My Canadian Pharmacy stresses out that the only group of drugs that have proven effective in ED treatment are inhibitors of phosphodiesterase-5 (PDE-5). Their application leads to relaxation of penile smooth muscles and dilates blood vessels, improving blood flow. All this leads to the normal erection appearance, in response to natural stimulation. 1998 was a landmark in the erectile dysfunction treatment. It was this year that the Food and Drug Administration (FDA) approved Viagra, which is still the gold standard in ED of any etiology treatment.
Erectile Dysfunction Treatment with Medications
Sildenafil Citrate (generic Viagra) is the first available inhibitor of PDE-5. Viagra is available in tablets of 25, 50 and 100mg dose, the most popular dosage is 50mg. After taking sildenafil orally, an erection occurs after 30 – 60 minutes, heavy fatty foods can reduce Viagra effectiveness, violating its absorption. Erection occurs in 54 to 84% of patients, regardless of ED causes. Naturally, the best results of sildenafil show in case of:
- psychogenic ED (84%);
- with diabetes and atherosclerosis of small pelvic vessels (54 – 66%).
Tadalafil (Generic Cialis) – approved for use in 2003. Produced in tablets of 2.5, 5, 10 and 20mg, the recommended initial dose is 10 mg. Cialis of generic origin starts to perform within 30 minutes. After taking Cialis effect lasts up to 36 hours. The maximum Cialis effect is observed 2 hours after taking, the food for tadalafil effectiveness affects significantly less.
Vardenafil (Levitra) – approved for use in 2003. Levitra is produced in tablets of 5, 10 and 20mg, the recommended Levitra initial dose is 10mg. Levitra effect comes within 30 minutes. After intake, heavy food weakens its effect.
All three drugs (Cialis, Levitra and Viagra) show exactly the same statistical results, both in effectiveness and in side effects, and some advantages of one in front of another tend to fit into the mathematical error, or studies are guilty of bias. True, there is evidence of better Vardenafil effectiveness in patients with diabetes mellitus (72%). Therefore, the choice of the drug is based on personal preferences and price component.
Combination with Other Drugs
The combined use of PDE-5 inhibitors and nitrates (nitroglycerin, isosorbide mono- and dinitrate, etc.) is categorically contraindicated. This combination of medications can cause a critical drop in blood pressure.
The combined use of alpha-blockers and PDE-5 inhibitors can also cause a critical drop in blood pressure, so this combination of drugs is prohibited in the US. The group of alpha-blockers is very extensive, it includes antihypertensives, drugs for prostate adenoma treatment and others. Some of the alpha-blockers are used in ED treatment – yohimbine.
Causes of PDE-5 inhibitors Inefficiency
Most often, the reason lies in drug misuse:
- Lack of adequate sexual stimulation;
- Inadequate time from taking the drug, before attempting to have sexual intercourse. Although the drug starts within 30 minutes. After admission, most men need an hour of eradication when using sildenafil and vardenafil, and 2 hours when speaking about tadalafil.
- The use of fatty foods together with PDE-5 inhibitors not only postpones the onset of action but also weakens effectiveness, even in tadalafil.
Posted: Erectile Dysfunction