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Sildenafil in Europe: on medical prescription only

Erectile dysfunction requires investigation of the possible organic or psychological causes. Sildenafil causes sometimes severe adverse effects, particularly cardiovascular. Two good reasons to restrict its use and to maintain it as a prescription-only drug.

The European Committee for Medicinal Products for Human Use gave an unfavourable opinion on the use of sildenafil without a medical prescription, which led to Pfizer withdrawing its application to sell sildenafil without a prescription. Sildenafil benefits some patients suffering erectile dysfunction, but its use should not become generalised.

Sildenafil exposes patients to troublesome, possibly severe, adverse effects, such as visual, auditory and cardiovascular disorders (notably myocardial infarction and stroke). Its combination with some cardiovascular drugs can result in sudden arterial hypotension and cardiovascular events.

If a patient complains of erectile dysfunction, first of all it is essential to carry out minimum tests especially to eliminate the possibility of organic disease or psychological or drug-related causes.

One more advantage of maintaining sildenafil as a prescription drug: advertising it to the general public remains prohibited in France – officially anyway.

©Prescrire July 2009

Source: "Sildenafil : pas sans ordonnance" Rev Prescrire 2009; 29 (308): 421.

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