ED Meds

Some men with erectile dysfunction, or ED, find they can return to an active sex life by treating an underlying condition, such as high blood pressure or diabetes, or with counseling and lifestyle changes. But others find they may need medication to get and keep an erection. The FDA has approved several prescription drugs you take orally to treat ED.

What Medications Are Available?

All of these work by relaxing your muscles and boosting blood flow to your penis, making erections easier to get and maintain. They are:

avanafil (Stendra)
sildenafil (Viagra)
tadalafil (Cialis)
vardenafil (Levitra, Staxyn)

Caution: Do not use these ED medications if you take nitrates, such as nitroglycerin or a similar medicine, for chest pain. The combination can cause dangerously low blood pressure.

Are There Differences in Them?

These medications all work similarly to each other. However, there are subtle differences in how long they stay effective and how quickly they begin to work.

Levitra takes about 30 minutes to start working and the effects last a little longer than Viagra, about 5 hours.

Staxyn dissolves in your mouth. It contains the same active ingredient as Levitra and can begin working in about 15 minutes.

Viagra takes around 30 minutes to become effective and lasts about 4 hours. Cialis lasts much longer — up to 36 hours in some cases. Stendra can start doing its thing in as little as 15 minutes, and its effects last up to 6 hours.

Can I Make a Switch?

Yes. You may find that one works better for your schedule or that there are differences in the side effects for you. But these medications work the same basic way, so you’re likely to have similar results.

What Precautions Should I Take?

Again, do not use these ED medications if you take nitrates, such as nitroglycerin or a similar medicine, for chest pain. But other situations may make these medications unsafe as well. Before you take Viagra or one of the others, tell your doctor:

If you are allergic to any medications, including other ED medications
About any prescription or nonprescription medications you take, as well as any herbal and dietary supplements
If you are scheduled for surgery, even dental surgery
If you take alpha-blockers for blood pressure or prostate problems. These can lower your blood pressure when taken with ED pills.

Always follow the directions on your prescription label carefully. Also, make sure to ask your doctor or pharmacist to explain anything you don’t understand. Take these drugs exactly as directed.

Who Should Not Take These?

You should also avoid these medications if you have uncontrolled high or low blood pressure or if you get chest pain while having sex.

Any Side Effects?

Side effects are not common, but they can happen. You may get:

A headache
Upset stomach or heartburn
Feeling of warmth
Nasal congestion
Changes in vision (lights tinged with color, glare)
Back pain
Hearing loss

Warnings

You may need emergency treatment if you get an erection that lasts for more than 4 hours and happens without any sexual excitement. You may hear a doctor call it a “priapism.” Blood becomes trapped in the penis and can’t flow back out. It can lead to scarring and permanent ED if not treated.

Also, get emergency treatment with any of the following:

A rash
Painful erection
Fainting
Chest pain
Itching or burning during urination

If you’re having chest pain and have taken Viagra in the past 24 hours or Cialis in the past 48 hours, don’t take nitroglycerin. Call for an EMS and make sure you or someone with you tells them which ED medicine you took.

Vision Problems

You should also stop these medications and call your doctor right away if you have vision loss.

A rare vision problem called NAION — short for “nonarteritic anterior ischemic optic neuropathy” — has been reported by a few men using these drugs.

The condition causes a sudden loss of eyesight because blood flow is blocked to the optic nerve. People who have a higher chance for NAION include those who:

Are more than 50 years old
Smoke
Have heart disease, diabetes, high blood pressure, or high cholesterol levels
Have certain other eye problems

How Should I Store Them?

Keep them in their original container and out of reach of children. Store them away from heat and moisture (not in the bathroom). When they expire or you don’t need them anymore, get rid of them.