Problems of Forensic Sciences 2005 Vol. 63 (LXIII) 247-258
DRUGS USED IN THE TREATMENT OF ERECTILE DYSFUNCTION – A NEW CHALLENGE FOR FORENSIC TOXICOLOGISTS?
Dariusz ZUBA
Institute of Forensic Research, Krakow
Streszczenie
Currently, the drugs most commonly used in the treatment of erectile dysfunction are oral phosphodiesterase type 5 inhibitors (PDE-5 inhibitors). Three drugs of this type have been approved in Poland: sildenafil (Viagra, Pfizer), vardenafil (Levitra, Bayer) and tadalafil (Cialis, Lilly Icos). In this paper, their properties are discussed from the point of view of potential toxic action on the human body as well as possibilities of their determination in biological material. The concentrations of drugs used to treat erectile dysfunction in plasma are relatively high, even after consumption of a single tablet, and range from approximately 20 ng/ml for vardenafil to approximately 450 ng/ml for sildenafil. The most common analytical method used for identification and determination of sildenafil, vardenafil and tadalafil, as well as their metabolites, is high performance liquid chromatography, often in connection with mass spectrometry. The limits of detection vary from 0.1 ng/ml to 10 ng/ml. The great popularity of drugs for the treatment of erectile dysfunction on the illegal market and their availability, e.g. by internet, mean that they are most often taken without consulting a doctor. Taking into account their interactions with other medicines, this can lead to a health- or even life-threatening situation. Because of the high concentrations of these substances, detection of them and their metabolites is not difficult, even after administration of only a single tablet. Therefore, it seems to be reasonable to include erectile dysfunction drugs in the standard procedure of analysis of biological material for the presence of drugs.
Słowa kluczowe
Erectile dysfunction; Sildenafil; Vardenafil; Tadalafil.