Men
Erectile Dysfunction
Mild to moderate erectile dysfunction affects around 50% of men aged 40+ years, making it one of the most common disorders in older men worldwide. An erection is a carefully orchestrated physical response to sexual stimulation. Sensory nerve signals in the brain compel the smooth muscles in the penis to relax which increases blood flow to the male sex organ. As a result, the penis expands and becomes erect. Erections start and stop with the help of nitric oxide and phosphodiesterase-5 (PDE-5). While nitric oxide promotes relaxation of the penis muscles, PDE-5 blocks an erection after intercourse.
In men with erectile dysfunction, these processes are disrupted. Luckily, effective medications are available. PDE-5 inhibitors are effective in up to 63% of men. There are three main types of PDE-5 inhibitors – sildenafil (Viagra, Revatio), vardenafil (Levitra) and tadalafil (Cialis). All of these drugs act by inhibiting PDE-5, the enzyme responsible for shutting down an erection. When PDE-5 is blocked, the smooth muscles of the penis relax, allowing for a firmer and longer-lasting erection.
Technically, sildenafil is the active ingredient in Viagra. In other words, there is no difference. But sildenafil is also a compound of a drug called Revatio which treats pulmonary hypertension (high pressure in the lungs).
Revatio can technically be prescribed for the treatment of erectile dysfunction, but it exists only as a 20 mg dose. Doctors may prescribe Revatio instead of Viagra, but it is at their discretion to do so. Patients can take multiple doses of Revatio at once to reach a higher dose of sildenafil. Having smaller doses to work with can provide more flexibility in treating mild to moderate or occasional erectile dysfunction.
Viagra is available in three doses: 25 mg, 50 mg, and 100 mg and is a branded prescription drug. However, Pfizer’s patent of the drug expired in 2019, which means that cheaper, generic versions are available.
Erectile dysfunction prescription medications usually differ in the time it takes for them to work, the duration of action, and their side effects and contraindications.
Although all three medications share a similar mode of action, that is, they inhibit PDE-5, they vary when it comes to effectiveness.
Viagra and Levitra are effective within one hour after ingestion, while Cialis takes a little longer (2-4 hours). But the action of Cialis lasts considerably longer at up to 36 hours compared to 3-6 hours for Viagra and Levitra.
Viagra and Levitra are best taken on an empty stomach because food may delay absorption. Cialis can be taken alongside food and is a better option for men who may not know when intercourse will occur. Cialis has also been approved as a daily medication to treat both ED and symptoms of an enlarged prostate.
Cialis is available in doses ranging from 2.5 to 20 mg. The starting daily dose of Cialis is 2.5 to 5 mg. Daily dosing eliminates the timiing and planning needed with Levitra or Viagra, allowing for more spontaneity.
Side effects can vary from pill to pill. Headaches, runny nose, upset stomach, flushing, and back pain are common for all three erectile dysfunction medications. Nausea, dizziness and visual disturbances are more common when taking Viagra. Indigestion is a more common side effect with Levitra and Cialis.
It’s important to discuss side effects with a doctor before committing to a prescription drug. Patients may also wish to try a few different medications or vary their doses depending on their symptoms. Finding the best erectile dysfunction drug for you can be a case of trial and error.
All three prescription drugs can interact with certain blood pressure medications and nitrates. Beta and alpha-blockers, and some anti-fungal and anti-bacterial drugs are also known to interact with erectile dysfunction medications. Read the package insert and discuss your medical conditions with a doctor.
The answer to that question will vary from patient to patient and is highly dependent on the severity of erectile dysfunction, the desired effect, and whether a patient suffers from other medical conditions.
One research study found that patients taking sildenafil (Viagra) or tadalafil (Cialis) were similarly satisfied with their resulting erections. But a meta-analysis of 16 separate drug trials noted that although both drugs improved erectile dysfunction symptoms in men, sexual confidence was higher in those taking Cialis. Both men and women preferred Cialis over sildenafil for the treatment of erectile dysfunction.
A comparison of the biochemical and physiological effects of Viagra and Levitra found Levitra to be preferable for efficacy and a better choice for men when Viagra does not produce the desired effect.
Ultimately, the choice between Viagra, Levitra and Cialis should be dependent on a patient's medical history and the potential side effects.
Avanafil is a newer PDE-5 inhibitor. It was approved by the US Food and Drug Administration in 2012 and is available in a dose of 50 mg, 100 mg or 200 mg.
Avanafil has been shown to act more rapidly compared to sildenafil and vardenafil. Marketed under the name Stendra by Mitsubishi Tanabe, avanafil acts within 30 minutes after ingestion and lasts up to six hours. It is less affected by food intake. Some studies have shown successful intercourse after only 15 minutes of taking the drug, making it an excellent option for men seeking a quick-acting PDE-5 inhibitor. Stendra is not currently available in generic form, and is therefore quite expensive compared to Viagra, Levitra and Cialis in their generic forms.
Message Sent We will get back to you as soon as possible
To get fast delivery and the best prices,
choose your location below:
Delivery to Germany only
Delivery to the US only
Delivery to UK only
You’ve successfully logged in.
