Long-Term Efficacy of Sildenafil and Tachyphylaxis Effect

El-Galley, Rizk; Rutland, Harry; Talic, Riyadh F.; Keane, Thomas E.; CLARK, HARRY

doi:10.1097/00005392-200109000-00028

Cited by 29 publications

(41 citation statements)

References 14 publications

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“…El-Galley et al found that 43 (52%) out of 82 sildenafil users who had been followed-up for a period of 2 y were still using sildenafil at this time. 7 Their results seem comparable with the observations in this study, although it must be noted that 46% of the patients interviewed at baseline in the El-Galley study were lost to follow-up and results might therefore be biased. Studies on the efficacy of sildenafil have shown that the etiology of ED is a principal determinant of efficacy.…”

Section: Discussionsupporting

confidence: 85%

Incidence and determinants of sildenafil (dis)continuation: the Dutch cohort of sildenafil users

et al. 2002

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Sildenafil utilization was prospectively evaluated among 153 men with a history of erectile dysfunction (ED)-prescription drug use prior to starting sildenafil and 164 men who were new starters of ED-prescription drugs. Further, some determinants of sildenafil discontinuation were identified. During a median follow-up period of 18 months 45% of all patients discontinued sildenafil treatment, regardless of earlier treatment history. However, patients with a history of drug treatment for ED were nearly eight times as likely to switch or re-start another EDprescription drug after discontinuing sildenafil compared to previously untreated users. Age > 60 y, diabetes medication, nitrate use, and use of incontinence pads (a proxy for disease=surgery in the pelvic region) were associated with an increased likelihood of discontinuing sildenafil. Although the introduction of sildenafil reduced the barrier to seek medical help for erectile problems, sildenafil treatment failure in previously untreated patients results in a high dropout rate from further ED drug treatment of any kind.

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Section: Discussionsupporting

confidence: 85%

Incidence and determinants of sildenafil (dis)continuation: the Dutch cohort of sildenafil users

et al. 2002

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“…20 Moreover, the tachyphylaxis effect from long-term use of sildenafil might need a dose escalation. 23,24 In the future, we might have to consider approval of the use of 100 mg sildenafil in Japan, too.…”

Section: Discussionmentioning

confidence: 99%

Outcome analysis of sildenafil citrate for erectile dysfunction of Japanese patients

et al. 2005

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The approved maximal dose of sildenafil is only 50 mg in Japan, but the impact of dose regulation on treatment outcomes has not been established. Moreover, the contributors to the efficacy in patients having an intact peripheral nervous system have not been fully elucidated. We assessed in Japanese patients the treatment outcomes of sildenafil for erectile dysfunction (ED) under regulation of the approved dose and identified factors contributing to its efficacy among those with various etiologies other than pelvic surgery. We retrospectively reviewed 196 ED patients treated with sildenafil. The overall efficacy was 70.9% (139/196), and patients with psychological problems and concomitant cardiovascular disease showed high response rates (82.4 and 87.0%, respectively). Of the 139 responders, 89.9% achieved efficacy with a dose of 25 or 50 mg. Logistic regression analysis revealed concomitant cardiovascular disease and a favorable nocturnal penile tumescence result to be independent contributors to the efficacy.

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“…It is well known, for several drug classes, that several doses are required to achieve an optimal response 6 and conversely there are drugs where repeated dosing can lead to pharmacological tolerance and diminution of effect. 7 The clinical trials data for apo SL detail the response to such sequential dosing under conditions of similar stimulus, in that the patients and their partners engaged in regular sexual attempts in a familiar environment. The reproducibility of effect with Uprima 1 has been documented 1 and in this analysis the efficacy enhancement with sequential dosing has been examined.…”

Section: Uprimamentioning

confidence: 99%

Sequential administration enhances the effect of apomorphine SL in men with erectile dysfunction

Heaton

Dean²,

Sleep

2002

Int J Impot Res

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Long-Term Efficacy of Sildenafil and Tachyphylaxis Effect

Abstract: Our data suggest that there is a possible tachyphylaxis effect with sildenafil. Of the patients who were followed for 2 years 20% had to increase the sildenafil dose to have the same effect and 17% discontinued use due to loss of efficacy.

Cited by 29 publications

References 14 publications

Incidence and determinants of sildenafil (dis)continuation: the Dutch cohort of sildenafil users

Incidence and determinants of sildenafil (dis)continuation: the Dutch cohort of sildenafil users

Outcome analysis of sildenafil citrate for erectile dysfunction of Japanese patients

Sequential administration enhances the effect of apomorphine SL in men with erectile dysfunction

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