Increased risk with increasing age and duration of diabetes
Phosphodiesterase inhibitors (e.g. sildenafil)
Things to remember when treatment with phosphodiesterase inhibitors is being considered:
1. Sildenafil is contraindicated in patients being treated with nitrates, and in those who are hypersensitive to sildenafil.
2. Sildenafil is used with precaution in conditions predisposing to priapism.
3. Concurrent use of drugs which interfere with the metabolism of sildenafil (e.g. erythromycin, cimetidine) may predispose to adverse reactions by prolonging its plasma half life.
4. While combining with an alpha-blocker (e.g. doxazosin), it is important to give the drugs with at least a 4-hour interval to reduce the risk of hypotension.