Erectile Dysfunction and Viagra

Viagra (also known as Sildenafil) was developed to treat heart disease, but during its clinical trials the subjects noticed they were having erections. Viagra works best between one and two hours after taking it. Sexual function improves by a factor of three to four; 4 out of 5 patients taking the drug report improvement. Viagra has been shown to be effective in ED associated with diabetes, spinal cord injury, and medicines used to treat depression.

In contrast to the other agents listed below, sildenafil does not produce an erection in the absence of sexual stimulation. It merely enhances the response. Take sildenafil about an hour before planned sexual activity.

Read more details about Viagra.

• Erectile Dysfunction and Alprostadil

Viagra should not be used in the following conditions:

• Recent heart attack or stroke
• Heart failure
• Concurrent use of nitrate
• Concurrent use of other medicines for erectile dysfunction
• Hereditary retinal disorders, such as retinitis pigmentosa

Viagra should be used with caution in the following:

• Liver or kidney failure
• Bleeding disorders
• Ulcer disease
• Heart disease
• Concurrent use of blood pressure medicines, especially alpha-blockers
• The elderly

Viagra must be obtained by prescription. There is important information your doctor needs to know about your health before the medicine is prescribed.

Possible side effects include:

• Headache
• Flushing
• Indigestion
• Visual disturbances, a condition known as nonarteritic anterior ischemic optic neuropathy (NAION) that can cause sudden blindness
• Drug interactions

There are two types of alprostadil:

• Transurethral alprostadil (MUSE)
• Intracavernosal alprostadil (Caverject, Edex)

Alprostadil acts directly on the blood vessels in the penis to...

Read more about Erectile Dysfunction and Alprostadil.

Levitra (Vardanafil) and Cialis (Tadalafil)

These newer drugs have the same efficacy, safety profile, and cost effectiveness as Viagra. However, the following are major differences you should be aware of:

• Food, especially fatty food, can delay the absorption of Viagra and Levitra, but not Cialis.
• The duration of action of these drugs are different: o 4-5 hours for sildenafil and vardanafil o Up to 36 hours for tadalafil

American Academy of Family Physicians website. Available at: http://www.aafp.org/online/en/home.html .

Guay AT, Spark RF, Bansal S, et al. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of male sexual dysfunction: a couple’s problem: 2003 update. Endocr Pract. 2003;9:77-95.

McMahon CN. Treating erectile dysfunction when PDE5 inhibitors fail. Brit Med J. 2006;332:589-592.

Montorsi F, Padma-Nathan H, Gilina S. Erectile function and assessments of erection hardness correlate positively with measures of emotional well-being, sexual satisfaction, and treatment satisfaction in men with erectile dysfunction treated with sildenafil citrate (Viagra). Urology. 2006;68:26-37.

Nonsurgical management of erectile dysfunction (ED). American Urological Association Foundation website. Available at: http://www.urologyhealth.org/adult/index.cfm?cat=11&topic=174 . Accessed August 8, 2010.

Sivalingam S, Hashim H, Schwaibold H. An overview of the diagnosis and treatment of erectile dysfunction. Drugs. 2006;66:2339-2355. Webber R. Erectile dysfunction. Clinical Evidence. 2005;13:1120-1127.