Erectile Dysfunction Medications: An Overview

It is estimated that nearly half of men between the ages of 40–70 experience some degree of erectile dysfunction (ED). However, your sex life does not have to suffer. This review discusses everything you need to know about oral prescription ED medications.

Key takeaways:
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    Erectile dysfunction can affect up to half of the men in their 40–70’s.
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    Viagra, Levitra, Stendra, and Cialis are available for the oral treatment of erectile dysfunction.
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    Each medication differs in cost, time of onset, length of effectiveness, and individual response.
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    A trial of each medication can help determine what works best for you.

What’s available?

There are four medications available:

  • Sildenafil (Viagra)
  • Vardenafil (Levitra)
  • Avanafil (Stendra)
  • Tadalafil (Cialis)

When should you take them?

Viagra and Levitra typically take about 30 minutes or more to begin working. Thus, it is recommended they be taken an hour before sex.

Cialis should be taken at least 30 minutes or more before sexual activity. However, it is available in a daily dosage that provides continuous support giving you the ability to engage in sexual activities on demand.

Stendra has the quickest mechanism of action and can be taken in as little as 15–30 minutes before engaging in sexual activity.

How long do they last?

Cialis is the longest-acting medication and can be effective for up to 36 hours. Stendra is the quickest-acting medication and can last between 6-12 hours making it the second longest-acting medicine available. Viagra and Levitra are effective for up to 4–5 hours after taking.

All of these medications have a range of effectiveness which is thought to be related to the severity of erectile dysfunction. Therefore, the more severe the case the shorter the effective time for these medications.

Can they be taken with food?

Viagra should be taken on an empty stomach as food can prevent its absorption. Levitra can be taken with or without food but high-fat meals can slow the absorption. Cialis and Stendra can be taken without regard to food

What are the side effects?

The side effects of all ED medications are similar and include:

  • Headache
  • Flushing
  • Heartburn
  • Nasal congestion or runny nose
  • Vision abnormalities (blurred vision, blue tint to vision)
  • Dizziness
  • Rash
  • Erections lasting more than 4 hours (seek immediate medical attention)

Drug interactions

The use of nitrates is contraindicated with all of these erectile dysfunction medications due to unsafe drops in blood pressure. The medications considered nitrates include nitroglycerin, isosorbide mononitrate, and isosorbide dinitrate.

Alpha-blockers such as doxazosin, prazosin, and terazosin can also interact with ED medications resulting in an unsafe drop in blood pressure.

What ED medication should I use?

Although all erectile dysfunction medications work the same way, each user will have their individual response. Therefore, if one ED medicine does not work for you, try a different one as it may be more effective or have fewer side effects.

The cost of these medications can be prohibitive as many insurances will limit the number of pills you can obtain each month. Thus, finding manufacturer discount programs or shopping at different pharmacies can reduce the cost of these medications.

Additionally, all of these medications can be cut in half. This can easily double your supply and limit the overall monthly cost of these medications.

Overall, these medications should be viewed as trial and error. It is important to try them all to see which one works best for you.

Erectile dysfunction affects a large proportion of men but there are oral medications that can help. Each medication differs in cost, time of onset, length of effectiveness, and a patient’s individual response. All of these factors need to be considered when determining what medication is right for you.