The Viagra era was launched on March 27, 1998. More than six million Americans are using the drug with an approximate overall success rate of about 75 percent. What can be done for those patients who have suboptimal results or no effect on their erectile dysfunction?

Viagra is a safe and effective oral treatment for men with erectile dysfunction of physical, psychological or mixed cause. However, it is important that patients should be aware of the low probability (less than 50%) that intercourse will be possible after the first dose - particularly in severe or advanced cases. The majority of men who stop Viagra because of apparent lack of effect will in fact respond and achieve intercourse if they continue to try, progress from 50 mg to 100 mg, or take the pill without food on an empty stomach (3 hours after eating).