What is Fildena 100 mg

Sildenafil (Viagra): Dosage of Sildenafil

MEDICINE: Discussion

to the contribution by Priv.-Doz. Dr. med. Jochen Schophol Priv.-Doz. Dr. med. Ekkehard Haen Dr. med. Traugott Ullrich Prof. Dr. med. Roland Gärtner in issue 6/2000
Schopohl et al. give a balanced overview of the pharmacology and clinical use of Sildenafil. We can only welcome such a factual discussion of this important drug, as the discussion about sildenafil in the past was all too often characterized by emotionality, right into the medical literature.
Unfortunately, an error has crept into the article in the dosage recommendation that could lead to confusion. The valid dosage recommendation, which has emerged from clinical studies and has been confirmed by the regulatory authority, is:
If necessary, take 50 mg about an hour before sexual intercourse. Depending on the effectiveness and tolerability, the dose can be adjusted to 100 mg or 25 mg. In elderly patients, the starting dose is 25 mg, depending on the effectiveness and tolerability, the dose can be increased to 50 mg and then to 100 mg. In the case of hepatic insufficiency, severe renal insufficiency or concomitant administration of CYP-3A4 inhibitors, an initial dose of 25 mg should be considered; depending on efficacy and tolerability, this can be increased to 50 mg and then to 100 mg.
The need for a sufficient dosage can be illustrated using the example of the diabetic patient group. In the twelve-week study with 268 patients with erectile dysfunction and diabetes mellitus (mean age 57 years, range 27 years to 79 years), zero percent took the 25 mg dose, seven percent took the 50 mg dose and 93 percent took the 100 dose at the end of the study -mg dosage (1). In another twelve-week study with 225 diabetics with erectile dysfunction (mean age 57 years), 89 percent had chosen the 100 mg dose at the end of the study (2). A meta-analysis of clinical studies also showed that 85 percent of diabetics with erectile dysfunction were treated with the 100 mg dose at the end of the study (3).
These data show, for example, that a sufficiently high dose of sildenafil is decisive for the success of the therapy and that this is only possible in some of the patients with the 25 mg dose.

literature
1. Rendell MS et al .: Sildenafil for the treatment of erectile dysfunction in men with diabetes. A randomized controlled trial. JAMA 1999; 281: 421-426.
2. Hirsch IB et al .: Viagra (sildenafil citrate): Efficacy and safety in the treatment of erectile dysfunction (ED) in men with diabetes. Diabetes 1999; 48 (Suppl.): A 90.
3. Pfizer Inc, Data on file.

Dr. med. Horst Berghof
Dr. med. Martin Burkart
Department of Medicine
Pfizer GmbH
P.O. Box 49 49
76032 Karlsruhe
Sildenafil (Viagra): Dosage of Sildenafil

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