A new original nutraceutical formulation ameliorates the effect of Tadalafil on clinical score and cGMP accumulation

  • Vincenzo Mirone Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, University of Naples Federico II, Naples, Italy.
  • Luigi Napolitano | dr.luiginapolitano@gmail.com Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, University of Naples Federico II, Naples, Italy.
  • Roberta D’Emmanuele di Villa Bianca Department of Pharmacy, School of Medicine and Surgery, University of Naples, Federico II, Naples, Italy.
  • Emma Mitidieri Department of Pharmacy, School of Medicine and Surgery, University of Naples, Federico II, Naples, Italy.
  • Raffaella Sorrentino Department of Pharmacy, School of Medicine and Surgery, University of Naples, Federico II, Naples, Italy.
  • Arianna Vanelli Responsabile Ricerca e Sviluppo Nutrilinea SRL, Varese, Italy.
  • Domenico Vanacore Department of Pharmacy, School of Medicine and Surgery, University of Naples, Federico II, Naples, Italy.
  • Carlotta Turnaturi Department of Pharmacy, School of Medicine and Surgery, University of Naples, Federico II, Naples, Italy.
  • Roberto La Rocca Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, University of Naples Federico II, Naples, Italy.
  • Giuseppe Celentano Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, University of Naples Federico II, Naples, Italy.
  • Davide Arcaniolo Urology Unit, Department of Woman Child and of General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
  • Giuseppe Cirino Department of Pharmacy, School of Medicine and Surgery, University of Naples, Federico II, Naples, Italy.


Objective: To assess the efficacy of the combination of Tadalafil 5 mg and nutritional supplements composed by Panax ginseng, Moringa Oleifera and Rutin on erectile function in men with mild and moderate vasculogenic ED.
Methods: we prospectively enrolled 86 patients divided into two groups A (45), B (33) in this multicenter randomized, doubleblind, placebo-controlled trial . Drop out was 8 patients (3 patients in group A and 5 in Group B). At screening visit patients underwent clinical examination, blood test (hormonal and metabolic profile) and filled out the IIEF-5 questionnaire and the SEP-2, SEP-3. Patients were randomized by a computergenerated list to receive either Tadalafil 5 mg once daily plus nutritional supplement once daily (group A) or Tadalafil 5 mg plus placebo with the same administration schedule (group B) for 3 months. Blood samples, IIEF-5, SEP-2 and SEP-3 have been collected again after 3 months. cGMP was measured in platelets of 38 patients at baseline and after one months.
Results: Mean age was 59.98 ± 6.90 (range 38-69), mean IIEF-5 score at baseline was 13.59 ± 3.90. After three months of treatment, IIEF-5 score significantly improved in both groups compared to baseline (13.18 ± 3.75 vs 20.48 ± 2.24, p < 0.0001; 14.15 ± 4.09 vs 19.06 ± 4.36, p < 0.0001, in group A and group B respectively). Patients treated with Tadalafil plus nutritional supplement showed a significantly higher increase in IIEF-5 score compared to those who received placebo (7.27 ± 2.20 and 4.9 ± 2.79, respectively; p < 0.0001;). No hormonal differences and metabolic effects were found. According cGMP result, nutritional supplements ameliorates and extends the activity of the chronic treatment.
Conclusions: IIEF-5 significant increase in group B, can be ascribed to the nutritional supplement properties and antioxidant effects of moringa oleifera, ginseng and rutin and this can enhance the endothelial NO and cGMP production.



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Original Papers - Andrology
Erectile dysfunction, PDE5, Dietary supplement, Phosphodiesterase, Natural health product
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How to Cite
Mirone, V., Napolitano, L., D’Emmanuele di Villa Bianca, R., Mitidieri, E., Sorrentino, R., Vanelli, A., Vanacore, D., Turnaturi, C., La Rocca, R., Celentano, G., Arcaniolo, D., & Cirino, G. (2021). A new original nutraceutical formulation ameliorates the effect of Tadalafil on clinical score and cGMP accumulation. Archivio Italiano Di Urologia E Andrologia, 93(2), 221-226. https://doi.org/10.4081/aiua.2021.2.221