SILDENAFIL - HOPEFUL OR UNREASONABLE

Due to its specific action on the intracavernous mechanism of erection , sildenafil is the first oral treatment for erectile dysfunction ther efore much more effective than earlier oral therapies. Patient accepta nce is greatly improved with the simple oral dose one hour before sexu al activity, avoiding commonly observed dissatisfaction with intracave rnal injections or vacuum devices: will its efficiency be the same! Tr eatment with nitrate derivatives for angina pectoris is the major cont raindication. Global management for the patient and his partner, remai ns essential for optimal efficacy of this new compound. Considering pa tient habits and medical prescriptions in France where use of anti-anx iety and anti-insomnia drugs is relatively high but use of vitamins an d regenerating drugs relatively low, only the future will tell whether use of sildenafil win remain within 'reasonable' limits. No decision concerning reimbursement by the French Social Security health care sch eme has been made to date. (C) 1998, Masson, Paris.