ABSTRACT
The advent of the first effective oral agent in the management of erectile dysfunction, sildenafil, has had a revolutionary impact in the medical societal and economic aspects of this field. This review will examine the clinical research and field experience with respect to efficacy and safety as well as touch on the broader societal and economic issues related to sildenafil. The following topics are extensively presented and discussed in this article: molecular pharmacology, pharmacokinetics and pharmacokinetics in special populations (geriatrics, renal insufficiency, hepatic insufficiency). The indications, contraindications and precautions. Dosage and administration, efficacy in general and in diabetic patients, spinal cord injured patients, radical prostatectomy, and according to age and severity of erectile dysfunction. The safety and the side effects are also discussed