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Insomnia or paresthesia was reported in 7 or 3%, respectively, of patients with PAH receiving sildenafil in a controlled clinical trial. Rarely, cardiovascular effects may be severe enough to result in discontinuance of the drug, but the rate of discontinuance secondary to intolerable cardiovascular effects has been similar for sildenafil (0.9%) and placebo (0.9%) in controlled clinical trials for the treatment of ED.

The goal of such therapy is to provide an erection of adequate rigidity and duration to be sexually functional and that is satisfying to the patient and his partner, and the main health benefit is improved quality of life. Patient assessment may also uncover related dysfunctions such as premature ejaculation, increased latency time associated with age, and psychosexual relationship problems. While VIAGRA helps most patients with correcting their erectile dysfunction issues, there is the possibility of unwanted side effects when taking it.

Treatments

Epistaxis was reported in 13% of patients with PAH secondary to connective tissue disease, 3% of patients with primary pulmonary hypertension, and 1% of those receiving placebo in controlled clinical trials. Nasal congestion, including rhinitis, occurred in 4% of the patients receiving sildenafil for the treatment of ED in controlled clinical trials. Nasal congestion appears to be secondary to sildenafil-induced hyperemia of the nasal mucosa, which results from inhibition of mucosal PDE type 5 and resultant local vasodilation.

The ease of taking an oral tablet for erectile dysfunction has revolutionized ED treatment. Sildenafil is the generic formulation of Pfizer’s Viagra, the “little blue pill” that has gained immense popularity for treatment of erectile dysfunction .

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In part, the absence of an effect on sexual desire may be attributed to the fact that men enrolling in ED studies generally have a near-normal level of sexual desire upon study entry. Improvement in erectile function sufficient for successful intercourse can be achieved with sildenafil in a substantial percentage of patients with ED, and the strength and duration of erection achieved with the drug in such patients approached those achieved in untreated healthy men. However, the dependence on adequate sexual stimulation for the erectile activity of sildenafil may not alleviate patient and partner performance pressures and therefore may limit efficacy in some patients. In addition, unlike intracavernosal or intraurethral therapy or vacuum constriction devices, selective PDE type 5 inhibitors are only effective in the presence of adequate sexual stimulation.

  • In one case, a 44-year-old man experienced permanent, bilateral sensorineural deafness 15 days after initiating therapy with sildenafil 50 mg daily; this patient did not have any prior or current risk factors for ototoxicity.
  • Pretreatment with erythromycin , a specific CYP3A4 inhibitor, increased the AUC of a single 100-mg dose of sildenafil by 182%.
  • In flexible-dose clinical studies in patients with erectile dysfunction , 62% of all reported adverse effects were classified as mild, with only about 7% being classified as severe.
  • The manufacturer states that efficacy and safety of sildenafil in patients with sickle cell anemia have not been established.
  • Postural hypotension also has occurred in at least one patient with PAH after an initial 40-mg dose.

Patients in the study had predominantly WHO functional class II (57%) or III (41%) PAH and were predominantly female (67%) and Asian (67%). The mean increase in the placebo-corrected 6-minute walking distance was meters with all 3 dosages of sildenafil at 12 weeks; no difference in efficacy was observed among the dosage groups.

Dosage

All medicines have a possibility of side effects and Viagra in Canada is no exception. It is reported to have nearly the same level of efficacy as the branded tablets, and the appeal of generic Viagra is that of course it is priced lower and can be acquired with the same prescription for Viagra that you receive from your physician. Men who have had a heart attack in the past six months, those taking nitrates for heart disease, and men taking protease inhibitors for an HIV infection shouldn’t take erectile dysfunction drugs, Bromberg said. And though rare, it is possible to have an erection that lasts for four hours or more. Both doctors said this has led many men in the United States to buy erectile dysfunction drugs online or in Canada.

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Improvement in walking distance was apparent after 4 weeks of therapy with sildenafil and improvement was maintained for the duration of the trial. Results of the extension study indicate that the effect of sildenafil on exercise capacity is maintained after 1 year of treatment.

Sildenafil has been shown to remain effective for at least 0.5-3 years in controlled and uncontrolled studies. There currently are no specific limitations to continued sildenafil therapy based on patient age and/or duration of therapy alone. Sildenafil is administered orally for the treatment of erectile dysfunction . Administration of the drug with a high-fat meal decreases the rate but not extent of absorption, potentially delaying the onset of action of sildenafil. The study was terminated prematurely after enrollment of 129 of a planned 219 patients.

It was originally approved in the U.S. in 1998, and over 30 million prescriptions have been dispensed for Viagra in 120 countries. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Data sources include IBM Watson Micromedex , Cerner Multum™ , ASHP and others. Even if the Viagra brand name is not covered, the generics may be, and are very affordable if you have to pay the full cash price. Viagra® is the first FDA-approved oral treatment for erectile dysfunction. Viagra® is a brand name drug made by Pfizer, which originally discovered it in 1989. This medication is known as a PDE-5 inhibitor, which can relax blood vessels and improve blood flow to important parts of your body.