The Pharmaceutical Journal
Vol 271 No 7277 p735
29 November 2003

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Counselling and sildenafil dose increase improves erectile function

Counselling and dose titration of sildenafil (Viagra) leads to satisfactory erections in more than half of men initially not responding to the drug, according to a study reported at the 6th congress of the European Society for Sexual Medicine held in Istanbul earlier this month. The findings demonstrate the need for patient education and follow-up to achieve optimal treatment of erectile dysfunction (ED).

The study, carried out in Israel, recruited 220 men with ED who had previously discontinued sildenafil due to what had been considered insufficient response. They were invited for three clinic visits. At the first visit, their ED was assessed and they were given detailed instructions about how to use sildenafil and issued with four 100mg tablets. The proportion of patients achieving improvement in erectile function (defined as a score of 17 on the Erectile Dysfunction Symptom Scale) increased from 20 per cent after the first visit, to 53 per cent at the second visit and 59 per cent after the third clinic visit.

Dr Ian Eardley, consultant in urology, St James University Hospital, Leeds, commented: “This study demonstrates the value of careful patient counselling and using the appropriate dose of sildenafil for achieving a high success rate in the treatment of ED. Repeated consultations were able to convert 59 per cent of initial sildenafil non-responders to responders.”