A 52-year-old male with ED and a history of refractory angina (despite treatment) requests a PDE5 inhibitor. What is the most appropriate action?

Question

Answer

Refer him to a cardiologist for clearance before prescribing any PDE5 inhibitor.

Answer

Prescribe alprostadil intraurethral as an alternative with no cardiac risk.

Answer

Prescribe sildenafil 25 mg with strict instructions to monitor for chest pain.

Answer

Explain that the use of PDE5 inhibitors is contraindicated and sexual intercourse should be deferred.

Answer

Prescribe tadalafil 5 mg daily as it is the safest option for daily use.

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