Beste apotheek van Nederland

Topical Nitroglycerine versus Minoxidil. One trial (n=132 participants) compared the
efficacy and harms of nitroglycerine ointment to minoxidil. 313
Harms. Men assigned to received nitroglycerine ointment group reported more frequent side
effects than did men in the minoxidil group, including more frequent burning at the application
site (12.6 versus 6 percent) and hypotension (10.3 versus 0 percent). 313
Efficacy. Among men in the nitroglycerine ointment group, 20.7 percent reported improved
erections versus 44.0 percent of those in the minoxidil group.
Topical Aminophylline plus Isosorbide dinitrate plus Co-dergocrine versus Placebo.
Two crossover trials compared the efficacy and harms of Aminophylline plus Isosorbide dinitrate
plus Co-dergocrine versus placebo. 312,314 In the first trial (n=36), men with predominately
physiologic ED were assigned to receive 2 gm of 3 percent aminophylline plus 0.25 percent
isosorbide dinitrate plus 0.05 percent co-dergocrine mesylate taken once during a 7 day period
versus placebo. 314 In the second trial (n=14), men with predominately psychogenic ED who
previously responded to IC injections were allocated to 2 ml doses of 3 percent aminophylline
plus 0.25 percent isosorbide dinitrate plus 0.05 percent co-dergocrine mesylate or placebo. 312
Harms. None of the patients had prolonged erection or priapism, clinically significant
cardiovascular adverse events (such as postural dizziness), headache, or pain at site of
application. 314 The other trial did not report any data on harms. 312
Efficacy. In the first trial, among men assigned to active treatment, 58.3 percent reported
erection sufficient for successful intercourse versus 8.3 percent of those allocated to placebo. 314
In the second trial, men assigned to the active treatment reported that they experienced erections
adequate for intercourse after 3.9 percent of treatment applications versus after 5.3 percent of
placebo applications. All successful applications for both the active treatment and placebo
groups occurred in a single participant. 312
Minoxidil versus Placebo. One crossover trial (n=132) compared the efficacy and harms of
minoxidil to placebo. 313
Harms. Compared with placebo, men allocated to minoxidil reported more frequent burning
at the application site (6 versus 0 percent). No hypotension was reported by either the minoxidil
or placebo-treated participants.
Efficacy. Among men allocated to minoxidil, 44.0 percent reported improved erections
versus 1.7 percent of those allocated to placebo.
Topical Sildenafil versus Oral Sildenafil. One trial (n=80) compared the efficacy and
harms of topical sildenafil to oral sildenafil. 144
Harms. In men assigned to receive topical sildenafil, four (10 percent) reported mild
headache. In those assigned to receive oral sildenafil, two participants (5 percent) developed
severe headache, one participant (3 percent) reported disturbed visual function, and one
participant (3 percent) experienced severe dyspepsia.
Efficacy. Among men assigned to the topical sildenafil plus oral placebo group, 12.5 percent
reported improved erections versus 70.0 percent for men assigned to the oral sildenafil plus
topical placebo group.
Quantitative Synthesis
No meta-analysis could be performed because of substantial degree of clinical heterogeneity
across the trials with regard to patient characteristics, interventions, and the assessed outcomes.
89