Brief Answer:
Phosphodiesterase inhibitors

Detailed Answer:
Dear patient,

Thanks for sharing your concerns. With your history of CAV and diabetes, there is probably a physical substrated for your erectile dysfunction and many patients do benefit from phosphodiesterase inhibitors, such as sildenafil (viagra), tadalafil and others. The major contrainidcation for these medications is the simultaneous use with nitrates (like nitroglycerin or isosorbide), given risks of low blood pressure.

I would encourage you to discuss this option with your prescribing cardiologist.


Yours truly,



Dr Brenes-Salazar MD
Cardiology
Mayo Clinic MN

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Brief Answer:
50 mg usually starting dose

Detailed Answer:
Dear sir,

Thanks for the follow up. The usual starting dose of sildenafil is 50 mg, although some patients do respond to the smallest dose of 25 mg, 3 hours before planned intercourse. Side effects include headache, flushing, and rarely but importantly transient alterations in color perception.

Yours truly,

Dr B

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