No abstract available.
Drug Eruptions* ; Sildenafil Citrate*

No abstract available.
Korea* ; Marketing* ; Sildenafil Citrate*

No abstract available.
Korea* ; Marketing* ; Sildenafil Citrate*

No abstract available.
Cicatrix* ; Sildenafil Citrate* ; Ulcer*

PURPOSE: We investigated the efficacy and safety of oral sildenafil, and the selection rate of sildenafil, for the continuous treatment of erectile dysfunction (ED) in patients who received intracavernous injection (ICI) therapy. MATERIALS AND METHODS: A total of 69 ED patients (55.1+/-12.3 years) who received ICI therapy, with trimix (papaverine 18.75mg+phentolamine 0.625mg+PGE1 6.25microgram/ ml) for more than 6 months, were recruited for this study. All patients received a starting dose of 50mg sildenafil. The dose was adjusted to 100mg or 25mg based on its efficacy and tolerability. The erection quality, side effects, and selection rates of sildenafil for the continuous treatment, with reasons for its selection, were compared with those of ICI. RESULTS: Good erectile responses, to both trimix and sildenafil, were noted in 52 (75.4%) patients. There were no differences in the age, frequency of associated diseases, dose of trimix, duration of the injection therapy, and IIEF Q3 or Q4 on the ICI between sildenafil-responders and -nonresponders. The dose of sildenafil in the responders was 100mg, 50mg and 25mg in 37, 14 and 1, respectively. Of the 52 sildenafil-responders, the erectile quality with ICI was better than with the sildenafil in 46 (88.5%), whereas only 2 showed a better quality, and 4 showed similar responses. Among the 52 responders, 18 (34.6%) preferred to continue the oral drug, 18 (34.6%) used both treatment alternatively, and 16 (30.8%) returned to the ICI. The main reason for selecting sildenafil was its easier administration (88.9%), whereas that for the ICI was its better erection quality (74.3%). The most common adverse reactions to the sildenafil included, hot flushes (17.4%) and headaches (13%). CONCLUSIONS: Patients with ED on the ICI therapy are likely to have similar erectile responses and adverse reactions to those on sildenafil from their comparison with other clinical trials on sildenafil. However, the selection rate of ICI for the continuous treatment in sildenafil-responders was high due to its better erection quality.
Erectile Dysfunction ; Headache ; Humans ; Male ; Sildenafil Citrate

PURPOSE: The aim of our study was to assess whether an intracavernous injection test can predict the effectiveness of sildenafil oral medication in patients with erectile dysfunction (ED). MATERIALS AND METHODS: A total of 80 patients with ED underwent an intracavernous injection test with trimix (papaverine 18.75 mg+phentolamine 0.625 mg+PGE1 6.25microgram/ml) 0.2 ml. Patients were divided into 2 groups according to rigidity formation following trimix injection: group I had no rigidity formation, group II had some rigidity formation. All patients received a starting dose of 50 mg sildenafil. The dose was adjusted to 100 mg based on its efficacy and tolerability. Erectile function was measured before and during the therapy using the International Index of Erectile Function (IIEF) questionnaire. RESULTS: All patients had erection function (EF) domain scores of the IIEF less than 16, denoting moderate to severe ED (group I, 50 patients; group II, 30 patients). The response rates with sildenafil 50 mg were 24% (12/50) in group I and 87% (26/30) in group II. The overall response rates with sildenafil (50 mg or 100 mg) were 68% (34/50) in group I and 93% (28/30) in group II. The change in ED domain score was significantly higher in group II (9.87+/-3.18 to 15.40+/-4.50; p<0.001) compared to group I (7.80+/-2.43 to 9.08+/-3.84). CONCLUSIONS: The erectile response from the intracavernosal injection test was correlated with the sildenafil response rate. This result implies that intracavernosal injection test may predict the erectile response to oral phosphodiesterase type 5 inhibitor.
Erectile Dysfunction* ; Humans ; Male ; Sildenafil Citrate

A simple, rapid, and reliable UPLC-MS/MS method was developed and validated for the determination of tadalafil in human plasma. The plasma samples were deproteinized with acetonitrile. Chromatographic separation was performed on a Shiseido C18 (100 × 2.1 mm, 2.7 µm) column with isocratic elution using 2.0 mM ammonium acetate and acetonitrile (55:45, v/v) with 0.1% formic acid at a flow rate of 0.7 mL/min. The total run time was 1 min per sample. The quantitative analysis was performed using multiple reaction monitoring at transition of m/z 390.4 → 268.3 for tadalafil and m/z 475.3 → 283.3 for sildenafil as an internal standard. The method was fully validated over a concentration range of 5–1,000 ng/mL with a lower quantification limit of 5 ng/mL. Intra- and inter-day precision (relative standard deviation, %RSD) were within 8.4% and accuracy (relative error, %RE) was lower than -3.2%. The developed and validated method was successfully applied to a pharmacokinetic study of tadalafil (20 mg) in Korean healthy male subjects (n = 12).
Ammonium Compounds ; Humans* ; Male ; Methods* ; Pharmacokinetics ; Plasma* ; Sildenafil Citrate ; Tadalafil*

PURPOSE: This study aimed to examine the effects of oral sildenafil on erectile function according to the number of accompanying cardiovascular risk factors. MATERIALS AND METHODS: The Q3 (the ability to achieve an erection) and Q4 (the ability to maintain an erection) scores of the International Index of Erectile Function (IIEF) were obtained, before and after the administration of oral sildenafil at least 4 times, in a total of 195 patients (mean age: 57.9 8.9 years) with erectile dysfunction. Of these, 125 had 1 (n=76), 2 (n=33) or 3 (n=16) cardiovascular risk factors. The effects of oral sildenafil for each group were compared by mean paired differences of the Q3 and Q4 scores after treatment. RESULTS: The mean Q3 and Q4 scores increased significantly in all patients, regardless of the presence and number of risk factors (p<0.001). The greater the number of risk factors, the lower the Q3 and Q4 scores, while the mean paired differences in the scores before and after treatment were not significantly different between patients without and with cardiovascular risk factors. CONCLUSIONS: Oral sildenafil improves the erectile function in patients with cardiovascular risk factors, and combined erectile dysfunction and the degree of improvement seem to be similar, regardless of the number of cardiovascular risk factors.
Cardiovascular Diseases ; Erectile Dysfunction ; Humans ; Male ; Risk Factors* ; Sildenafil Citrate

Currently intracavernous pharmacotherapy is the second common therapeutic modality for erectile dysfunction after the introduction of Viagra. Nevertheless, intracavernous pharmacotherapy has increased in popularity for the past 15 years. While having an overwhelming safety after complete training in injection method, this treatment option can reveal unexpected complications related to self-injection. We report two cases of intracavernous needle breakage associated with alprostadil (Caverject , Pharmacia-Upjohn) and trimix self-injection therapy with a brief review of the literature.
Alprostadil ; Drug Therapy ; Erectile Dysfunction ; Male ; Needles* ; Sildenafil Citrate

Idiopathic pulmonary arterial hypertension (previous primary pulmonary hypertension) was a progressive disease with high mortality. Many patients with idiopathic pulmonary arterial hypertension did not show vasoreactivity, rapidly resulted in marked disability, right heart failure and death. Recent advances of therapeutic modalities have revolutionized the treatment of idiopathic pulmonary arterial hypertension. Irrespective of pulmonary arterial vasoreactivity, new vasodilatng agents, such as epoprostenol, treprostinil, iloprost, bosentan, and sildenafil, significantly improved hemodynamics, symptoms, exercise capacities, quality of life, and survival. The median survival of patients with idiopathic pulmonary arterial hypertension has been prolonged from 2.8 years to more than 5 years. In a near future, pulmonary arterial hypertension could be easily controlled like a systemic arterial hypertension.
Diagnosis* ; Epoprostenol ; Heart Failure ; Hemodynamics ; Humans ; Hypertension* ; Iloprost ; Mortality ; Quality of Life ; Sildenafil Citrate