Sildenafil-associated hepatoxicity: a review of the literature.

摘要: Sildenafil citrate (Viagra®) is a vasoactive agent available worldwide since 1998 for the treatment of male erectile dysfunction. It selective phosphodiesterase type 5-enzyme inhibitor able to potentiate downstream effects nitric oxide on smooth muscle relaxation and vasodilation through its cyclic guanosine monophosphate (c-GMP) pathway in tissue penis. When sildenafil orally administered, it rapidly absorbed with maximum plasma concentration achieved within 1 h has terminal half-life between 3 6 h. The drug extensively metabolized by liver, primarily CYP3A4 enzyme. Although well tolerated, specific adverse events have been observed, like flushing, headaches, dyspepsia, visual disturbances. Liver toxicity related consumption considered very rare event. However, last decade, some cases sildenafil-associated hepatotoxicity reported. Furthermore, hepatic intoxications reported after intake "natural" or "herbal" aphrodisiac supplements sold Internet, sex shops, social media, word-of-mouth found contain other 5 (PDE-5) inhibitors. Studies investigating possible link use liver damage are limited, underlying mechanism responsible still missing. animals evidence that hematopoietic function may severely affected as result probable toxic effect sildenafil. Here, studies reporting humans discussed.