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Sildenafil, sold under the brand name Viagra, among others, is a medication used to treat erectile dysfunction and pulmonary arterial hypertension. Common side effects include headaches, heartburn, and flushed skin. Sildenafil acts nizagara 200mg blocking phosphodiesterase 5 PDE 5, an enzyme that promotes breakdown of cGMP, which regulates blood flow in the penis. Pfizer originally discovered the medication in while looking for a treatment for angina. The primary indication of sildenafil is treatment of erectile dysfunction inability to sustain a satisfactory erection to complete sexual intercourse.

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The objectives of this study were to evaluate the efficacy and tolerability of high dose sildenafil as a salvage therapy for patients refractory to the maximum recommended dose of sildenafil. Fifty four fully evaluated patients with chronic erectile failure ED who had previously failed to respond to a home trial of sildenafil mg with erections suitable for sexual intercourse were studied. Each man was treated at home with sildenafil at escalating doses of up to mg until either maximal response or intolerable adverse effects occurred. Erectile function was quantified using the erectile function domain of the International Index of Erectile Function IIEF before treatment, with sildenafil mg and with maximal dose of sildenafil and a global efficacy question after 4 weeks of treatment. The mean age of the study group was

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