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Drugs for Erectile Dysfunction

Treatment of erectile dysfunction.

Adult 50 mg once daily, taken approx 1 hr before sexual activity. The dose may be increased to 100 mg or decreased to 25 mg. Max: 100 mg once daily. Elderly > 65 yr old Initially 25 mg, may increase to 50-100 mg based on efficacy & toleration.

Should be taken 2 hrs. after food.

Men for whom sexual activity is inadvisable (patients w/ severe CV disorders eg unstable angina or severe cardiac failure). Severe hepatic impairment, hypotension (< 90/50 mmHg), recent history of stroke or MI, known hereditary degenerative retinal disorders such as retinitis pigmentosa. Coadministration w/ nitric oxide donors (eg amyl nitrite), nitrates in any form. Hypersensitivity to sildenafil.

A medical history & physical exam should be undertaken to diagnose erectile dysfunction & determine potential underlying causes, before Viagra is considered. Anatomical deformation of the penis (angulation, cavernosal fibrosis or Peyronie's disease), conditions which may predispose to priapism (sickle cell anaemia, multiple myeloma or leukaemia). Patients w/ bleeding disorders, active peptic ulceration, or untreated proliferative diabetic retinopathy. Co-administration w/ ritonavir not advised, if necessary, max dose of sildenafil is 25 mg/48 hr.

Headache, flushing, dizziness, dyspepsia, nasal congestion, altered vision.

Organic nitrates, nitric oxide donors (amyl nitrite), ritonavir, ketoconazole, itraconazole, erythromycin, cimetidine, saquinavir,

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