
Multi-view semi-supervised adversarial attention network for drug repurposing, Computer Methods and Programs in Biomedicine, 282, (109406), (2026).
No man had priapism after sildenafil treatment. Sildenafil has modest vasodilator properties but no effect on heart rate. The American Urological Association Panel on the Treatment of Organic Erectile Dysfunction stated that the ultimate goal is a therapy that is reliable, has minimal side effects, and is simple to use.6 Sildenafil appears to meet these specifications. Oral therapy permits discreet administration and is less invasive than some other treatment options, including injections into the corpus cavernosum, transurethral drug delivery, and prosthesis implantation. Goldstein, Lue, Padma-Nathan, Rosen, and Steers have served as consultants to Pfizer, manufacturer of sildenafil, as well as to other companies making products for the treatment of erectile dysfunction.
We are indebted to all the investigators who participated in the trials; to Dr. Ian Osterloh and Dr. David Cox of Pfizer for their help with the study design and logistics; to Dr. Michael Collins and Dr. Michael Smith of Pfizer for their assistance with data analysis; and to Dr.
Patricia Leinen and Dr. Michael Sweeney for aid in the preparation of the manuscript. The other members of the Sildenafil Study Group are S. Auerbach, Newport Beach, Calif.; A.L. Burnett, Baltimore; R. Multi‐Target Mechanisms of Moroccan Aphrodisiac Plants: An Integrative Computational and Phytochemical Investigation, Food Science & Nutrition, 14, 5, (2026).
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Viagra Generic | 200mg | 180 + 10 Pills | 277.56€ 264.34€ | |
| Viagra Generic | 200mg | 120 + 8 Pills | 204.80€ 195.05€ | |
| Viagra Generic | 150mg | 180 + 10 Pills | 236.46€ 225.20€ | |
| Kamagra Polo | 100mg | 272 + 12 Pills | 622.94€ 593.28€ | |
| Viagra Generic | 150mg | 20 Pills | 55.02€ 52.40€ | |
| Kamagra Polo | 100mg | 180 + 8 Pills | 446.52€ 425.26€ | |
| Viagra Generic | 25mg | 10 Pills | 25.19€ 23.99€ | |
| Kamagra Oral Jelly | 100mg | 110 + 9 Sachets | 334.87€ 318.92€ | |
| Kamagra | 100mg | 180 + 6 Pills | 436.79€ 415.99€ | |
| Kamagra | 100mg | 32 Pills | 121.24€ 115.47€ | |
| Kamagra Soft Tabs | 100mg | 120 + 6 Pills | 311.78€ 296.93€ | |
| Kamagra Polo | 100mg | 84 + 4 Pills | 244.49€ 232.85€ | |
| Viagra Generic | 100mg | 180 + 8 Pills | 199.37€ 189.88€ | |
| Kamagra Polo | 100mg | 60 + 4 Pills | 189.39€ 180.37€ | |
| Viagra Generic | 50mg | 360 + 10 Pills | 225.33€ 214.60€ | |
| Viagra Generic | 100mg | 10 Pills | 28.91€ 27.53€ |
Artificial intelligence in drug research and development: a review of methods and applications in drug repurposing, Briefings in Bioinformatics, 27, 3, (2026).
Endocrine-metabolic crosstalk in erectile dysfunction: mechanistic insights and therapeutic implications, International Journal of Impotence Research, (2026).
); the Department of Urology, University of California, San Francisco (T.F.L. ); the Department of Urology, University of Southern California, Los Angeles, and the Male Clinic, Santa Monica, Calif. (H.P.-N.); the Department of Psychiatry, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Piscataway, N.J. ); the Department of Urology, University of Virginia, Charlottesville (W.D.S. Select the format you want to export the citation of this publication. Therapeutic applications of phosphodiesterase inhibitors in male reproductive health: narrative review, Sexual Medicine Reviews, 14, 2, (2026).
The International Index of Erectile Function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Riley, AJ, Athanasiadis, L. Impotence and its non-surgical management. Br J Clin Pract 1997;51:99-103 Any commercial reuse of NEJM Group content requires permission. From the Department of Urology, Boston University Medical Center, Boston (I.G. Oral suspension versus tablet sildenafil for erectile dysfunction: a prospective multicenter comparative study on patient satisfaction, International Journal of Impotence Research, (2026).
Castellanos, Fort Myers, Fla.; L. Charles, Stratford, N.J.; F. Eid, New York; R. Feldman, Waterbury, Conn.; W. Fitch III, San Antonio, Tex.
; T. Garland, Lawrence, N.J.; M. Gittelman, North Miami, Fla.; D. Gleason, Tucson, Ariz.; F. Govier, Seattle; L.
Hoffman, Gurnee, Ill.; J.M. Kaufman, Aurora, Colo.; I. Klimberg, Ocala, Fla.; V. Longo, New London, Conn.; T. Malloy, Philadelphia; A. Low‐intensity shockwave therapy for erectile dysfunction: An abridged Cochrane review, BJU International, 137, 6, (949-957), (2026).
| Brand Name | Manufacturer | Price Range (per pill) | Availability | Notes |
|---|---|---|---|---|
| Viagra | Pfizer | $10 - $30 | Widely available | Most popular brand |
| Kamagra | Ajanta Pharma | $2 - $8 | Online, some stores | Cheaper alternative |
| Sildenafil Citrate | Generic | $1 - $5 | Online, pharmacies | Generic form available |
Current state of the problem, Andrology and Genital Surgery, 25, 4, (33-40), (2026).
Emerging Trends and Research Focus in Erectile Dysfunction Treatment: A 1993–2023 Bibliometric Analysis, Andrologia, 2026, 1, (2026).
Physiology of penile erection. The role of nitric oxide in the physiology of erection. Sildenafil: an orally active type 5 cyclic GMP-specific phosphodiesterase inhibitor for the treatment of penile erectile dysfunction. Sildenafil, a novel effective oral therapy for male erectile dysfunction. Br J Urol 1996;78:257-261 Rosen, RC, Riley, A, Wagner, G, Osterloh, IH, Kirkpatrick, J, Mishra, A. [1][2][4][5][7][8][10][24][27][33][41][56][57][67][91][131] Brand Name: Vybrique, ViagraClasses: Phosphodiesterase Type 5 Inhibitors (24:08.12), Phosphodiesterase type 5 inhibitors (48:48.24) Sildenafil citrate (Viagra® and generic equivalents) is used orally for the treatment of erectile dysfunction (ED, impotence).
McCullough, New York; J. McMurray, Huntsville, Ala.; D.F. ; J Susset, Providence, R.I.; J. Tuttle, Lexington, Ky.; G. Wells, Birmingham, Ala.; C.
White, Mobile, Ala.; J. Young, Laguna Hills, Calif.; and N. Zinner, Torrance, Calif. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. Sex-ual behavior in the human male.
Efficacy and safety of intracavernosal alprostadil in men with erectile dysfunction. Treatment of men with erectile dysfunction with transurethral alprostadil. Clinical Guidelines Panel on Erectile Dysfunction: summary report on the treatment of organic erectile dysfunction. Nitric oxide as a mediator of relaxation of the corpus cavernosum in response to nonadrenergic, noncholinergic neurotransmission. N Engl J Med 1992;326:90-94 Andersson, K-E, Wagner, G. [1][4][6][7][8][9][10][25][33][34][67][81][102][104][105][107][108][112][118][126][127][128][129][130][131][132][133][134][140][142][143][144][189] A thorough medical, sexual and psychosocial history, physical examination, and selective laboratory testing should be undertaken to diagnose ED, determine potential underlying causes, exclude potentially reversible or treatable causes (e.g., hypogonadism with inadequate testosterone replacement, hyperprolactinemia, drug-induced dysfunction, dyslipidemias, alcoholism, other substance abuse, hypertension, thyroid disease, cardiovascular or cerebrovascular disease, neurologic disease, adrenal dysfunction, psychologic dysfunction, marital discord, smoking), and identify appropriate treatment in conjunction with or prior to initiating vasoactive therapy (e.g., PDE 5 type inhibitor).
In keeping with sildenafil's mode of action (i.e., the drug causes erection only in response to sexual stimulation), the studies were performed entirely in a natural environment, which meant that we had to rely on the men's own reports of efficacy. However, the self-administered International Index of Erectile Function has a high degree of sensitivity and specificity for detecting treatment-related changes in men with erectile dysfunction.13 This questionnaire, together with the global-efficacy question, provided a comprehensive assessment of erectile function during a specified recall period (four weeks), and the event log provided information about individual events during treatment. The men's partners were questioned in each of the studies, and although the results corroborated the men's efficacy assessments, only 25 percent of the partners completed the optional questionnaire. Recognizing the fact that in most men erectile dysfunction is a multifactorial problem, we enrolled men with a broad variety of causes of erectile dysfunction. The identification of an organic abnormality does not establish it as the cause of erectile dysfunction.14 Conversely, failure to identify an organic cause does not prove a psychogenic origin.
In the dose–response study, increasing doses of sildenafil (25 to 100 mg) were increasingly effective in improving the frequency of penetration and the maintenance of erections after penetration, the mean score for the erectile-function domain of the International Index, and the percentage of men reporting better erections. In the dose-escalation study, sildenafil treatment was associated with improvements in the frequency of penetration and the maintenance of erections after penetration. The therapeutic response to sildenafil was similar in men with various causes of erectile dysfunction. The mean scores after sildenafil therapy approached those of normal men of the same age. The men we studied had a normal level of sexual desire, as might be expected of men with erectile dysfunction who enter a clinical trial,13 and sildenafil did not alter that level.
Successful sexual intercourse was therefore a key end point for these men. Overall, the results of the efficacy assessments demonstrated that sildenafil significantly improved erectile function and quadrupled the success of intercourse, with effectiveness maintained for at least six months. Its main adverse effects were headache, flushing, dyspepsia, and visual disturbances and were usually mild. Only one man with a visual disturbance discontinued treatment, and he also had flushing. Few men discontinued sildenafil, suggesting a relatively high level of drug tolerability and acceptance. [12][28][30][31][57][65][66][70][78][83][94][144][145][160][161][189][601][602][603] A review of the patient's current drug regimens should be conducted to detect possible drug-induced ED (e.g., certain antihypertensive, antidepressant, antipsychotic, or antiarrhythmic agents); it may be possible to substitute alternative drug(s) that lessen the risk of such dysfunction.
[12][28][70][81][118][144][161][602][603] In instances where substitution therapy is not feasible, concomitant vasoactive therapy with a PDE 5 type inhibitor may promote patient compliance by counteracting ED as an adverse effect. [12][28][70][81][118][144][161][602][603] Efficacy of sildenafil is variable in patients with ED, in part depending on the underlying etiology, severity, and dose employed, but the drug generally appears to be effective in restoring sexual function to an acceptable level in the majority of treated men. [1][7][8][9][10][25][33][34][65][76][81][101][104][105][126][127][131][142][143][144] The erectile response generally increases with increasing sildenafil dose and plasma drug concentration, with response becoming greater at 50- 20mg sildenafil and 100-mg doses than at 25 mg.[1][8][9][33][126][130][131][155] Analyses of subgroups of patients with ED indicate that efficacy of sildenafil is not affected by race or age, duration of ED, or duration of select underlying disease states (e.g., diabetes mellitus), and the drug has been effective in a broad range of patients with ED, including those with a history of coronary artery disease (e.g., coronary artery bypass graft [CABG]), hypertension, other cardiac disease (including ischemic heart disease), peripheral vascular disease, type 1 or 2 diabetes mellitus, depression, radical prostatectomy, prostate brachytherapy, transurethral resection of the prostate (TURP), spina bifida, spinal cord injury, and in patients taking antidepressants, antipsychotics, diuretics, and antihypertensive agents.
| Parameter | Value | Details |
|---|---|---|
| Absorption | Rapid, within 30-60 minutes | Food can delay absorption |
| Peak Plasma Levels | 1.5 hours after intake | |
| Half-life | Approx. 4 hours | Eliminated via liver metabolism |
| Metabolization | Liver (Cytochrome P450 enzymes) | CYP3A4 major enzyme |