A 60-Year-Old Man Comes to the Office Due to Erectile

A 60-year-old man comes to the office due to erectile dysfunction that has progressed slowly over the last year.  He finds it difficult to attain an erection and has noted a decrease in nocturnal erections.  Medical history is significant for type 2 diabetes mellitus and benign prostatic hyperplasia.  Ophthalmologic evaluation 6 months ago revealed diabetic retinopathy that was treated with photocoagulation.  The patient also had a negative treadmill cardiac stress test 4 months ago after presenting with atypical chest discomfort.  Current medications include metformin, sitagliptin, rosuvastatin, and doxazosin.  Blood pressure is 122/70 mm Hg and pulse is 76/min.  Cardiopulmonary examination is unremarkable except for mildly decreased pedal pulses on the right.  There is decreased vibration sensation in both feet.  Hemoglobin A1c measured 2 weeks ago was 8%.  The patient requests a prescription for sildenafil.  Which of the following is the most important concern in prescribing sildenafil to this patient?

A) Diabetic retinopathy
B) Interaction with doxazosin
C) Interaction with metformin
D) Peripheral neuropathy
E) Peripheral vascular disease

Correct Answer:

Verified

Unlock this answer now
Get Access to more Verified Answers free of charge

Access For Free