What is it about?

Despite the initial enthusiasm, the significant number of patients in whom sildenafil is contraindicated or ineffective is a major challenge to all urologists. Our aim was to determine the safety and efficacy of adjunctive atorvastatin in restoring normal erectile function in hypercholesterolemic (low-density lipoprotein (LDL) cholesterol >120 mg per 100 ml) sildenafil nonresponders.

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Why is it important?

Community-based epidemiological studies indicate that ED is common. ED affects roughly 150 million men worldwide and the number is likely to exceed 300 million men by the year 2025. Sildenafil citrate is effective oral first-line medication for ED. It appears to be effective for symptomatic relief of ED in a wide variety of men. However, not all men suffering from ED have effectively responded to sildenafil. Early treatment discontinuation rates for the drug attributed to the patients’ dissatisfaction range from 14% to as high as 47%. The most common cause for patient dissatisfaction is lack of consistent efficacy. A substantial number of sildenafil nonresponders can be rescued with appropriate instructions and education followed by rechallenge.


In hypercholesterolemic sildenafil nonresponders, adjunctive atorvastatin successfully improved erectile function in about one-third of patients. However, this medication does not restore normal erectile function. By this trial, long-term effects could not be evaluated. Controlled studies will be needed to know for sure.

Dr Mohammad Reza Safarinejad
University of Medical Sceices

Read the Original

This page is a summary of: Atorvastatin improves the response to sildenafil in hypercholesterolemic men with erectile dysfunction not initially responsive to sildenafil, International Journal of Impotence Research, October 2009, Springer Science + Business Media,
DOI: 10.1038/ijir.2009.48.
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