should not be too fast, should be to maintain sufficient erection. 4, the combination of drugs If a single PDE-5 inhibitor can not get satisfactory results, you can combine two. Such as tadalafil 5~10mg daily, add sildenafil 100mg before sex (preferably 60 minutes before) or vardenafil 20mg (can be used about 30 minutes in advance), after getting satisfactory effect, change to tadalafil daily dosing. 5, bedtime dosing Daily dosing of patients who do not have sex or asexual ED patients, the drug can be taken at bedtime, so that patients can get a satisfactory nocturnal erection and morning erection at the time the drug reaches its peak, which is conducive to increasing the patient’s self-confidence and cure rate. Of course, if the use of PDE-5 inhibitors at the same time can be combined with Chinese medicine evidence-based treatment or with the second-line treatment of ED can shorten the course of treatment and improve the effectiveness.