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Although some men have taken two different PDE-5 inhibitors simultaneously, no evidence suggests any benefit and the risk of significant adverse effects is greatly enhanced. However, the use of both a shorter-acting agent and a longer-acting agent is not unreasonable at appropriate times and intervals as long as they are not taken together. Pediatric <18 years: Not established "The presence of unknown pharmaceutically active ingredients and/or impurities may lead to undesirable and serious adverse events, even death" warns lead author and journal editor Graham Jackson, a London-based cardiologist. branded lyrics Possible priapism (rare <1%) Other adverse events associated with oral PDE-5 inhibitor therapy appear to be few (Table 4). 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