Selectivity is the ability of the drug to attach to the specific enzyme PDE 5 found in penile tissues. Vardenafil (Levitra) is more selective than sildenafil and tadalafil (Cialis) to PDE5, which again means a lower dose is needed with potentially less side effects. Tadalafil is very specific for PDE5 and is also very specific for the enzyme PDE11. Unfortunately, we don’t know much about PDE11, which is found in the heart, in the pituitary gland in the brain and in the testicles. Pharmacokinetics, half-life, is how long the medication stay s in the blood.
Some doctors prescribed it to their patients in combination with other treatments for erectile dysfunction. Even then it was not a recommended treatment and is still not today. Studies have not proven that it works. Men with high blood pressure especially shouldn't take either the prescription form or the herb. Currently, no herb blue sex pills or supplements have been proven to help with erectile dysfunction.
Herbs and supplements that some believe are helpful for erection problems include: Before trying any alternative treatment, be sure to ask your doctor about it. Herbs and supplements, whether they help with erections or not, have real effects on the body. They could cause dangerous reactions with other medicines you might be taking. The most common sexual dysfunctions in men include lack of interest, premature ejaculation and erectile dysfunction. The latter affects 52% of men between the ages of 40 and 70, including mild, moderate and complete forms of ED. This means that vardenafil (Levitra) should act longer than sildenafil (Viagra) but the clinical significance is not known. Tadalafil (Cialis) has the longest half-life and allows you to take the medication and not relate the sexual activity to the immediate use of the medication.
| Drug Name | Active Ingredient | Typical Dose | Onset Time | Duration of Action | Common Uses | Side Effects |
|---|---|---|---|---|---|---|
| Viagra | Sildenafil | 50 mg | 30-60 min | 4-6 hours | Erectile dysfunction | Headache, flushing |
| Cialis | Tadalafil | 20 mg | 30 min | Up to 36 hours | ED, BPH | Muscle pain, nausea |
| Levitra | Vardenafil | 10 mg | 25-60 min | 4-5 hours | ED | Nasal congestion |
| Stendra (Avanafil) | Avanafil | 100 mg | 15 min | Up to 6 hours | Rapid onset ED | Dizziness |
The drawback is if you need nitrates after using tadalafil (Cialis), this medication lasts a long time in your blood stream and may place you at a higher risk. Younger people might do well treated with tadalafil, (Cialis) while older people with other health issues might be better off using sildenafil (Viagra) or vardenafil (Levitra) but more data are needed.
The side effects of vardenafil (Levitra) are potentially less than sildenafil (Viagra), but more data are needed. In a recent study on men with erectile dysfunction and diabetes, vardenafil (Levitra) improved their erectile dysfunction. Tadalafil (Cialis) is as effective as sildenafil (Viagra), and vardenafil (Levitra) with similar side effects except for back pain that occurs occasionally with tadalafil, probably because of the long half-life.
Many people stop taking drugs because they are experiencing side effects, they no longer have a partner, or they are worried about safety. Sexual activity is not a major contributor to the risk of a heart attack.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Viagra Oral Jelly | 100mg | 220 + 18 Sachets | 562.28€ 535.50€ | |
| Cialis Professional | 40mg | 20 Pills | 110.24€ 104.99€ | |
| Levitra Generic | 40mg | 10 Pills | 41.37€ 39.40€ | |
| Levitra Generic | 60mg | 270 + 10 Pills | 714.53€ 680.50€ | |
| Cialis Professional | 20mg | 20 Pills | 78.33€ 74.60€ | |
| Cialis Original | 20mg | 8 Pills | 61.70€ 58.76€ | |
| Viagra Generic | 100mg | 30 + 4 Pills | 60.91€ 58.01€ | |
| Kamagra 100 mg | 100 mg | 60 + 4 Pills | 201.34€ 191.75€ | |
| Viagra Original | 100mg | 4 Pills | 40.94€ 38.99€ | |
| Cialis Black | 80mg | 10 Pills | 43.27€ 41.21€ | |
| Kamagra | 100mg | 60 + 4 Pills | 201.34€ 191.75€ | |
| Cialis Generic | 20mg | 20 Pills | 54.72€ 52.11€ | |
| Levitra Generic | 60mg | 60 + 4 Pills | 198.85€ 189.38€ | |
| Viagra Generic | 50mg | 180 + 8 Pills | 158.82€ 151.26€ | |
| Cialis Professional | 20mg | 90 + 2 Pills | 241.49€ 229.99€ |
Sexual activity, with or without sildenafil (Viagra) increases the chance of an MI during sexual activity by only 0.1%.
The device stores fluid in a reservoir under the skin of your abdomen or scrotum. You press on the reservoir to pump fluid into cylinders in the penis. A valve drains the fluid out of the penis when you're done. An erection you get with an implant may be slightly shorter than a natural erection. The device itself may malfunction, in which case it would require another surgery to remove or replace it.
Getting a penis implant is a big decision. Once you have it, you may not be able to try other treatments. That's because the implant replaces the chambers in the penis that fill with blood for a natural erection. Before Viagra hit the market in 1998, there was no proven treatment for erectile dysfunction that men could take in pill form. Doctors were interested in yohimbe, an herb that increases heart rate and blood pressure. If pills fail, there are vacuum devices, Muse, injections, bypass surgery and implants. The patient making a presentation has had penile bypass surgery. In addition he takes testosterone and sildenafil as needed.
| Country | Approved Brands | Over-the-counter Availability | Prescription Needed | Market Share (%) (approximate) | Notes |
|---|---|---|---|---|---|
| USA | Viagra, Cialis, Levitra | No | Yes | 70% | Widely prescribed, high brand recognition |
| Europe | Viagra, Cialis, Levitra | No | Yes | 65% | Various generics available |
| India | Generic versions available | Yes | Varies | 40% | Increased OTC options |
| Australia | Viagra, Cialis | No | Yes | 55% | Strict prescription controls |
This is a classic example of why people with ED need complete care: a psychological exam, history and physical exam, and diagnostic studies with long term follow-up care. Patients with ED should not just be prescribed fildena professional 100 sildenafil (Viagra) and then be lost to follow-up. What happens in the bedroom typically stays in the bedroom, with one major exception being when things aren't going well in there. In terms of sexual health, erectile dysfunction (ED) is the most common problem men report to their doctor. Most often, men are prescribed an oral medication such as 'the blue pill' or one of its closely related alternatives. But treating ED doesn't have to begin and end with oral medications — which can come with unwanted side effects. In addition, it's unsafe for some men to take these medications, including those who have severe heart disease/heart failure or low blood pressure, as well as those who take nitrate drugs to treat chest pain. And, finally, these medications often fail to work in some men altogether.
Organic or physical causes for sexual dysfunction in men include vascular, hormonal and neurologic factors. Concerning vascular causes, the risk factors for atherosclerosis (including smoking, high blood pressure, diabetes (diabetics do not respond well to pills like sildenafil (Viagra)) and high cholesterol are ALSO risk factors for erectile dysfunction. Since a straddle injury or use of a narrow saddle can obstruct and impair arteries to the penis, bicycle riding is also considered a risk factor for erectile dysfunction. Little attention has been paid to endocrine factors. Testosterone modulates desire, arousal and orgasmic function.
Concerning the orgasmic response, testosterone modulates the integrity of genital sensory receptors. Concerning the arousal response, decreased testosterone blood levels can influence the efficacy of sildenafil (Viagra). If the sildenafil response is not reliably improving erection, the physician should first check if the patient is taking the pill correctly. The physician should also check the patient’s testosterone level. One investigator in Italy gave testosterone to patients with low testosterone who did not respond to sildenafil (Viagra). Fortunately, there are several other ways to treat ED. For men who don't want to take a pill or for those who simply can't, here are a few other options. Often called a penile pump, a VED works by manually pulling blood into your penis using suction. Once the erection is formed, a tension ring is slipped to the base of the penis, which helps maintain an erection for about 30 minutes.
The suction creates a vacuum, so blood rushes in to fill the spaces in the spongy tissue of the penis, creating an erection. The erection lasts only as long as the blood stays in, so you slide the band down around the base of your penis, trapping the blood. It's safe to keep the band on for up to 30 minutes. These devices are available without a prescription, but it's important to buy one from a reputable manufacturer. The device must include a safety control so you can't harm your penis with too much suction.
Most men would prefer to avoid surgery, but for some men with erection problems, penis implants are another option for regaining sexual function. There are two kinds of penis implants. One kind is a rigid but flexible rod implanted in the penis. You bend it up for sex or down for daily living. The other kind is an inflatable implant. While many men do not love the concept of suction and ring compression to get and maintain erections, it is a reliable option that works for many couples to restore erection function without medication. Side effects of using a penile pump include: The penis feeling cold to the touch when used for an extended period ED is commonly caused by temporary stress or chronic cardiovascular conditions that reduce blood flow to the penis.
When daily testosterone was given, subsequent sildenafil (Viagra) use resulted in IIEF (the International Index of Erectile Function questionnaire used to determine erectile function) scores improving significantly. Other risk factors for erectile dysfunction include neurologic problems (multiple sclerosis, stroke), depression and medications for treating diabetes, hypertension, heart disease and depression. There are many oral therapies for erectile dysfunction, but the only approved medication in the US is the PDE 5 enzyme inhibitor sildenafil (Viagra). Unapproved therapies, some of which are available in the US and some elsewhere, some of which have data to prove efficacy and some not, include tadalafil (Cialis), vardenafil (Levitra), yohimbine, phentolamine, trazodone, apomorphine and neutraceuticals. PDE5 inhibitors act to relax penile erectile tissues with sexual stimulation thus enhancing your ability to get an erection.
Sildenafil (Viagra) is effective for all sorts of erectile dysfunction erectile dysfunction treatment in 69% of people. Why is there a need for another pill? In some cases the erection is not hard enough, sometimes sildenafil (Viagra) just doesn’t work. Structurally vardenafil (Levitra) is similar to sildenafil, while tadalafil (Cialis) is very different. Vardenafil (Levitra) is almost 10 times more biochemically potent than sildenafil, therefore a lower dose is needed to facilitate the penile erection, potentially resulting in less side effects. But, low testosterone can contribute to issues with forming and maintaining an erection.
Your doctor can help you understand if your testosterone levels are low and whether starting testosterone treatment may help alleviate your ED symptoms. Though testosterone replacement is not recommended as a first-line, single treatment for ED, your doctor may recommend it or try it in combination with another ED treatment option, depending on your individual symptom profile.
Intraurethral therapy involves inserting a small drug pellet into the tip of the penis. With this therapy, it only takes about 10 minutes for an erection to form — which can then last anywhere from 30 to 60 minutes.
| Drug | Contraindications | Precautions | Interactions | Special Notes |
|---|---|---|---|---|
| Sildenafil | Nitrate use, certain cardiac conditions | Hypotension risk | Nitrates, alpha-blockers | Use with caution in heart disease |
| Tadalafil | Nitrate use, eye disorders | Long duration may cause priapism | Same as sildenafil, antihypertensives | Dose adjustment needed |
| Vardenafil | Nitrate use | Allergies to PDE5 inhibitors | Similar to sildenafil | Avoid high-fat meals |
| Avanafil | Nitrate use | Liver impairment | CYP3A4 inhibitors | Fast onset, fewer side effects |