Abstract
The purpose of this work was to investigate the efficacy and safety of sildenafil in combination with doxazosin for the treatment of non-organic erectile dysfunction in patients who did not respond to sildenafil. We enrolled 28 patients with non-organic erectile dysfunction, for whom 3 months of sildenafil monotherapy had failed. They were divided in two random and homogeneous groups: 14 were treated with doxazosin (4 mg daily) and sildenafil (100 mg 1 h before sexual intercourse); the other 14 patients received sildenafil and placebo. The results were assessed by means of the IIEF questionnaire before the beginning of the study, after 30 days of therapy and after 60 days. Of the 14 patients treated with doxazosin and sildenafil, 11 (78.6%) showed a statistically significant increase of IIEF; in the placebo group, only one patient (7.1%) recorded a significant IIEF increase. The differences observed in the two groups were statistically very significant (P=0.0016). Blood pressure did not show significant alterations. Side effects were minimal and even present during sildenafil monotherapy. The combination therapy with sildenafil and doxazosin resulted in the safe and effective treatment of men with non-organic erectile dysfunction for whom sildenafil alone had failed.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 8 print issues and online access
$259.00 per year
only $32.38 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
NIH Consensus Development Panel on Impotence. . NIH Consensus Conference. JAMA 1993 270: 83–90.
Krane RJ. . Changes in ED therapy in the Viagra era. World J Urol 2001 19: 23–24.
Padma-Nathan H, Steers WD, Wicker PA. . Efficacy and safety of oral sildenafil in the treatment of erectile dysfunction: a double-blind, placebo-controlled study of 329 patients. Sildenafil Study Group. Int J Clin Pract 1998 52: 375–379.
Goldstein I et al . Oral sildenafil in the treatment of erectile dysfunction. Sildenafil Study Group. New Engl J Med 1998 338: 1397–1404.
Diederichs W et al . The sympathetic role as antagonist of erection. Urol Res 1991 19: 123–126.
Andersson KE, Hedlund P, Alm P. . Sympathetic pathways and adrenergic innervation of the penis. Int J Impot Res 2000 12: Suppl 1 5–12.
Traish A, Kim NN, Moreland RB, Goldstein I. . Role of alpha adrenergic receptors in erectile function. Int J Impot Res 2000 12: Suppl 1 48–63.
Bechara A et al . Comparative study of papaverine plus phentolamine versus prostaglandin E1 in erectile dysfunction. J Urol 1997 157: 2132–2134.
Zorgniotti AW. . Experience with buccal phentolamine mesylate for impotence. Int J Impot Res 1994 6: 37–41.
Becker AJ et al . Oral phentolamine as treatment for erectile dysfunction. J Urol 1998 159: 1214–1216.
Goldstein I. . Oral phentolamine: an alpha-1, alpha-2 adrenergic antagonist for the treatment of erectile dysfunction. Int J Impot Res 2000 12: Suppl 1 75–80.
Kaplan SA et al . Combination therapy using alpha-blockers and intracavernosal injection in men with erectile dysfunction. Urology 1998 52: 739–743.
Rosen RC et al . The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology 1997 47: 822–830.
Metro M, Broderick G. . The penile blood flow characteristics of Viagra failures. Int J Impot Res 2000 12: Suppl 3 78.
Padma-Nathan H et al . Efficacy and safety of alprostadil (Caverject) in sildenafil (Viagra) failures. J Urol 2000 163: Suppl 201–202.
Rosen RC. . Management of complicated and treatment refractory ED: clinical issues and guidelines. Int J Impot Res 2000 12: Suppl 3 59–60.
Padma-Nathan H. . The efficay and synergy of polypharmacotherapy in primary and salvage therapy of vasculogenic erectile dysfunction. Int J Impot Res 1990 2: 257–258.
Dula E et al . Efficacy and safety of fixed-dose and dose-optimization regimens of sublingual apomorphine versus placebo in men with erectile dysfunction. The Apomorphine Study Group. Urology 2000 56: 130–135.
Heaton JP. . Apomorphine: an update of clinical trial results. Int J Impot Res 2000 12: Suppl 4 67–73.
Vogt HJ et al . Double-blind, placebo-controlled safety and efficacy trial with yohimbine hydrochloride in the treatment of nonorganic erectile dysfunction. Int J Impot Res 1997 9: 155–161.
Klotz T et al . Vardenafil increases penile rigidity and tumescence in erectile dysfunction patients: a RigiScan and pharmacokinetic study. World J Urol 2001 19: 32–39.
Mydlo JH, Volpe MA, Macchia RJ. . Initial results utilizing combination therapy for patients with a suboptimal response to either alprostadil or sildenafil monotherapy. Eur Urol 2000 38: 30–34.
Nehra A et al . Effectiveness of combination therapy of MUSE and Viagra in the salvage of erectile dysfunction patients desiring non-invasive therapy: 18 month follow-up. J Urol 2000 163, (Suppl): 199.
Grimm RH Jr et al . Long-term effects on sexual function of five antihypertensive drugs and nutritional hygienic treatment in hypertensive men and women. Treatment of Mild Hypertension Study (TOMHS). Hypertension 1997 29: 8–14.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
De Rose, A., Giglio, M., Traverso, P. et al. Combined oral therapy with sildenafil and doxazosin for the treament of non-organic erectile dysfunction refractory to sildenafil monotherapy. Int J Impot Res 14, 50–53 (2002). https://doi.org/10.1038/sj.ijir.3900815
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.ijir.3900815
Keywords
This article is cited by
-
Non-invasive Management Options for Erectile Dysfunction When a Phosphodiesterase Type 5 Inhibitor Fails
Drugs & Aging (2018)
-
The effects of the combined use of a PDE5 inhibitor and medications for hypertension, lower urinary tract symptoms and dyslipidemia on corporal tissue tone
International Journal of Impotence Research (2012)
-
An open, comparative, multicentre clinical study of combined oral therapy with sildenafil and doxazosin GITS for treating Chinese patients with erectile dysfunction and lower urinary tract symptoms secondary to benign prostatic hyperplasia
Asian Journal of Andrology (2011)
-
Combination therapy for erectile dysfunction: an update review
Asian Journal of Andrology (2011)