Erectile dysfunction — Get the facts on the oral medications Viagra, Levitra and Cialis.
Viagra, Levitra and Cialis are often the first treatment tried for erectile dysfunction — the inability to achieve or sustain an adequate erection for sexual activity. For most men with erectile problems, they work well and have few side effects. All three medications improve erectile function in the same basic way, but the effects of tadalafil (Cialis) last longer. This and a few other minor differences among these medications may make one a better choice over another for some men.
Viagra, Levitra and Cialis: How they work
Viagra, Levitra and Cialis increase levels of nitric oxide, a chemical produced by your body during sexual stimulation that causes blood vessels in the penis to relax and open. This allows you to achieve and maintain an erection. These medications don't automatically trigger an erection; sexual arousal is needed to start the whole process.
Not safe for everyone
Although these erectile dysfunction medications can help many people, not all men can safely take them. Viagra, Levitra and Cialis may not be a good choice if you have:
- Heart problems, including a recent heart attack, heart pain (angina) during sex, heart failure, heart rhythm problems (arrhythmias)
- High or low blood pressure (hypertension or hypotension) that isn't controlled
- A history of stroke within the last six months
- Relatives with retina disorders, including retinitis pigmentosa
- Sickle cell anemia, leukemia or other health conditions that can cause an erection that won't subside (priapism)
Erectile dysfunction medications for other health problems
Viagra, Levitra and Cialis all belong to a type of medications called phosphodiesterase-5 (PDE-5) inhibitors, which improve erectile function by affecting blood pressure. Experts are investigating whether these drugs may be useful to treat certain heart or blood flow problems. Revatio, the same medication as sildenafil (Viagra) was recently approved by the Food and Drug Administration as a treatment for pulmonary hypertension, a rare condition affecting blood flow to the lungs.
Rare but serious side effects
In a small number of cases, men taking Viagra, Levitra or Cialis have reported:
- Vision loss. A few men using Viagra, Levitra and Cialis have had permanent vision loss due to a condition called nonarteritic anterior ischemic optic neuropathy (NAION). However, it's unclear whether the drug — or an underlying condition — caused blindness. If you have a retinal disorder, such as diabetic retinopathy, see your eye doctor before taking any medication for erectile dysfunction.
- Sudden hearing loss. Some men have reported hearing loss after taking Viagra, Levitra and Cialis. However, it isn't clear whether the hearing loss was directly caused by taking these medications. If you're taking one of these medications for erectile dysfunction and have sudden loss of hearing, don't take any more of the medication and seek medical help right away.
- An erection that doesn't subside on its own. Called priapism, this rare condition can be painful and requires medical treatment to avoid damage to your penis. If you have an erection that lasts more than four hours, see your doctor.
Cost
Viagra, Cialis and Levitra may not be covered by your insurance, and can be expensive. These medications are generally not covered by Medicare. Depending on the dose, quantity you purchase and the pharmacy, prices for Viagra, Levitra and Cialis range from $10 to $20 a pill.
Realistic expectations
Occasional erectile dysfunction is a common problem, particularly as men age. Medication won't make you feel like you're 20 again, but it can help you achieve satisfying sexual relations more often. Be willing to work with your doctor to find which medication and dosage is best for you. For some men, Viagra, Levitra or Cialis aren't a safe or effective choice, but other treatment options for erectile dysfunction may work. These include medications that are injected into the penis or put into the urethra (penis opening) before sex, penis pumps (vacuum constriction devices), and penile implants.
Last Updated: 04/05/2008
