ED drugs are not sold over the counter, and men need a doctor’s prescription to obtain them.
It’s important for men to see a doctor when they start having trouble with erections.
What Is Erectile Dysfunction cenforce professional 100 ( Updated 6/2018. Erectile Dysfunction (Impotence) ( Updated 8/26/2020. National Institute of Diabetes and Digestive and Kidney Diseases (U.S.) Definition & Facts for Erectile Dysfunction ( Updated 7/2017. At Cleveland Clinic, we offer specialty care that’s focused on you. When seeing a urologist for erectile dysfunction (ED), many men ask about oral medications (pills that can be taken by mouth).
These drugs have been a major force in erectile dysfunction treatment for over two decades. Sildenafil (brand name Viagra®) was the first to be approved by the U.S. Food and Drug Administration (FDA) in 1998. Tadalafil (Cialis®) and vardenafil (Levitra®) followed; both drugs were approved in 2003. The FDA approved the fourth ED drug, avanafil (Stendra®) in 2012. ED can be a sign of health conditions like diabetes and heart disease. If these conditions are found, they can be treated along with the ED.
| Innovation | Description | Potential Benefits | Current Status |
|---|---|---|---|
| Soluble Film Formulations | Medications in dissolvable film strips | Faster onset, easier administration | In development |
| Combination Therapies | Using PDE5 inhibitors with other agents | Improved efficacy in refractory cases | Clinical trials ongoing |
| Gene Therapy | Experimental approach targeting underlying causes | Potential long-term cure | Early research stage |
| Nanoparticle Delivery Systems | Enhanced targeted drug delivery | Reduced side effects, increased effectiveness | Preclinical studies |
ED drugs don’t increase sexual desire.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Levitra Generic | 60mg | 270 + 10 Pills | 714.53€ 680.50€ | |
| Viagra Generic | 200mg | 30 + 2 Pills | 83.07€ 79.11€ | |
| Viagra Generic | 100mg | 360 + 10 Pills | 330.21€ 314.49€ | |
| Cialis Generic | 60mg | 180 + 10 Pills | 313.11€ 298.20€ | |
| Cialis Professional | 40mg | 120 + 4 Pills | 436.68€ 415.89€ | |
| Kamagra Soft Tabs | 100 mg | 32 Pills | 120.11€ 114.39€ | |
| Levitra Original | 20mg | 4 Pills | 45.87€ 43.69€ | |
| Super Kamagra | 160 mg | 8 Pills | 69.23€ 65.93€ | |
| Cialis Generic | 60mg | 20 Pills | 65.61€ 62.49€ | |
| Viagra Super Active | 100mg | 20 + 4 Pills | 48.05€ 45.76€ | |
| Levitra Generic | 20mg | 180 + 10 Pills | 293.10€ 279.14€ | |
| Viagra Generic | 50mg | 360 + 10 Pills | 225.33€ 214.60€ | |
| Levitra Original | 20mg | 34 + 2 Pills | 188.51€ 179.53€ | |
| Levitra Original | 20mg | 64 + 4 Pills | 298.45€ 284.24€ | |
| Cialis Professional | 40mg | 90 + 2 Pills | 348.59€ 331.99€ | |
| Viagra Generic | 25mg | 20 Pills | 37.74€ 35.94€ | |
| Levitra Soft Tabs | 20mg | 360 + 20 Pills | 682.21€ 649.72€ |
ED drugs allow blood to flow into the penis more easily to create an erection, but they do not affect sexual desire.
| Age Group | Expected Efficacy | Safety Considerations | Notes |
|---|---|---|---|
| 40-50 years | High | Generally safe, monitor comorbidities | Regular health check, dose adjustments possible |
| 51-65 years | Moderate to high | Increased risk of cardiovascular issues | Screening recommended before therapy |
| Over 65 years | Variable | Higher likelihood of side effects | Careful evaluation, start with lower doses |
Men need to have the drive for sexual activity as well as sexual stimulation for the drugs to work. ED drugs don’t prevent pregnancy or lower risk for sexually transmitted infections. Couples still need to use contraceptives and follow safe sex practices, like using condoms and dental dams. ED drugs have some side effects in common.
Testosterone replacement therapy starts to work within four weeks. A penile implant is a procedure in which a surgeon places a device into your penis to make it hard. The device doesn’t affect sensation, peeing or orgasm. ED will not likely go away on its own without changes to your lifestyle or some kind of treatment. The outlook for ED is good and it’s a very treatable condition.
Though there aren’t cures for some causes of ED, many treatment options can help you get and maintain an erection hard enough for sexual intercourse. Certain lifestyle changes can help lower your risk of developing erectile dysfunction, including: Being more physically active, especially doing cardiovascular exercises like running, jogging or bicycling. Eating healthy foods with low saturated fats, such as fruits, vegetables and whole grains. Talk to a primary care physician or a urologist if you suspect you have erectile dysfunction. They can help diagnose ED, identify its cause and recommend the best treatment option for you.
A urologist is a healthcare provider who specializes in diagnosing and treating conditions that affect your reproductive system and urinary system. Go to your nearest emergency room if you’re taking medication for erectile dysfunction and have a painful erection that lasts longer than two to four hours. This may be a sign of priapism, which can cause permanent damage to your penis without treatment. Is it normal to have erectile dysfunction? How do you know I have erectile dysfunction? The 4 ED drugs do share some mild side effects, such as headache vardenafil oral and flushing.
Your partner will feel supported if you have accurate, up-to-date information on erectile dysfunction and its treatment options. Offer to go with your partner to their appointments. You can help your partner ask questions, take notes and relay information to a healthcare provider that can help them in making a diagnosis. Respect their privacy if they prefer to see a provider alone. Sexual intercourse isn’t the only way to increase intimacy between partners.
You can show your partner you care through physical contact such as holding hands or back rubs, spending time with them, kissing, writing notes, being patient and being a good listener. Erectile dysfunction (ED) is common, especially as you get older. It can cause embarrassment, low self-esteem and other more serious psychological conditions. But you shouldn’t feel ashamed or embarrassed to have ED. It may be your body’s way of telling you that something isn’t right.
It’s important to have an open conversation with a healthcare provider about your symptoms and how they affect your quality of life. They can diagnose ED, determine its cause and recommend the most appropriate treatment for you. Sign up for our Health Essentials emails for expert guidance on nutrition, fitness, sleep, skin care and more. Learn more about the Health Library and our editorial process. Cleveland Clinic’s health articles are based on evidence-backed information and review by medical professionals to ensure accuracy, reliability and up-to-date clinical standards. They also have some more serious side effects in common. If any of these symptoms occur, patients should seek emergency medical care: An erection lasting longer than 4 hours Swelling of the face, mouth, throat, hands, feet, or legs However, other side effects may be different for each drug: Numbness or tingling in the limbs, hands, or feet Changes in color vision, such as a blue tinge or trouble seeing the difference between blue and green Pain in the muscles, back, arms, legs, or stomach Changes in color vision, such as a blue tinge or trouble seeing the difference between blue and green Changes in color vision, such as a blue tinge or trouble seeing the difference between blue and green Patients should note that some side effects are more common with specific drugs. For example, men who take sildenafil may be more likely to experience a blue/green tinge to their vision than men who take tadalafil. And men who take tadalafil may be more likely to have muscle pain (myalgia) than men who take sildenafil. A man’s doctor can best advise on the likelihood of certain side effects and how they might affect a man’s personal situation. Men who take drugs containing nitrates should not take ED medications. This combination can cause a dangerous drop in blood pressure. Some examples of nitrates are nitroglycerin, isosorbide mononitrate, and isosorbide dinitrate. Nitrates are prescribed to prevent or treat chest pain related to heart disease.
All of the drugs are classified as phosphodiesterase type 5 (PDE5) inhibitors, and they work in similar ways. Many men find them effective and convenient. Still, they’re not right for every man, and there are differences among them that men should be aware of. For a man to get an erection, muscles in the penis need to relax so that blood can flow in during sexual stimulation. As the penis fills with blood, it becomes firm and erect. ED drugs are also not appropriate for men with low blood pressure, uncontrolled high blood pressure, and severe liver disease.
| Contraindication | Explanation | Usually applies to | Alternative approach |
|---|---|---|---|
| Use of Nitrates | Can cause severe hypotension | Heart patients on nitrate therapy | Psychological counseling, vacuum devices |
| Severe Liver Impairment | Reduced drug metabolism increases risk | Patients with hepatic failure | Dose adjustment, alternative therapies |
| Severe Cardiac Conditions | Risk of heart attack or arrhythmias | Unstable angina, recent MI | Medical evaluation, lifestyle changes |
| Hypotension | May worsen low blood pressure | Systolic BP <90 mm Hg | Non-pharmacological options |
Men who are on dialysis for kidney disease should also not take ED drugs. Men who take alpha blockers for enlarged prostate symptoms may need to space out their doses of these drugs and ED drugs to avoid an interaction. Men should always tell their doctor about any other medications, street drugs, herbs, or supplements they use. These products may interact with ED drugs. In addition, men should let their doctor know if they typically eat grapefruit or drink grapefruit juice, as this combination may cause an interaction as well. Sildenafil, avanafil, and vardenafil are taken on an as-needed basis, meaning a man takes them before he wishes to have an erection. Tadalafil may also be taken this way, but some prescriptions call for it to be taken every day.
Men should be sure to take their medicine as directed. The time between taking the drug and getting an erection may vary.
A chemical called nitric oxide, which is naturally produced by the body, helps this process along. The four oral ED drugs help nitric oxide do its job so that the penis muscles can relax and let the blood in. ED drugs do not create an erection automatically, however. A man still needs sexual stimulation to achieve an erection. In the United States, they are available by prescription only. ED drugs do not produce an erection immediately.
It takes some time for the drug to work, and these time frames vary by medication.
For example, men usually get an erection about 30 to 60 minutes after taking sildenafil or vardenafil. Men who take tadalafil as needed (not daily) may need to wait 30 to 45 minutes. For those who take avanafil, the wait may be 15 to 30 minutes.
What ED treatment option do you recommend? Can erectile dysfunction cause other conditions that affect my sexual health? Can you recommend a support group for people who have erectile dysfunction? Am I a candidate for a penile implant procedure? Erectile dysfunction can cause you to feel many different emotions.
You may feel embarrassed, frustrated, guilty, ashamed, angry or “less than.” This can lead to more serious long-term emotions, like anxiety and depression. But you don’t have to live with these feelings. ED is common, and it doesn’t reflect your worth as a person. Erectile dysfunction is a sensitive topic for many people. The following tips can help you support your partner if they have erectile dysfunction: Tell your partner you care about their feelings and well-being.
Find appropriate times to talk to your partner that won’t make them feel vulnerable. Remind your partner that they’re 100 sex tablet not alone. ED is common, and treatment is available. Therapists and support groups can help your partner process their feelings. Focus on the benefits of regular exercise, healthy foods and cutting back on substances that may cause ED. ED medications also vary in how long they are effective. For example, once sildenafil or vardenafil take effect, a man might be able to get an erection for four to five hours. For avanafil users, the time frame is about six to twelve hours. Tadalafil has the longest effective time—usually 24 to 36 hours for as- needed users. Men who take tadalafil daily should be able to get an erection at any time. When prescribing ED drugs, doctors take many factors into account.