Sildenafil is a competitive inhibitor of an enzyme of the phosphodiesterase type five class (PDE-5) and is the predominant isoform in the penis. PDE-5 breaks down the cGMP, resulting in a contraction of the penile arteries and smooth muscle, and causing detumescence which is actually an erectile dysfunction. Sildenafil can then inhibit PDE-5 to avoid this condition.
Sildenafil is absorbed rapidly in the small intestine after oral administration, with times to peak plasma concentration from 30 to 120 minutes; peak efficacy is seen after taking the medication on an empty stomach, where clinical efficacy has been observed within 19 minutes. The generic Sildenafil Citrare significantly improved erectile function both in elderly patients with ED of broad-spectrum etiology and in elderly patients with ED and diabetes.
Generally, sildenafil has been found by some studies to be effective in type II diabetics with more than one diabetic complication and with poor glycemic control. In the study of Dr. McCullough, he stressed out that the safety and efficacy track record of sildenafil citrate for the past 4 1/2 years is very good. The original clinical trial data has been validated by the post launch data, in millions of men. It may take six to eight doses of sildenafil before the patient has an optimum response. That is something that many patients don’t accept easily. The physician must encourage them that they will need to use all six pills of the sample pack, or even more perhaps, before they have a good response.