Treatment for men with erectile disfunction (ED)

Medication information

The staff at Vivian Pharmacy are passionate about Pharmaceutical Care. Our mission is to provide our patients with the best pharmaceutical service by ensuring they are well supported in taking their medications effectively and safely. We have a team of clinically orientated pharmacists and pharmacy technicians who are always happy, in addition to medication supply, to answer drug questions, counsel patients and provide medication education.

Here is the next article in our series on the complexities of safe and effective Pharmaceutical Care.

Words by Ger Jones, pharmacist

New Zealand men now have access to sildenafil for the treatment of Erectile Dysfunction (ED) via specially trained pharmacists, as an alternative to visiting their GP. At Vivian Pharmacy we have trained pharmacists providing this confidential service.

ED occurs when it is difficult to get or keep an erection that is sufficient for intercourse. The drug sildenafil (also known by the brand names Silvasta and Viagra) belongs to the class of oral ED treatments called PDE5 inhibitors which are effective for ED. Sildenafil was initially developed for use in hypertension (high blood pressure) and angina. The first clinical trials suggested that the drug had little effect on angina, but that it could induce the now well-known side-effect. Sildenafil was thus eventually marketed for ED, rather than for angina. It works by relaxing the blood vessels helping blood flow. Sildenafil does not increase libido.

Although sildenafil is generally effective it is a potent medication and patients must be carefully screened to ensure appropriateness of the therapy. Men with complex health conditions who experience ED are recommended to consult with their GP. Some men should not take ED medicine, e.g. men on certain medicines such as nitroglycerin or other medicine containing an organic nitrate (this combination can make blood pressure fall too low possibly causing a stroke, a heart attack, or death). Men who have had a recent heart attack or stroke should also not take these drugs. For these reasons our pharmacists will need to ask you some general health questions to ensure that sildenafil is appropriate.

Side-effects are not common, but they can happen including (but not limited to) headache, upset stomach or heartburn, a feeling of warmth, nasal congestion, changes in vision (colour, glare), back pain and hearing loss. There are other rarer but more serious side-effects which we fully inform patient of during consultations.

What the Pharmacy service involves

• Patient should be between the years of 35-70 and a non-smoker (smoking cigarettes can harm blood vessels and curb blood flow and nicotine makes blood vessels contract).

• In a confidential area, one of our trained pharmacists will run through a comprehensive checklist to ensure sildenafil is right for you.This will take around 10 minutes and includes a blood pressure check. Even if you don’t qualify you will get a free BP check.

• After this initial intensive assessment, repeat supplies will only take a few minutes to supply, provided your health hasn’t changed since

Vivian Pharmacy is keen to promote this service as we view it as an opportunity to get more men into the pharmacy and provide advice on health. ED itself isn’t necessarily dangerous but ED is often one of the earliest warning signs of other underlying health conditions such as diabetes, hypertension (high blood pressure), and depression. We thus encourage men during the consultation to have a health check off their doctor. We also provide general advice including getting fit (after checking with their doctor), losing weight if overweight, healthy eating, managing medications correctly and smoking cessation.

Final thought

We do have patients coming to see us who have in the past used on-line sites, where ED drugs cost far less than they would at a pharmacy. The erectile dysfunction drugs and herbal remedies you buy online aren’t always what they seem. Some ED drugs sold online have on analysis been found contain entirely different medicines! Even if a drug contains the right medicine, it may not be the right dosage. In one study, when samples of 100-milligram tablets purchased online were tested, only 10% were even close to the advertised strength. So caveat emptor.

 

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