title: Sublingual sildenafil in the treatment of erectile dysfunction: faster onset of action with less dose.
abstract: BACKGROUND
  The aim of the present study was to show the efficacy and safety of sublingual sildenafil and to determine whether lower doses cause the same effect with a faster onset of action in this mode of application.
  
  
  METHODS
  Forty consecutive patients with erectile dysfunction for more than three months were included in the study. The mean age was 55 years (range, 25-65). Serum glucose and testosterone levels, lipid profile and erectile function scores were obtained in all patients. Twenty patients received placebos and the other 20 patients received 20 mg sublingual sildenafil in a double blind randomized design.
  
  
  RESULTS
  The effect of sildenafil on erection was significantly higher than that of placebo. Sixty-five percent of patients (13/20) who received sublingual sildenafil achieved satisfying erections and coitus, whereas the rate was 15% in the placebo group (3/20). The mean onset of action with sublingual sildenafil was 15.5 min and lasted for an average of 40 min. Minimal headaches, sweating and flushing were noted as the side-effects.
  
  
  CONCLUSIONS
  20 mg sublingual sildenafil is safe and effective in the treatment of erectile dysfunction. Sublingual administration has some advantages as it is not effected by food ingestion and quickly appears in the circulation. These advantages provide a faster onset of action with a lower dose when compared to oral sildenafil. Sublingual use of sildenafil may be more cost-effective and possibly provides a more predictable onset of action.
authors.affiliation: Department of Urology, Başkent University School of Medicine, Ankara, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Deveci
authors.forename: Levent
authors.initials: L
authors.lastname: Peşkircioğlu
authors.forename: Cem
authors.initials: C
authors.lastname: Aygün
authors.forename: M Ilteriş
authors.initials: MI
authors.lastname: Tekin
authors.forename: Ayhan
authors.initials: A
authors.lastname: Dirim
authors.forename: Hakan
authors.initials: H
authors.lastname: Ozkardeş
mesh_terms: D015106:3',5'-Cyclic-GMP Phosphodiesterases / Q000037:antagonists & inhibitors; D000286:Administration, Sublingual; D000328:Adult; D000368:Aged; D004305:Dose-Response Relationship, Drug; D007172:Erectile Dysfunction / Q000188:drug therapy*; D005483:Flushing / Q000139:chemically induced; D006261:Headache / Q000139:chemically induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D010726:Phosphodiesterase Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D010879:Piperazines / Q000008:administration & dosage* / Q000009:adverse effects; D011687:Purines; D000068677:Sildenafil Citrate; D013450:Sulfones; D013546:Sweating; D016896:Treatment Outcome
chemical_list: D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D000068677:Sildenafil Citrate; D015106:3',5'-Cyclic-GMP Phosphodiesterases