Stents Help Some Erectile Dysfunction


By medpagetoday.com

Stenting blocked arteries in the pelvis may improve sexual function for certain men with erectile dysfunction that is unresponsive to medical therapy, results of a pilot trial indicated.

Internal pudendal artery stenting boosted erectile function scores by a clinically-significant degree in 84% of the 19 men followed for 12 months after the procedure, Krishna J. Rocha-Singh, MD, of the Prairie Vascular Institute at St. John's Hospital in Springfield, Ill., and colleagues found.

Moreover, blood flow through the stented vessels remained durably improved without any safety concerns, the group reported here at the Transcatheter Cardiovascualar Therapeutics meeting.

These first-in-man results from the ZEN trial are promising for the highly-selected group of men in the pilot, Rocha-Singh suggested.

However, the approach faces a multitude of challenges, he told MedPage Today.

Not only are the pelvic vessels foreign territory that "looks like a bowl of spaghetti" on angiography to most interventionalists, but the future looks dicey for further clinical trials.

The ZEN trial sponsor, Medtronic, dropped their involvement and cancelled further planned studies.

The financial return on investment for any individual stent manufacturer may not be deemed sufficient for the small population of men with vascular erectile dysfunction when clinicians could use any competitor's coronary stent for the procedure, Rocha-Singh suggested.

Fully 92% of the men screened for the trial weren't candidates for the intervention -- primarily because the vascular disease was so advanced that there was nothing to open up, Rocha-Singh pointed out.

Angiographic or penile duplex ultrasound characteristics required for inclusion criteria were 70% or more stenosis in one side or 50% or more on both sides.

The 30 men who were included were typically older (average age 60), with a substantial proportion having cardiovascular risk factors such as a history of tobacco use (70%) or coronary events (20% prior heart attack, 13% prior stroke, and 7% prior unstable angina).

Catching men earlier may be key, Rocha-Singh proposed.

"It was all about the simple fact that we get men too late," he said. "Instead of stenting men in their 60s who've had bypass or carotid endarterectomy or femoral popliteal bypass, we need to ask them the first time they get on a phosphodiesterase inhibitor and ask them on a regular basis how is it working."

Half of men develop a suboptimal response to these drugs within 3 years and the options for those men aren't great, often leading to penile implants, he pointed out.

In previously reported results from the trial, the primary endpoints showed no major adverse events at 30 days (deaths, perineal gangrene or necrosis, or perineal, penile, or anal surgery) and a 59% rate of a clinically-meaningful improvement in the gold-standard measure of erectile function.

Among the 23 patients who stayed in the trial to 6 month follow-up reported by Rocha-Singh, the rate of four-point or greater improvement in the International Index of Erectile Function (IIEF) was 67%.

That rate was 84% at 12 months, though Rocha-Singh pointed out that the patient numbers had fallen off to just 19 of the original 30, suggesting the possibility of survival bias.

"I can't absolutely tell you that the patients didn't come back because they were happy they were having erections or if they were unhappy because they were already having penile implants," he told attendees at the session.

Absolute IIEF scores rose from a mean of 40 at baseline to 60 at 12 months.

Peak blood flow velocity in the cavernosal arteries through the penis showed improvements through 12 months, though, from a mean baseline of 16 cm/s to 32 cm/s.

No major adverse events were seen through 12 months.

While device companies haven't shown interest in further developing this indication for stents currently approved in the coronary heart disease setting, "that doesn't mean it's going to go away," Rocha-Singh noted, pointing to a research consortium that's getting organized in Europe around the procedure.

Source: http://www.medpagetoday.com/meetingcoverage/tct/35494

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Sunday, May 17, 2026

Using Dramamine For Vertigo: What Patients Should Know

Vertigo is a condition that affects a significant number of people and can range from mild and occasional to persistent and severely disruptive. Understanding the available treatment options is an important part of managing symptoms effectively. Healthcare providers evaluate the severity of the condition and the patient's overall health profile before recommending a specific medication or combination of treatments. Nausea and vomiting are symptoms rather than diseases and can arise from an enormous range of causes including viral gastroenteritis, food poisoning, motion sickness, pregnancy, postoperative recovery, chemotherapy, medications, and serious conditions such as bowel obstruction or increased intracranial pressure. The vomiting center in the brainstem, the chemoreceptor trigger zone, and the vestibular system all play roles in initiating the complex coordinated reflex of vomiting. Dramamine (dimenhydrinate) belongs to the class of medications used for nausea and vomiting relief and is commonly considered by clinicians evaluating treatment options for this condition. Patients looking closely at dramamine for vertigo will find that the medication offers a practical option for many individuals dealing with this specific issue, particularly when first-line approaches have provided incomplete relief. As with any prescription or over-the-counter medication, proper dosing and adherence to usage guidelines are essential to getting the most benefit from Dramamine while minimizing the risk of side effects. Taking the medication as directed, at the appropriate time of day, and for the full recommended duration helps ensure therapeutic blood levels are maintained. Patients should inform their healthcare provider of all other medications they are taking to check for potential interactions. For broader context on treatment options related to nausea and vomiting relief, https://mednewwsstoday.com/nausea/ provides evidence-based information covering the full range of medications used in this therapeutic area, helping patients and caregivers compare approaches and make informed decisions alongside their medical team.

Thursday, May 14, 2026

Generic Fluoxetine: Reliability and Consistency Across Decades of Generic Prescribing

Fluoxetine's transition from brand-only Prozac to a competitive generic market happened following patent expiration in 2001. Since that time, generic fluoxetine has been prescribed at enormous volume, accumulating a real-world effectiveness record across millions of patients and many years of continuous clinical use. FDA bioequivalence requirements applied to generic fluoxetine are the same standards governing all generic drug approvals. Each manufacturer must demonstrate through pharmacokinetic studies that their capsule or tablet formulation delivers equivalent bloodstream concentrations of active fluoxetine as the Prozac reference product. The parameters tested include peak concentration and total drug exposure, which must fall within accepted bounds relative to the reference. Fluoxetine presents several factors that support straightforward bioequivalence assessment. The medication has well-characterized pharmacokinetics, long clinical use history, and an active metabolite, norfluoxetine, that contributes materially to the therapeutic effect. Bioequivalence studies for fluoxetine generics account for both parent drug and active metabolite characteristics in their evaluation frameworks. The extended half-life of fluoxetine and norfluoxetine, measured in days to weeks, means that minor day-to-day variation in absorption from different manufacturers' products is blunted by the drug's long pharmacokinetic averaging. This property supports relatively consistent blood levels even with some inter-dose variability in absorption. Patients who have been stable on a specific generic manufacturer's product and are switched due to pharmacy procurement changes may encounter capsules or tablets with different appearances. Colors, capsule sizes, and coatings differ across manufacturers because inactive ingredient selection is not required to be uniform across generics. These appearance differences do not reflect differences in the therapeutic compound delivered. A small subgroup of patients with mental health conditions are particularly attentive to perceived medication effects. For this population, transitions between manufacturers can feel meaningful. When a patient reports a notable change in how they feel after a manufacturer switch, the appropriate response is clinical evaluation by their provider rather than automatic attribution to generic substitution. Patient factors including psychosocial stressors, sleep changes, and illness often explain perceived differences more parsimoniously than manufacturing variation. For patients who want a grounded understanding of what generic prescribing means for their ongoing fluoxetine therapy, reviewing information about generic fluoxetine reliability supports informed and confident long-term management. For patients who want to understand how fluoxetine's generic track record compares across the SSRI class, the resources at antidepressant medication category guides provide useful comparative context.

Sunday, May 10, 2026

Amitriptyline Pricing: What Patients Pay for a Long-Established Generic Tricyclic

Amitriptyline has been available as a generic medication for decades, making it one of the most affordable prescription medications in the antidepressant and pain management categories. With numerous manufacturers producing multiple tablet strengths, competitive generic pricing has kept costs consistently low for patients. Generic amitriptyline tablets are available in strengths including 10 mg, 25 mg, 50 mg, 75 mg, and 100 mg. A 30-day supply at the 25 mg or 50 mg strength, commonly prescribed doses for pain or sleep applications, typically costs between five and fifteen dollars at retail pharmacies without insurance. Antidepressant doses at 75 to 100 mg daily provide similarly affordable monthly costs. Brand-name Elavil is essentially unavailable in current US pharmacy practice, as dispensing has shifted entirely to generic products. The competitive multi-manufacturer generic market has produced sustained low pricing without significant variation across pharmacy chains. Prescription discount programs offer free coupon pricing at major chains and independent pharmacies. Presenting a discount card often results in pricing at the lowest end of the generic range, sometimes below five dollars for a 30-day supply, depending on the pharmacy and dose. No enrollment or eligibility requirements are needed to access these programs. Medicaid covers generic amitriptyline at all strengths with minimal cost sharing for enrollees. State formularies uniformly include this medication at preferred generic tier status. Medicare Part D plans include amitriptyline universally and typically place it in the lowest cost tier, resulting in minimal or zero copay for eligible beneficiaries. Commercial insurance plan copays for generic amitriptyline are generally minimal given its generic status. In the uncommon event that a plan's copay exceeds available cash pricing, using a discount card outside the insurance plan is a practical alternative. Patients who take low doses of amitriptyline, such as 10 to 25 mg at bedtime for pain or sleep, frequently find this represents one of the least expensive elements of their medication regimen regardless of whether they carry insurance. For patients who want to identify the most accessible pricing for their prescription, exploring elavil-amitriptyline pricing options provides a useful reference for comparison shopping. For patients evaluating the broader antidepressant category and how pricing compares across classes including newer agents, the resources at antidepressant medication category guides offer comprehensive context.

Thursday, May 7, 2026

Colchicine Article

Colchicine plans often fail when patients do not match dose timing to clinician instructions during early flare onset. Delayed first dose or repeated unsupervised dosing can reduce benefit and increase adverse effects. Better outcomes usually come from clear education, accurate timing, and rapid communication when symptoms shift. Before appointments, patients can review colchicine flare-management guidance and bring detailed notes. Useful records include onset time, affected joints, pain severity, swelling progression, hydration status, food and alcohol triggers, and exact medication timing. These details help clinicians refine strategy and prevent recurrent episodes. Medication counseling should emphasize strict schedule adherence and dose-limit safety. Patients should report persistent diarrhea, vomiting, abdominal pain, unusual fatigue, numbness, muscle weakness, or systemic symptoms early so clinicians can reassess toxicity risk. Supportive routines remain important. Hydration goals, trigger moderation, sleep stability, weight management, and consistent follow-up improve gout stability over time. Urgent evaluation is needed for severe systemic illness, chest symptoms, dehydration signs, progressive weakness, or concerning neurologic changes. Early escalation improves safety. Medication reconciliation at each visit is critical because interaction risks can increase colchicine adverse-effect potential. Patients should bring complete lists of prescriptions, over-the-counter products, and supplements. For broader gout-prevention strategy and self-monitoring tools, patients can use gout support resources and keep written logs for clinicians. Reliable colchicine outcomes usually come from accurate timing, strict safety adherence, and timely reassessment when warning signs appear. Patients who keep weekly logs for flare timing, hydration, and trigger foods often detect instability early, helping clinicians adjust plans before severe recurrence. Written dose-limit reminders and toxicity-warning checklists improve safety during active treatment periods. Routine follow-up with medication review reduces avoidable complications. Structured hydration and sleep routines can improve recovery between flares. Early clinician reassessment after persistent symptoms improves safety and supports steadier long-term gout flare control. Monitoring matters.