Erectile dysfunction is the inability to get and keep an erection long enough to have sexual intercourse. If erectile dysfunction is an on-going issue, you should consult with your doctor to find a suitable solution.

What Medications Are Available?

The medications listed below will relax your muscles and increase blood to your penis: 

• Avanafil (Steindra)
• Sildenafil (Viagra) 
• Tadalafil (Cialis) 
• Vardenafil (Levitra, Staxyn)

How are they different?  

Each of these oral medications has a slightly different chemical ingredient which can affect the way it works. For example, how quickly the medication starts working, how long it lasts, and other potential side effects. Your physician, before prescribing, will consider these differences along with the details of your condition and possible drug interactions.

Sildenafil (Viagra)

Sildenafil should be taken on an empty stomach for it to have the quickest onset of action – usually about an hour before sex. It is effective for four or five hours or more if you have mild to moderate erectile dysfunction.

Vardenafil (Levitra , Staxyn)

This medication is also most effective when taken one hour before intercourse. It can be taken with or without food, but high fat meals can slow down absorption. This medication is also effective for mild to moderate ED. Vardenafil tends to last a little longer than sildenafil.

The newer form of this medication (Staxyn) which dissolves under the tongue may work faster compared to swallowing a pill. 

Tadalafil (Cialis)

Tadalafil is the most popular ED medication available (sildenafil is a close second). Tadalafil can be taken with or without food. It can take a little longer to have an effect – up to two hours. However, this medication is effective for up to 36 hours. This medication is often taken at as a smaller daily dose but can also be taken as a larger dose on an as needed basis.

Avanafil (Stendra)

Stendra is the latest addition to the market and can be taken with or without food, 30 minutes before sexual intercourse. This medication is the fastest working of all the ED medications available currently. It can last up to 6 hours.

Generic versions of sildenafil, tadalafil, and vardenafil are available at a cost savings compared to branded medications. Many prefer the branded products even though the active ingredients are the same.

How are these medications similar?

They are all taken by mouth (orally) and usually in a tablet form. They all work by enhancing the effects of nitric oxide, a natural chemical your body produces that relaxes muscles in the penis. This muscle relaxation allows blood flow to increase and allows you to get an erection in response to sexual stimulation.

Which ED medication can I use with less to no planning?

Stendra or daily use of Cialis would be the closest to an “on demand” erectile medication. The other medications do require a little planning.

Precautions to Take

You should not use erectile dysfunction medication if you are also on nitrates (i.e. nitroglycerin) for chest pain, as the combination could lead to dangerously low blood pressure. Before taking erectile dysfunction medication, you should tell your doctor:

• About any allergies you may have to medications
• About any prescription drugs you are currently taking
• If you have a surgery scheduled 
• If you currently take alpha-blockers for blood pressure or prostate issue. 

You should always read and understand your prescription.

Side-Effects

While side-effects are uncommon, they can still happen and it is important that you know how to identify them. You may experience: 

• Headache
• Flushing
• Back pain 
• Nasal Congestion
• Hearing loss 
• Upset stomach or heartburn 
• vision problems,
• diarrhea
• dizziness
• rash

Warning: If you have an erection lasting up to four hours without any sexual excitement, you should seek medical attention.  A sustained erection lasting for longer than four hours can cause permanent damage if left untreated.

This information is provided to help you better understand this medical condition or process and may contain information about medication often used as part of a treatment plan prescribed by a doctor. It is not intended to be used as either a diagnosis or recommendation for treatment of your medical situation. If you are unwell, concerned about your physical or mental state, or are experiencing symptoms you should speak with your doctor or primary health care provider. If you are in medical distress, please contact emergency services (such as 911).