Latest research on Sildenafil

Sildenfail is a vasoactive agent used to treat erectile dysfunction and reduce symptoms in patients with pulmonary arterial hypertension (PAH). Sildenafil elevates levels of the second messenger, cGMP, by inhibiting its breakdown via phosphodiesterase type 5 (PDE5). PDE5 is found in particularly high concentrations in the corpus cavernosum, erectile tissue of the penis. It is also found in the retina and vascular endothelium. Increased cGMP results in vasodilation which facilitates generation and maintenance of an erection. The vasodilatory effects of sildenafil also help reduce symptoms of PAH.

Sildenafil dosage

The rationale of high-dose Sildenafil after RP is the preservation of smooth muscle within the corpora cavernosa with a better return to spontaneous normal erectile function. [source, 2016]
All patients were given oral Sildenafil (50–100 mg), with a minimum recommended dose of 50 mg and the dosage adjusted according to the parameters of penile blood flow, penile rigidity, and patient compliance. [source, 2016]
During the admission, he was also started on Sildenafil (1 mg/kg/dose) and prophylactic enoxaparin. [source, 2016]
Approaches to mitigating the sexual dysfunction associated with SSRI treatment include lowering dosage, switching antidepressant medications, or adding concomitant medications such as a phosphodiesterase inhibitor type 5 (PDE5; e.g., Sildenafil), a norepinephrine-dopamine reuptake inhibitor (e.g., Bupropion), or a 5-HT1A receptor partial agonist (e.g., Buspirone) (Rizvi and Kennedy 2013). [source, 2016]
A randomized, double-blind, placebo-controlled, low-dose Sildenafil trial for IC showed a significant improvement in the symptom, problem index scores, and urodynamic index in the treatment group, with the efficiency of treatment reaching 62.5%. [source, 2015]
Bosentan accelerates Sildenafil clearance and reduces Sildenafil concentrations by ~60% when used at standard doses. [source, 2015]
Assessment of exercise capacity in this study was based on the 6-minute walk test, with a dose-related increase in the average distance walked by 13% (average improvement of 38 m; 99% confidence interval [CI]: 12–64 m), 13.3% (average improvement of 45 m; 99% CI: 21–70 m), and 14.7% (average improvement of 42 m; 99% CI: 9–75 m), for Sildenafil tid doses of 20, 40, or 80 mg, respectively.25 [source, 2015]
Each patient enrolled in SUPER-2 was titrated to the maximum tolerable tid dose of Sildenafil (up to 80 mg per dose) with 6-minute walk assessed at each scheduled visit. [source, 2015]
In the 16-week Pulmonary Arterial Hypertension Combination Study of Epoprostenol and Sildenafil (PACES) study, 267 patients with PAH receiving long-term intravenous Epoprostenol were randomized to placebo or Sildenafil, dosed at 20 mg tid and titrated up to a maximum of 80 mg tid. [source, 2015]
In a smaller crossover trial, Sastry et al41 randomized 22 patients to placebo versus Sildenafil (dose ranging from 25 to 100 mg tid) for a total of 6 weeks. [source, 2015]