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Highlights
- FDA-approved PDE5 inhibitors like Viagra, Cialis, Stendra, and Levitra enhance blood flow for better erections.
- Medications vary in onset, duration, and potential side effects.
- Efficacy rates range from 74-82 percent for each medication, which may make it difficult for some men to choose.
- Consider factors beyond efficacy, including cost, ease of use, and duration of effects, and consult with your doctor for personalized guidance on ED treatment.
If you have erectile dysfunction (ED), you have many treatment options. The best choice for you will depend on your health history and personal preference. Learn the ins and outs of each medication so you can get your sex life back on track without delay.
Overview of ED Medications
The most common popular medications used to treat ED are known as PDE5 inhibitors. They don’t influence your desire to have sex, but they do make it easier to get and keep an erection.
The Food and Drug Administration (FDA) has approved the following PDE5 inhibitors to safely and effectively treat ED:
- Viagra (sildenafil)
- Cialis (tadalafil)
- Stendra (Avanafil)
- Levitra (vardenafil)
These drugs work by enhancing blood flow to the penis, extending the time you can maintain an erection for a better sexual experience. While all PDE5 inhibitors work in the same way, each oral medication for ED has a slightly different makeup. These differences affect how quickly they work, how long their effects last, and potential side effects.
To find the best fit, consult with a healthcare professional, who will consider your personal health history and possible interactions with other medications you’re taking. This personalized approach will ensure an effective and safe solution for addressing ED.
Viagra (sildenafil)
Viagra, the first FDA-approved medication for ED, is often the go-to solution for ED symptoms. It’s fast-acting and can kick in within 30 minutes. It reaches peak effectiveness between 45 and 60 minutes and can last up to eight hours.
For best results, take Viagra on an empty stomach, preferably an hour before engaging in sexual activity. Experts also recommend choosing a light, low-fat meal and avoiding alcohol before taking Viagra.
Cialis (tadalafil)
Cialis has remarkable longevity, lasting up to an impressive 36 hours. It has a quick onset — as little as 30 minutes — and reaches peak effectiveness within two hours. Depending on your preference and prescription, you can take Cialis as needed or as part of a daily regimen.
Unlike some ED medications, food doesn’t affect its performance, which provides users with more flexibility for timing their dose. Cialis is also FDA-approved for treating benign prostatic hyperplasia (BPH), making it a great choice if you’re suffering from BPH-related ED.
Stendra (avanafil)
Stendra works similarly to Viagra, Cialis, and Levitra. It has a speedier onset, with the standard dose taking effect in as little as 15 minutes. It typically lasts four to five hours but may last longer for men with mild to moderate ED.
Providers recommend taking Stendra about 30 minutes before intimacy. You can take it with or without food, so it can be used as a rapid, on-demand solution.
Vardenafil
Vardenafil, once sold as Levitra and Staxyn but now discontinued in the brand-name form, stands out as a potent generic option for treating ED. Comparable in effectiveness to Viagra, vardenafil kicks into action faster, with a potential onset as quick as 15 minutes. It typically lasts four to five hours, but may last longer for men with mild to moderate ED.
Vardenafil is taken orally as a pill that you swallow, or as a tablet that dissolves on your tongue. Like Viagra, you should only take it on an empty stomach. Providers recommend waiting at least one to two hours after eating or opting for a light, low-fat meal when eating before taking vardenafil.
Comparing Efficacy of ED Medications
In the context of ED medications, “efficacy” refers to the ability of a treatment to produce the desired results in overcoming ED. PDE5 inhibitors are considered first-line treatments due to their high safety ratings and effectiveness.
Efficacy Rates
| Medication | |
|---|---|
| Viagra (sildenafil) | 74-82% |
| Vardenafil (formerly Levitra) | 75-81% |
| Cialis (tadalafil) | 81% |
| Cialis for Daily Use (low-dose tadalafil) | 81% |
| Stendra (avanafil) | 75-81% |
When comparing the efficacy of different ED medications, all PDE5 inhibitors show similar effectiveness in treating ED. Sildenafil has an efficacy rate ranging from 74-82 percent, while vardenafil demonstrates a 75-81 percent success rate. The efficacy rate of tadalafil is the same for both on-demand and daily versions, at 81 percent.
While these rates don’t vary widely, if you are especially sensitive to ED medications, the small difference between the low end of the range for Viagra or vardenafil and Cialis may be enough to make a real difference in how they work for you.
Systematic reviews reveal that ongoing research consistently demonstrates the safety and efficacy of these drugs. However, additional high-quality research directly comparing the safety and efficacy of different PDE5 inhibitors is needed to determine the ideal dosage and formulation for most users.
A meta-analysis comparing sildenafil and tadalafil suggests that patients and their partners prefer tadalafil over sildenafil, indicating it may be a more favorable choice for ED treatment. The authors cited improved psychological outcomes as the key difference among participants. This highlights the fact that it’s important to consider efficacy, patient satisfaction, and personal patient preferences when choosing an ED medication.
Factors Influencing the Effectiveness of ED Medications
Efficacy rates aren’t the only thing that determine whether or not an ED medication will work for you. Individual factors, such as your lifestyle and health status, as well as precise dosage and timing, also play an important role in getting the best results.
Individual Factors
The effectiveness of ED medications can vary based on individual factors such as age, health status, and lifestyle:
- Age. Generally, older individuals may experience a slower metabolism affecting drug absorption.
- Health status. Health conditions like diabetes or cardiovascular issues can impact blood flow, which can reduce medication effectiveness.
- Lifestyle. Lifestyle factors, including diet and alcohol or energy drink consumption, may also play a role, as high-fat meals or excessive alcohol can hinder the quick absorption of ED medications.
Dosage and Timing
The effectiveness of ED medications is influenced by factors like dose and timing. Finding the right balance ensures optimal results and a satisfying sexual experience.
- Dose. The right dose is essential, as too little may be ineffective, while too much can lead to side effects.
- Timing before sex. Timing matters too. Most medications need to be taken about 30 minutes before sexual activity.
- Timing after meals. Taking ED medication on an empty stomach enhances absorption, while high-fat meals can delay effectiveness.
Beyond Efficacy
When selecting an ED medication, consider factors beyond efficacy and individual health, such as personal preferences. Talk to your doctor about your preferences regarding cost, ease of use, duration of the drug’s effects, and potential side effects.
Explore brand-name and generic versions of medications available through online pharmacies, and take advantage of telehealth services for convenient consultations and prescription refills.
Side Effects and Safety Concerns
PDE5 inhibitors are proven safe and effective for most men, but like all medications, they come with potential side effects and drug interactions.
Common Side Effects
Side effects of ED medications are typically mild and temporary. However, rare but serious side effects can occur. Tell your doctor right away if you experience any side effects while taking an ED medication.
Common side effects include:
- Back pain
- Dizziness
- Facial flushing
- Headaches
- Nasal congestion or runny nose
- Upset stomach
- Blue vision and other visual side effects
Rare but serious side effects include:
- Hearing loss
- Priapism (an erection that doesn’t go away on its own)
- Severe drop in blood pressure
- Vision loss
When to Avoid Certain ED Medications
Certain medication interactions and health conditions can increase your risk of serious side effects while taking ED medications. Talk to your doctor about your current health conditions and about all the medications and supplements you’re taking before starting a new ED medication.
You may need to avoid ED medications if you have take:
- Alpha-blockers
- Nitrate medications
- Medications that block the enzyme CYP3A4, such as:
- Ketoconazole
- Itraconazole
- Clarithromycin
- Ritonavir
- Cobicistat
- Verapamil
- Diltiazem
- Erythromycin
- Amiodarone
While not a medication, grapefruit also acts as a CYP3A4 inhibitor, so don’t eat or drink it with your ED medication.
You may also need to avoid ED medications if you have one of the following health conditions:
- Advanced or severe liver disease
- An inherited eye disease affecting the retina
- Kidney disease
- Ongoing or recent heart or blood vessel problems
- Very low blood pressure or uncontrolled high blood pressure
Avoid “Herbal” Viagra
Stay away from products marketed as “herbal Viagra.” The FDA warns that these products are often ineffective, and some may contain harmful substances. For a safer and more effective approach to treating ED, stick to FDA-approved medications under the guidance of a licensed healthcare provider.
Talk to a Provider
Never take an ED medication without consulting a healthcare provider. Signs of ED can signal other serious health issues, like heart disease. Your doctor can explore the potential cause of your ED, discuss your health history and current medication list, and offer personalized professional guidance to help you find the best treatment for your needs.
Conclusion
ED medications like Viagra, Cialis, Stendra, and vardenafil are safe and effective solutions for treating ED. They’re all FDA-approved and work by boosting blood flow to the penis.
Efficacy rates are comparable across medications, ranging from 74 to 82 percent. Additional research is needed to compare various medications head-to-head.
Each of these ED medications has unique features that make them appealing to different patients. For example, some kick in fast, while others last longer. Finding the right one depends on your health and personal preferences.
Always consult with a healthcare provider for personalized guidance on ED treatment. And be sure you are buying your erectile dysfunction medications from a legitimate source you can trust, like eDrugstore.
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This information is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication.
Shelby is a public health professional with research and field experience in sexual and reproductive health. She holds a Master of Public Health (MPH) and is a Certified Health Education Specialist (CHES).