Prostaglandin E1 (intraurethral alprostadil or MUSE) can be inserted in a pellet (suppository) form into the urethra to attain erections. It is recommended that one start with a low dose and increase in small doses until the dose that results in a rigid enough erection for completion of sexual activity is achieved. Avanafil is the most recently FDA-approved PDE5 inhibitor to treat erectile dysfunction.

Metabolism (clearing of the drug from the body) of Fildena can be slowed by liver disease, kidney disease , and concurrent use of certain medications (such as erythromycin, ketoconazole, and protease inhibitors). or disease of the heart valves (for example, aortic stenosis) Unstable angina (chest pain due to coronary artery disease that occurs at rest or with minimal physical exertion)

Back pain and muscle aches occur in less than 7% of men taking Fildena and in most patients will go away without treatment within 48 hours. is currently the only PDE5 inhibitor that is FDA-approved for daily use for erectile dysfunction and is available in 2.5 mg or 5 mg dosages for daily use. In some patients, Fildena can be taken less frequently since the improvement in erectile function may last 36 hours. recommended starting dose of Fildena for use as needed for most patients is 10 mg taken orally approximately one hour before sexual activity. Therefore, in men over 65 years of age with liver disease, or who are also taking medication(s) that can slow the breakdown of vardenafil, the doctor will initiate vardenafil at low doses to avoid its accumulation. or disease of the heart’s valves, for example, aortic stenosis (hardening of the main artery in the body)

Uncontrolled high blood pressure (greater than 170110 mm Hg) Low blood pressure (a resting systolic blood pressure less than 90 mm Hg) Unstable angina ( chest pain due to coronary artery disease that occurs at rest or with minimal physical exertion)

The QT interval is measured with an electrocardiogram ( EKG ). Some people have longer than normal QT intervals, and they may develop potentially life-threatening abnormal heart rhythms, especially when given certain medications. Other medications that may affect the level of Fildena include erythromycin and ketoconazole. Metabolism (breakdown) of Fildena is slowed by aging, liver and kidney problems, and concurrent use of certain medications (such as erythromycin an antibiotic and protease inhibitors for HIV ). Slowed breakdown allows Fildena to accumulate in the body and potentially may increase the risk of side effects.

In prescribing Fildena, a doctor considers the age, general health status, and other medication(s) the patient is taking. Sexual stimulation is needed for these medications to work. The PDE5 inhibitors have not been tested in patients with retinitis pigmentosa , an eye condition that affects the retina and can cause blindness , and so caution is recommended if you have this health condition.