Erectile dysfunction, or ED, is a condition commonly treated using oral medications. There are currently five oral drugs prescribed by doctors to help men achieve and maintain an erection. These all work similarly in that they increase blood flow to the penis when a man is sexually aroused.
The drugs increase the production of nitric oxide, a substance that relaxes and opens the blood vessels in the penile area and promotes blood flow. Erections only happen when the man is sexually stimulated.
The chance of experiencing ED increases with age; however, age is not the only factor. Many older gentlemen continue to enjoy great sex and experience little or no decrease in performance. There is some correlation between low sex drive and ED. Obesity, heart conditions, diabetes, other medical conditions as well as depression and other emotional/psychological conditions also contribute to ED.
Which ED medication will your doctor prescribe?
It depends on your personal needs, cardiovascular health and medical history (specifically, any possible negative interactions with other medicines you take, including herbal or non-prescription medicines and dietary supplements).
Which one will your doctor prescribe first? The most popular are Viagra, Levitra and Cialis. This is due in part to their fast-acting effectiveness and ease of use, as well as a longer history on the market.
The five FDA-approved ED medications:
● Viagra (sildenafil)
● Levitra (vardenafil)
● Cialis (tadafil)
● Staxyn (vardenafil) - orally dissolving tablet
● Stendra (avanafil)
Although these medications all increase blood flow to the penis, there are differences. The chemical makeup of these drugs varies slightly and this influences how quickly and how long the drugs can be expected to work. Potential side effects also vary due to these differences - consult your doctor for a list of side effects when you are discussing which drug to choose. Common side effects can include headache, blurry vision, low blood pressure, upset stomach or hot flashes.
How much should you take of each?
The dosages suggested below are average dosages. Doctors will usually recommend starting with a low dose and if that is not effective, moving up slowly to a higher one. It is always a good idea to take the smallest effective amount of any drug to lessen the chance of side effects.
Dosages and Frequency
Some ED medications must be taken on an empty stomach and within a certain time period before sex to be effective. Please note that these are suggested doses only - you must consult your doctor for an accurate dosage for your specific needs!
● Viagra: 50 mg on an empty stomach, 30-60 minutes before sex, no more than once a day
● Levitra: 10 mg on an empty stomach, 30-60 minutes before sex, no more than once a day
● Cialis daily: 5-20 mg with or without food, approximately 15 minutes before sex, once a day
● Cialis 36 hour: 5-20 mg with or without food, 30 minutes before sex, once in 36 hours
● Staxyn: 10 mg with or without food, 1 hour before sex, no more than once a day
● Stendra: 50 mg on an empty stomach, 15 minutes before sex, no more than once a day
Which one works the best?
All of these ED medications are effective, but they will not work on all sexual dysfunctions since blood flow is not the only factor in a man’s ability to achieve and maintain an erection - for example, low libido is not treated using these medicines.
It’s important to note that if an erection cannot be achieved and maintained using these drugs, switching to another oral ED medication will probably not work since they use the same mechanism; however, adjusting your dosage according to the advice of your doctor may achieve the desired result.
How Quickly the Medications Work
● Viagra: 30 minutes
● Levitra: 30 minutes
● Cialis: 15 minutes
● Staxyn: 1 hour
● Stendra: 15 minutes
● Viagra: 4 hours
● Levitra: 5 hours
● Cialis: up to 36 hours (Cialis comes in two forms; a daily tablet and a 36-hour tablet)
● Staxyn: 8 hours
● Stendra: 6 hours
Common precautions when using ED medications
● Do not exceed the prescribed dose and take them as directed.
● If you have a history of heart attack, stroke or take alpha blockers or nitroglycrerin, do not use any of the above ED medications.
● Do not take oral ED medications if you have experienced an allergic reaction or if you will be undergoing surgery.
● Stop taking the medication and consult your doctor immediately if you have any adverse reactions such as a painful erection, rash, chest pain, decreased vision, fainting or prolonged erection (4+ hours)
While not a cure for low libido, ED medications can enhance sexual enjoyment by helping men achieve and maintain an erection. Consult with your doctor about your needs, health and medical history to make the best and safest choice for you.