PDE5 Inhibitor
At a Glance
- Same active ingredient found in Viagra®
- Take orally, 30 to 60 minutes prior to intercourse
- Effective for up to 4 hours
- Available in 20mg and 100mg tablets, prescription required
The Details
PDE5 (phosphodiesterase type-5) inhibitors like sildenafil work by preventing the body from breaking down the chemicals needed for achieving an erection. This class of oral medications are the American Urological Association’s recommended first-line treatment for ED.
Sildenafil should be taken 30 to 60 minutes prior to sexual activity, as it requires sexual stimulation to result in the desired erection. Ensuring proper timing allows for enhanced effectiveness during intimate moments.
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What to know about Sildenafil
How it Works
Sildenafil works effectively by preventing the body from breaking down the essential chemicals required for achieving a firm erection. These crucial chemicals facilitate the dilation of the corpora cavernosa within the penis, thereby promoting increased blood flow necessary for an erection when sexual stimulation occurs.
To optimize absorption, sildenafil should ideally be taken on an empty stomach, as food can delay the onset of action. This absorption pattern differs from medications like tadalafil, which show less impact from meal intake.
Who is it for?
Sildenafil is primarily recommended for men experiencing erectile dysfunction (ED). Additionally, healthcare providers may prescribe it to assist men recovering from radical prostatectomy surgery related to prostate cancer, enhancing their post-operative recovery and improving the quality of their intimate life.
Be cautious: DO NOT take sildenafil or other PDE5 inhibitors if you are using nitrate medications for heart conditions. Always consult with your healthcare provider before starting sildenafil, especially if you are on alpha blockers for hypertension or if you have conditions such as low blood pressure, uncontrolled hypertension, cardiac failure, or angina.
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Effectiveness
Sildenafil has proven effective in treating erectile dysfunction. In a series of 16 clinical trials involving men with various comorbidities, results indicated that the average percentage of successful sexual intercourse was 69% with sildenafil treatment, compared to 35.5% with a placebo. This demonstrates significant efficacy across different patient profiles.1
As previously discussed, taking sildenafil on an empty stomach optimizes its absorption, contrasting with tadalafil’s more stable performance regardless of food intake.
1. NIH National Library of Medicine, Phosphodiesterase-5 (PDE5) Inhibitors In the Management of Erectile Dysfunction
Off-Label Uses
Off-label prescribing occurs when physicians use a medication for conditions outside of those approved by the FDA or change dosages. While there are few widespread off-label applications for sildenafil, it's crucial to discuss any new treatment or dosage alterations with your doctor.
FDA Approved Use
Sildenafil is a leading treatment option for men experiencing erectile dysfunction. Its effectiveness and tolerability make it a go-to choice for many healthcare professionals in managing ED.
Climax Control
Some studies suggest sildenafil may help men experiencing issues with climax control, with evidence indicating that PDE5 inhibitors can be effective in delaying orgasm in certain cases.1
1. NIH National Library of Medicine, Phosphodiesterase-5 inhibitors for premature ejaculation: a systematic review and meta-analysis
Prostate Cancer
Moreover, sildenafil can be beneficial for men who have undergone radical prostatectomy for prostate cancer, aiding in the recovery and restoration of erectile function post-surgery.
Medical Chart
Sildenafil Side Effects
- Facial flushing
- Nasal congestion
- Blurred vision
- Headaches
- Heartburn
Good to Know
It’s essential to recognize that sildenafil may fail due to inadequate dosing. Higher doses than 100mg can lead to an increase in side effects, thus it’s advisable to seek alternative treatment methods once you reach the maximum prescribed dosage.
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Other devices and medications used to treat erectile dysfunction
Tadalafil
Tadalafil
Same active ingredient found in Cialis. Taken one hour prior to sexual activity, effective for up to 36 hours.
Available in 5mg, 10mg and 20mg tablets and 5mg or 20mg lozenges, prescription required.
Vacuum Erection Devices
Vacuum Erection Devices
The VED is a plastic tube that fits over the penis, creating suction to draw blood into the penis, thus facilitating an erection.
Intraurethral Gel
Intraurethral Gel
Intraurethral gels are injected directly into the urethra using a needleless syringe approximately 5-15 minutes before intercourse.
Available in three formulations, prescription required.
Trimix
Trimix
Injection therapy, often regarded as the most effective treatment for ED, involves injecting a three-drug mixture into the shaft of the penis about 5-15 minutes prior to sexual activity.
Available in 11 formulations, prescription required.