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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. The mean age of the study group was Mean IIEF question 3 and 4 scores were 1. Erectile dysfunction ED is the inability to achieve and maintain an erection of sufficient rigidity for satisfactory sexual intercourse. Sildenafil citrate Viagra TM, Pfizer, UK, a potent, competitive phosphodiesterase type 5 iso-enzyme PDE-5 inhibitor, is the first oral medication to demonstrate significant and reliable efficacy in most patients with ED.

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