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I've been taking Cialis and Vigamed (oral phentolamine) for over a year and I'm very happy with the results. Cialis is very effective but it works even better if taken with Vigamed. This shows that combination therapy may be a good solution for some men.

In fact, there are several studies that show the benefits of combining different ED drugs. Here's a study on the combination of PDE-5 inhibitors (Viagra, Cialis, Levitra) and alpha blockers:

'Combination therapy using PDE5 inhibitors and alpha-blockers to treat LUTS and sexual dysfunction also shows promise. In a study by Yassin and Diede [22], 42 men with ED considered nonresponders to tadalafil monotherapy were given alfuzosin. This combination therapy improved ED in 71% of these patients. Further studies are needed to assess the efficacy of combination therapy, but this study provides promise.'

(Alpha blockers and ejaculatory function: a state of the art review)

Read more: http://www.springerlink.com/content/e7rl7k3360p3hw6v/

The study mentions alfuzosin but phentolamine (brand name Vigamed) is also an alpha blocker and works in a similar way.

There are, however, several precautions that should be taken.

Cialis and Vigamed are approved ED meds but not everyone responds to these treatments. Consult your urologist before you decide to try any of these drugs. Self-medication is always a risk.

Start with small doses (e.g. Cialis 5 mg + Vigamed 20 mg) to see if you can tolerate these drugs.

Combining these drugs may increase the risk of side effects, e.g. hypotension, headaches, nasal congestion.

Always read the medication guide or patient instructions provided with each medication.

Hi! I'm new here; Have been reading with considerable interest Flavio´s posts in another forum (EDGUIDERFORUM- quite an active member, no pun

intended...) and decided to try this combination myself, my favourite PDE5 inhibitor (sildenafil) with Phentolamine (Vigamed/Vasomax). Talked to my

cardiologist and he gave me the green light- actually, he was a bit too eager to know the results :- ) Fearing side effects, palpitations, priaprism, etc, I

started with 25mg Sildenafil one hour before and 20mg-half a pill of vigamed half an hour before. It worked just fine. Then, a couple of days later, Sildenafil

increased to 38mg and Vigamed 20mg. It worked even better. Finally, 38mg Sildenafil and 30mg Vigamed (3/4 of a pill) and it was wonderful!! I will try the

same dosage again or maybe increase the Phentolamine to 40mg. I had read a paper (see below) where this combination was tried to non responders to 50mg

or 100mg of Sildenafil but the results were not very encouraging. On me, it worked wonders…


“Purpose: Despite the good results of oral sildenafil in the treatment of the erectile dysfunction, some men do not respond to this drug. Due to its mild side effects, we tested the association of oral sildenafil and phentolamine in men with erectile dysfunction who did not respond to sildenafil alone.
Material and Methods: The association of 50mg of sildenafil given one hour and 40mg of phentolamine given half an hour before intercourse was used to treat 31 impotent men (36 to 82 years-old, median=69) who had previously failed to 50mg and 100mg of sildenafil given alone. Among this 31 patients, 17 (54.8%) had been submitted to radical prostatectomy due to localized prostate cancer. Each patient tried this association at least four times. We consider success the presence of full erection and normal intercourse without complementary methods.
Results: The association of sildenafil and phentolamine failed to improve erection in this group of patients. None of the 31 men reported full erections.
Conclusion: The association of sildenafil and phentolamine does not represent a good option to impotent men who had previously failed the treatment with sildenafil alone.”

I'm glad it worked for you too.

I guess this combination works so well for some men because both drugs work in entirely different ways: Cialis, Viagra and Levitra inhibit an enzime called PDE-5; Vigamed (formerly known as Vasomax) blocks the physiological system that controls penile detumescence.

I didn't know the study you mentioned but it doesn't surprise me much. Not everyone responds to these drugs.

The earlier study you referenced used the Alpha-blocker Alfuzosin (Uroxatrol) which is commonly prescribed for BPH. (The alpha-blocker Flomax is more commonly prescribed for BPH, but I don't like the side effects.) I asked the doctor for Uroxatrol for my BPH. I tried it with Cialis, and I got a better response than with Cialis alone.

I have no scientific studies to back me up, but I have had good results by combining Viagra with an otc supplement, Maxidus, which is a combination of 7 herbs, primarily eurycoma longifolia (aka tomkatali). I have been able to reduce my Viagra dosage from 100 to 50 mg and I am able to get a better quality erection.

In case someone wants some
scientific info on the above
combination therapy.

http://scholar.google.com.br/scholar?hl ... =&as_vis=1