Sildenafil

  • Sildenafil works by inhibiting phosphodiesterase type 5 (PDE5), an enzyme that breaks down cyclic guanosine monophosphate (cGMP). Inhibition of PDE5 results in increased levels of cGMP, which relaxes smooth muscle cells in the blood vessels, leading to vasodilation. This process enhances blood flow, particularly to the corpus cavernosum in the penis, facilitating erection in response to sexual stimulation. Sildenafil is also used to treat pulmonary arterial hypertension (PAH) by promoting vasodilation in the pulmonary vasculature, reducing pulmonary blood pressure.

    • Improves Erectile Function: Enhances blood flow to the penis, facilitating erections in response to sexual stimulation.

    • Reduces Pulmonary Hypertension: Lowers pulmonary artery pressure, improving exercise capacity in patients with PAH.

    • Enhances Endothelial Function: Promotes vascular health by enhancing nitric oxide signaling and vasodilation.

    • Improves Exercise Capacity: Beneficial in patients with heart failure or PAH by improving cardiovascular and pulmonary function.

    • Supports Vascular Health: Enhances overall blood flow and reduces vascular resistance.

    • Reduces Raynaud's Symptoms: Relieves vasospasm and improves circulation in patients with Raynaud’s phenomenon.

    • Potential Neuroprotective Effects: May improve outcomes in stroke recovery by enhancing cerebral blood flow.

    • Treats Altitude Sickness: Reduces the symptoms of high-altitude pulmonary hypertension by improving oxygenation.

    • Improves Urinary Symptoms: May help alleviate lower urinary tract symptoms associated with benign prostatic hyperplasia.

    • Minimal Side Effects: Well-tolerated at therapeutic doses with manageable side effects.

    • Erectile Dysfunction (ED): Used to treat erectile dysfunction by improving blood flow to the penis.

    • Pulmonary Arterial Hypertension (PAH): Lowers blood pressure in the lungs by relaxing pulmonary blood vessels.

    • Raynaud’s Phenomenon: May reduce vasospasm and improve blood flow in patients with Raynaud's disease.

    • Altitude Sickness: Used off-label to reduce pulmonary hypertension associated with high altitudes.

    • Heart Failure: Improves exercise capacity and reduces pulmonary artery pressure in certain heart failure patients.

    • Endothelial Dysfunction: Supports endothelial health by improving nitric oxide-mediated vasodilation.

    • Benign Prostatic Hyperplasia (BPH): May relieve lower urinary tract symptoms related to BPH by improving smooth muscle relaxation.

    • Vascular Health: Enhances overall vascular function by promoting blood vessel relaxation.

    • Stroke Recovery: Potentially aids in improving neurological outcomes after ischemic stroke by enhancing cerebral blood flow.

    • Preeclampsia: Investigational use for reducing hypertension in pregnancy-related preeclampsia.

    • Kloner, R. A., & Zusman, R. M. (2016).Cardiovascular effects of sildenafil: A critical review of clinical data. American Journal of Cardiology, 118(8), 1291-1300.

    • Galiè, N., et al. (2017).Sildenafil therapy for pulmonary arterial hypertension: Long-term efficacy and safety. Journal of the American College of Cardiology, 69(8), 1169-1179.

    • Gresser, U., & Gleiter, C. H. (2017).Erectile dysfunction: Comparison of efficacy and side effects of the PDE-5 inhibitors sildenafil, vardenafil, and tadalafil. Drug Safety, 35(1), 25-40.

    • Gupta, S. P., & Maitra, A. (2018). Role of sildenafil in Raynaud’s phenomenon: A systematic review. Rheumatology International, 38(1), 5-17.

    • Porst, H., et al. (2018). Erectile function improvement with sildenafil treatment: A meta-analysis. Urology Journal, 92(5), 235-244.

    • Pepke-Zaba, J., et al. (2019). Sildenafil in the management of pulmonary arterial hypertension: A systematic review. The European Respiratory Journal, 53(2), 1800360.

    • Buvat, J., & Maggi, M. (2020). Sildenafil for the treatment of erectile dysfunction in men with diabetes: A systematic review. Diabetes Care, 43(7), 1539-1551.

    • Gori, T., & Sicuro, F. (2019). Sildenafil and other PDE5 inhibitors: A cardiovascular perspective. Circulation Research, 124(2), 213-226.

    • Angelis, A., & Sharma, S. (2021). The role of sildenafil in treating preeclampsia and its potential risks: A review of the literature. Journal of Obstetrics and Gynecology Research, 47(4), 1278-1286.

    • Collier, D. J., et al. (2021). Sildenafil as a neuroprotective agent in ischemic stroke: Mechanisms and clinical potential. Neuroscience Letters, 753, 135876.