I nearly passed out. It sent my blood pressure to a high level. He said they would be good for me. She had me on a monitor and I knew my blood pressure had gone up but not quite like that.
The woman told me to keep still and relax until my heart rate got down to a low level and eventually it did so I decided not to go to hospital. It should be a national thing being discussed. Imagine if someone dies because no-one has spoken about the dangers. People shy away from the subject. It took around 24 hours for things to go back to normal.
At a bus stop, alert, orientated and good colour. No nausea or vomiting, no headache. Means were also calculated for those assessments in which data were normally distributed.
Patients' self-assessments of total mean durations of grade 3 and 4 erections were analysed using an analysis of variance anova model appropriate for a two-treatment, two-period crossover design Study I. The duration of grade 3 or 4 erections Study 2 was analysed using an anova model, with terms for sequence, patient, period and treatment. The proportion of responders was calculated for the sildenafil and placebo treatment groups and was analysed Study II using the Mainland-Gart test for treatment effect. A total of 17 patients entered Study I.
The mean age was 52 years range 37—70 years , and the mean duration of ED was 3. Of these 17 patients, three had a vasectomy, one had a unilateral orchidectomy, one had prostatitis and one had varicosities. Seven patients had received previous treatments for ED: One patient in Study I discontinued the study after completing treatment and was lost to follow-up. The mean age was 57 years range 35—68 years , and the mean duration of ED was 1. Of the 16 patients, seven had a vasectomy, one had an undescended right testicle, one had redundant prepuce, one had a scrotal cyst and one had hyperplasia of the prostate.
None of the patients had received previous treatment for ED. The onset of all erections occurred only after the start of VSS. Bars indicate the range between minimum and maximum values.
Among the 14 sildenafil responders, the median duration of erections was Among the nine placebo responders, the median duration of erections was 7. Among all patients treated with sildenafil, the median duration of grade 3 or 4 erections was The median and mean durations of grade 3 or 4 erections for the treatment groups as a whole and for the responder subsets are shown in Figure 2. Total duration of grade 3 hard enough for penetration and grade 4 fully hard erections, determined from patient self-assessment during 60 min of visual sexual stimulation in Study II.
When VSS commenced 2 h after dosing, the median total duration of grade 3 or 4 erections for patients receiving sildenafil was In contrast, the median duration for patients receiving placebo was 0 min range 0—23 min , and the mean duration was 3. Among the sildenafil responders, the median total duration of grade 3 or 4 erections was When VSS commenced 4 h after dosing, the median total duration of grade 3 or 4 erections in patients receiving sildenafil was 5. For the sildenafil responders, the median total duration of grade 3 or 4 erections was 10 min range 2—45 min , and the mean was For the placebo responders, the median total duration of grade 3 or 4 erections was 0 min range 0—27 min and the mean was 3.
Desirable characteristics of an oral treatment for ED include pharmacokinetic properties that allow a prompt onset of clinical effect and several hours of clinical activity after administration of a single dose, in addition to reliable efficacy and a favourable safety profile at recommended doses. The results of the present studies demonstrate that in men with ED of no known organic cause, treatment with or mg oral doses of sildenafil facilitated the achievement of erections in the presence of VSS that were rigid enough for penetrative sexual intercourse.
Furthermore, the onset of action was achieved within a median time of 27 min after sildenafil dosing. This finding reflects the time to peak plasma concentration of sildenafil after oral dosing 30— min [ 3 ] and is consistent with the results of other clinical trials [ 5 — 11 ].
The proportion of responders was calculated for the sildenafil and placebo treatment groups and was analysed Study II using the Mainland-Gart test for treatment effect. Get daily news updates directly to your inbox Subscribe See our privacy notice More newsletters. Between 30 and 80 per cent of men find it effective. The picture that shows why the strawberry terrorists Oral sildenafil in the treatment of erectile dysfunction. His heart was also beating at a high rate of beats per minute - above the regular beats.
Erections also were achieved when VSS was delayed for 2 or 4 h after patients received mg doses of sildenafil. Patients were able to maintain erections for a mean duration of 19 min 2 h after dosing and 14 min 4 h after dosing. These data suggest that sufficient sildenafil remains systemically available to allow for adequate erections 4 h postdose and are consistent with a sildenafil half-life of 3—5 h [ 3 ].
This is an appropriate period of therapeutic activity that is realistic and convenient for most couples.
These findings suggest that a large proportion of the patients enrolled in these two studies appeared to have had a significant psychogenic component to their ED. In clinical practice, it would be worthwhile to perform nocturnal penile tumescence and rigidity testing [ 12 ] in patients presenting with ED of no organic cause and a history suggestive of psychogenic causes. An objective evaluation of psychogenic factors leading to ED may serve to direct the patient to the appropriate therapy, such as psychological treatment with or without pharmacological treatment.
Although this report supplies specific and detailed information related to the onset and duration of action of sildenafil, several limitations are inherent in the study design. The use of 60 min of continuous VSS may have confounded the results as, on its own, prolonged continuous VSS may produce some effects. Without suitable controls, the contribution of this variable to treatment outcome is not known. Even though the number of patients is small, reasonable means and medians were generated.
Although direct comparisons between the two different sildenafil doses from the two studies are not possible, we felt it was important to investigate the onset of the recommended starting dose 50 mg and the duration of the recommended highest dose mg [ 5 ].
The lowest recommended dose of sildenafil 25 mg is generally reserved for special populations e. Thus, the findings presented have great relevance to clinical practice and suggest that the majority of patients with ED of no known organic cause can expect to have erections rigid enough for penetrative sexual intercourse within 30 min and as late as 4 h after taking sildenafil. In conclusion, oral sildenafil at recommended doses has a rapid onset of action and is effective for several hours after dosing, allowing couples to engage in sexual activity within a natural time frame.
National Center for Biotechnology Information , U. Br J Clin Pharmacol. This article has been cited by other articles in PMC. Abstract Aims To determine the onset and duration of action of sildenafil in patients with erectile dysfunction ED.
Methods Two randomised, double-blind, placebo-controlled, two-way crossover studies were conducted in men with ED of no known organic cause. Conclusions Sildenafil is an effective oral treatment for ED that produces a penetrative erection as early as 12 min and for most patients, within 30 min after dosing, and a duration of action lasting at least 4 h.
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Introduction The ability to achieve penile erection is dependent on several factors, including relaxation of corpus cavernosal smooth muscle, increased vascular blood inflow and restricted venous outflow in the penis [ 1 ]. Study design Both studies used a randomized, double-blind, placebo-controlled, two-way crossover design.