- Repositioning of molsidomine for its efficacy in diabetes induced erectile dysfunction in rats: In silico, in vitro and in vivo approach. [Journal Article]
- PRPharmacol Rep 2017 Sep 04; 70(2):309-315
- CONCLUSIONS: The results highlight the rationale behind the repositioning of molsidomine therapy for the management of diabetic erectile dysfunction.
- Five-year prospective study on cardiovascular events, in patients with erectile dysfunction and hypotestosterone. [Journal Article]
- AIArch Ital Urol Androl 2017 Dec 31; 89(4):313-315
- CONCLUSIONS: A therapeutic intervention on testosterone may not only have a positive effect on the cardiovascular system but also an important role in preventing new cardiovascular events.
- Association between sarcopenia and erectile dysfunction in males with type II diabetes mellitus. [Journal Article]
- AMAging Male 2018 Feb 22; :1-8
- CONCLUSIONS: Although muscle mass remains unchanged, muscle strength and physical performance decrease in diabetic ED patients. Diabetic patients with severe and moderate ED have lower muscle strength and physical performance.
- Obesity, An Enemy of Male Fertility: A Mini Review. [Review]
- OMOman Med J 2018; 33(1):3-6
- Obesity is a highly prevalent non-communicable disease worldwide and is commonly associated with male infertility. Several etiopathological theories have been mentioned in the literature by which obe...
Obesity is a highly prevalent non-communicable disease worldwide and is commonly associated with male infertility. Several etiopathological theories have been mentioned in the literature by which obesity affects spermatogenesis, thus affecting the male fertility potential. Mechanisms for explaining the effect of obesity on male infertility include endocrinopathy, increased aromatization activity, associated erectile dysfunction, psychological and thermal effects, obstructive sleep apnea, increased leptin and oxygen free radicals, and associated inflammatory and obstructive elements of epididymitis. Treatment of such a complex problem includes weight reduction (by lifestyle modification and increased physical activity), optimization of altered testosterone-to-estradiol ratio using aromatase inhibitors and/or gonadotropins, treatment of associated comorbidities by phosphodiesterase inhibitors for erectile dysfunction, and insulin-sensitizing agents for the management of diabetes. The aim of this mini-review is to highlight the pathological basis of this problem and to focus on obesity as an etiology of male infertility.
- Sublingual Administration of Sildenafil Oro-dispersible Film: New Profiles of Drug Tolerability and Pharmacokinetics for PDE5 Inhibitors. [Journal Article]
- FPFront Pharmacol 2018; 9:59
- Objective: Type 5 phosphodiesterase inhibitors (PDE5i) are efficient drugs used for treatment of erectile dysfunction (ED); however, a large discontinuation rate due to major side...
Objective: Type 5 phosphodiesterase inhibitors (PDE5i) are efficient drugs used for treatment of erectile dysfunction (ED); however, a large discontinuation rate due to major side effects is reported. The aim of this study was to evaluate the possible improvement of sildenafil (Sild) pharmacokinetics associated to the sublingual administration of the new available oro-dispersible film (ODF), compared to both the oro-dispersible tablet (ODT) and the film-coated tablet (FCT) as originalper osformulation.Methods:In vitrodisaggregation test, dissolution test, and permeation test in specific devices to estimate the trans-mucosal absorption.In vivoanalysis of serum Sild levels, by high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS), was performed in 20 patients with psychogenic ED receiving alternativelyper osFCT or sublingual ODT or ODF, at an equal dosage (50 mg). Pharmacokinetic parameters of Sild and adverse drug reactions experienced after the dosing of each formulation were compared.Results:In vitro, ODF showed the highest time to disaggregation and an increased rate of permeation compared to both ODT and FCT (P= 0.017 andP= 0.008, respectively).In vivo, compared to both FCT and ODT, ODF showed a faster increase of serum Sild levels (serum levels at 15 min from dosing, respectively: 2.24 ± 1.4 ng/ml FCT, 0.5 ± 0.3 ng/ml ODT, and 13.5 ± 9.1 ng/ml ODF;P< 0.01 andP< 0.05 vs. ODF) together with a higher drug bioavailability within 60 min from dosing (relative AUC60minvs. FCT, respectively: 100.0 ± 44.9% FCT, 183.8 ± 75.4% ODT, and 304.2 ± 156.0% ODF). A trend toward lower peak serum levels was observed for ODF. Finally, ODF showed a lower prevalence of headache compared to FCT (1 vs. 35%;P< 0.05) and improved pattern of flushing and nasal congestion.Conclusion:Sublingual Sild ODF improves the drug tolerability through a likely modified pharmacokinetic, suggesting a possible implication also in the clinical efficacy profile. Sublingual administration of oro-dispersible formulations may represent a strategy to ameliorate the adherence to therapy with PDE5i, particularly in patients discouraged by side effects.
- Non-invasive Management Options for Erectile Dysfunction When a Phosphodiesterase Type 5 Inhibitor Fails. [Review]
- DADrugs Aging 2018 Feb 20
- Phosphodiesterase type 5 inhibitors (PDE5Is) are the drug of choice for medical management of erectile dysfunction (ED). On-demand PDE5Is have an overall efficacy of 60-70% for ED; 30-35% of patients...
Phosphodiesterase type 5 inhibitors (PDE5Is) are the drug of choice for medical management of erectile dysfunction (ED). On-demand PDE5Is have an overall efficacy of 60-70% for ED; 30-35% of patients fail to respond to a PDE5I, and 30-50% of non-responders can be salvaged with detailed counseling on proper use and physician follow-up to ensure that the patient has been prescribed an appropriate and full PDE5I clinical trial. True non-responders may be offered intracavernosal injections of erectogenic drugs, intraurethral alprostadil, or surgical insertion of a penile prosthesis. Such options are not discreet and are associated with more adverse effects than PDE5Is. Thus patients may request additional non-invasive medical management options. This review describes published literature on patients who failed to respond to an on-demand PDE5I regimen and were treated with a non-invasive PDEI-based regimen, including switching from one PDE5I to another; increasing the dose of PDE5I above the labeled dosage range; using two PDE5Is concurrently; using a daily PDE5I regimen; or combining a PDE5I with a testosterone supplement, α-adrenergic antagonist, intraurethral or intracavernosal alprostadil, vacuum erection device, or low-intensity shock wave therapy. The limitations of published clinical trials do not allow for sufficient evidence to recommend one option over another. Therefore, in PDE5I-refractory patients, the choice of a specific next step should be individualized based on the preference of the patient and his sexual partner, the advantages and disadvantages of the various options, the concurrent medical illnesses and medications of the patient, and the patient's response to treatment.
- The Effect of Transdermal Testosterone Administration on Lower Urinary Tract Symptoms and Erectile Dysfunction: A Prospective, Randomized, Placebo-Controlled Trial. [Journal Article]
- CUCurr Urol 2017; 11(1):4-8
- CONCLUSIONS: This study revealed that testosterone replacement therapy is effective in improving LUTS and ED symptoms.
- Should information about sexual health be included in education directed toward men with cardiovascular diseases? [Journal Article]
- AMAging Male 2018 Feb 20; :1-8
- CONCLUSIONS: Cardiac patients with ED know more about risk factors for CVD than ED. It is necessary to include information about the negative impact of modifiable risk factors on sexual health into education programs promoting healthy lifestyles in men with cardiovascular diseases.
- Sexual habits of men with ED who take phosphodiesterase 5 inhibitors: a survey conducted in 7 countries. [Journal Article]
- IJInt J Clin Pract 2018 Feb 20
- CONCLUSIONS: Sexual activity is usually planned by ED medication users several hours in advance, and the vast majority are attempting activity within a short time after ingestion of the agent. These data should aid clinicians in the selection of the optimal PDE5I.
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- Erectile dysfunction: they don't talk, we don't ask. [Journal Article]
- DMDiabet Med 2018 Feb 19
- Erectile dysfunction is an under-reported complication of diabetes mellitus affecting over half of male patients . Although many men with diabetes consider that erectile dysfunction has a negative...
Erectile dysfunction is an under-reported complication of diabetes mellitus affecting over half of male patients . Although many men with diabetes consider that erectile dysfunction has a negative influence on their quality of life, they are reluctant to report it; and while most would like treatment, they prefer physicians to start the conversation [2-4]. Erectile dysfunction predicts future cardiovascular disease, and screening for erectile dysfunction is advocated in several cardiovascular risk assessment algorithms . This article is protected by copyright. All rights reserved.