1.化學名:Sildenafil citrate

2.商品名:Sildenafil citrate [Viagra威而鋼,威而剛,偉哥-Pfizer]

1998.3.27 FDA核准

3.化學結構: 5-[2-Ethoxy-5-(4-methylpiperazin-1-ylsulfonyl) phenyl]-1-methyl-3-

propyl-6,7-dihydro-1H-Pyrazolo [4,3-d] pyrimidin-7-one

4.分類:

•藥理分類: Phosphodiesterase (cGMP subtype 5) inhibitor磷酸二酯媒抑制劑

•治療分類: Male erectile dysfunction男性勃起不能

•懷孕危險分類: B

•授乳:不建議使用

•小兒使用:不適

5.作用機轉:

(1)cGMP為使陰莖海綿體平滑肌鬆弛之化學介質

(2)cGMP很快被Phosphodiesterase(磷酸二酯媒媒)所破壞,在陰莖組織內之

Phosphodiesterase以5次型居多

(3)Sildenafil為具有選擇性(cGMP-subtype 5)之Phosphodiesterase inhibitor

1.臨床療效:

(1)以問卷調查方式顯示Sildenarfil之療效在七成左右

[Goldstein I:Oral sildenafil in the treatment of erectile dysfunction.NEJM 1998;338:1397-1404]

(2)口服30分鐘以後配合視覺刺激(Visual sexual stimulation)可維持2小時左右

2.適用症與劑量:

(2)劑量:行房前1小時口服Sildenafil 25mg,50mg,100mg St

3.代謝:與血中蛋白質緊密結合,無法經由血液透析排除,甚少由尿液中排出

10.禁忌:

effects of nitrates)

11.參考資料:

(2)Goldstein I:Oral sildenafil in the treatment of erectile dysfunction. NEJM:1998;338:1397-1404.

(3)Editorial,Utiger DR:A Pill for impotence. NEJM 1998;338:1458-1459.

(4)Feldman HA,Goldstein I:Impotence and is medical and psychosocial correlates:

Results of the Massachusetts male aging study. J Urol 1994;151:54-61.

(5)Boolell M:Sildenafil,a novel effective oral therapy for male erectile dysfwnction.

B J Urol 1996;78:257-261.

(6)Boolell M:Sildenafil:an orally active type 5 cyclic GMP,specific phosphodiesterase inhibitor

for the treatment of penile erectile dysfunction.

International Journal of Impotence Research 1996;8:47-52.

(9)Viagra仿單

12.感謝:

[87.12.11 (五) ]