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Title:Oral Sildenafil in the treatment of erectile dysfunction
Author:I. Goldstein et al.
Address: Boston Massachusetts
Source: New England Journal of Medicine 20:(May) 1998
Summary:Sildenafil increases the penile response to sexual stimulation through its action as a potent inhibitor of cyclic guanosine monophosphate in the corpus cavernosum. This long awaited report examined the safety of sildenafil. This determination was the result of two sequential double -blind studies of men with erectile dysfunction. The erectile dysfunction was with either organic, psychogenic, or from mixed causes. In the first study, 532 men were treated with oral sildenafil (25, 50, or 100 mg) or placebo over a 24-week dose-response study.The second group consisted of 329 different men and was designed as a 12-week, flexible dose-escalation study . All participants were treated with sildenafil or placebo, with dose escalation up to 100 mg . Following this dose-escalation study, 225 of the 329 men entered a 32-week, open-label extension study. Efficacy was assessed by utilizing the guidelines from the International Index of Erectile Function, a patient log, and a global-efficacy question. Increasing doses of sildenafil were associated with improved erectile function (Pless than 0.0001) in the dose-response study. A 100% successful attempt response was noted for the men receiving 100 mg of sildenafil when answering the question about achieving erections treatment than at base line (4.0 vs. 2.0 of a possible score of 5). 69% percent of all attempts at sexual intercourse were successful for the men receiving sildenafil,comparing with 22% placebo group (P<0.001). The mean numbers of successful attempts per month were 5.9 for the men receiving sildenafil and 1.5 for those receiving placebo (P<0.001). The most common adverse effects were headache, flushing, and dyspepsia in 6 % to 18%t of the men. The researchers concluded that oral sildenafil is an effective, well-tolerated treatment for men with erectile dysfunction. Note: Patients on nitrates(eg. nitroglycerin) should never receive oral sildenafil. Oral sildenafil is shown to potentiate the hypotensive effects of nitrates.
Comment: This problem is more common than most are aware. If it only worked on libido! Rave reviews thus far.
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