Medications

Medicines that can help produce an erection may be used to treat erection problems (erectile dysfunction) that are caused by blood vessel (vascular), hormonal, nervous system, or psychological problems. They also may be used along with counseling to treat erection problems that have psychological causes.

If erection problems could be caused by a prescribed medicine, it may be possible to change the dose or try another medicine. Do not change or stop taking any medicine without first talking with your health professional.

Medication Choices

There are a number of treatments for erection problems. But phosphodiesterase-5 inhibitors (PDE-5 inhibitors), such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra), are generally tried first because of the success rate, ease of use, and convenience of these medicines. If you have already tried one of these medicines and it has not worked for you, see your health professional.

Commonly used oral medicines include:

• Phosphodiesterase-5 inhibitors (PDE-5 inhibitors) such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra).

Sildenafil, sold as Viagra, Revatio and under various other trade names, is a drug used to treat erectile dysfunction and pulmonary arterial hypertension (PAH). It was developed and is being marketed by the pharmaceutical company Pfizer. It acts by inhibiting cGMP specific phosphodiesterase type 5 (PDE-5 inhibitors), an enzyme that regulates blood flow in the penis. Since becoming available in 1998, sildenafil has been the prime treatment for erectile dysfunction; its primary competitors on the market are tadalafil (Cialis) and vardenafil (Levitra). It is frequently called the 'blue pill'.

Tadalafil is a PDE5 inhibitor, currently marketed in pill form for treating erectile dysfunction (ED) under the name Cialis; it has recently been approved for the treatment of pulmonary arterial hypertension, and has been used for other conditions. It initially was developed by the biotechnology company ICOS, and then again developed and marketed world-wide by Lilly ICOS, LLC, the joint venture of ICOS Corporation and Eli Lilly and Company. Cialis tablets, in 5 mg, 10 mg, and 20 mg doses, are yellow, film-coated, and almond-shaped. The approved dose for pulmonary arterial hypertension is 40 mg, and will be marketed under the brand name Adcirca.

Vardenafil is a PDE5 inhibitor used for treating impotence (erectile dysfunction) that is sold under the trade name Levitra (Bayer AG, GSK, and SP).

Other medicines that may be used include:

* Injected medications.
* Intraurethral alprostadil (MUSE).

Hormones and other medicines may be prescribed for men who have low testosterone or high prolactin levels.

Consider the following when making your decision:

* PDE-5 inhibitors (such as sildenafil [Viagra], tadalafil Cialis , and vardenafil [Levitra]) may not be an option if you have heart disease that may require you to take nitroglycerin or other medications containing nitrates.
* If you and your partner have decided that sexual intercourse is an important part of your relationship, you may want to use PDE-5 inhibitors. About 80% of the men who use PDE-5 inhibitors have an erection and successfully have intercourse.