Carson Culley C
Division of Urology, School of Medicine, University of North Carolina at Chapel Hill, 427 Burnet-Womack Bldg, Campus Box 7235, Chapel Hill, NC 27599-7235, USA.
Curr Urol Rep. 2003 Dec;4(6):488-96. doi: 10.1007/s11934-003-0031-1.
Sildenafil citrate, the first internationally approved and widely used oral agent for the treatment of erectile dysfunction (ED), has revolutionized the treatment of ED throughout the past 5 years. This phosphodiesterase type-5 (PDE-5) inhibitor is selective for corpus cavernosum smooth muscle tissue and produces excellent erectile function. Its efficacy and safety over a wide variety of etiologies of ED and severities of ED demonstrates its usefulness in the clinical treatment of these patients. More than 20 million men have been treated worldwide with sildenafil with excellent results. ED caused by difficult-to-treat etiologies such as radical prostatectomy, severe diabetes, and spinal cord injury have demonstrated efficacy. Although sildenafil citrate, like all PDE-5 inhibitors, is contraindicated in patients taking nitrate medications for cardiac disease, it is effective and safe for those cardiovascular patients who are not taking nitrate medications. The incidence of adverse cardiovascular events in patients taking sildenafil does not differ from those of the general population. Investigations into the pharmacologic effect of sildenafil on coronary myocardial tissue further supports the safety of this medication. Sildenafil has been safe and effective in patients taking various medications including multiple antihypertensive drugs, selective serotonin reuptake inhibitors, cardiac, and diabetic medications.
枸橼酸西地那非是首个获得国际批准并广泛应用于治疗勃起功能障碍（ED）的口服药物，在过去5年里彻底改变了ED的治疗方式。这种5型磷酸二酯酶（PDE-5）抑制剂对海绵体平滑肌组织具有选择性，并能产生出色的勃起功能。它在多种ED病因和严重程度的患者中都具有疗效和安全性，证明了其在这些患者临床治疗中的实用性。全球已有超过2000万男性接受了西地那非治疗，效果良好。由难以治疗的病因引起的ED，如根治性前列腺切除术、严重糖尿病和脊髓损伤，使用西地那非也已证明有效。尽管枸橼酸西地那非与所有PDE-5抑制剂一样，禁用于正在服用治疗心脏病的硝酸盐类药物的患者，但对于未服用硝酸盐类药物的心血管疾病患者，它是有效且安全的。服用西地那非的患者发生不良心血管事件的发生率与普通人群无异。对西地那非对冠状动脉心肌组织药理作用的研究进一步支持了该药物的安全性。西地那非在服用包括多种抗高血压药物、选择性5-羟色胺再摄取抑制剂、心脏和糖尿病药物在内的各种药物的患者中都是安全有效的。
