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Abstract:
(1) The clinical file is bulky, including 14 double-blind, placebo-controlled trials conducted in normal conditions of use. (2) Sildenafil effectively treats the symptoms of erection disorders, whatever their origin (psychogenic or organic, especially spinal injuries). Efficacy seems slightly lower in case of diabetes or total prostatectomy. (3) Overall, sildenafil allows 80 to 90% of patients to have an erection adequate for sexual intercourse, but only one in two sexual acts on average were considered "satisfactory" by the clinical trial investigators. (4) Sildenafil does not affect sexual desire. It has not been studied in men without erection disorders. The results of ongoing trials in women are not yet known. (5) The adverse effects of sildenafil seem infrequent and generally mild. However, the risk of sudden arterial hypotension if the drug is combined with nitrate derivatives calls for careful safety monitoring. This combination is contraindicated. (6) In our opinion sildenafil should not be prescribed to anyone with cardiovascular risk factors or a history of heart problems.