With the accelerated pace of life in modern society and the increasing pressure of life and work, many people have male erectile dysfunction, which is what we usually call impotence.
It hurts the patient’s self-esteem, increases the patient’s mental pressure, destroys the patient’s marital relationship, and has a great impact on the patient’s daily life.
It is the wish of many men to make love last longer and harder. In order to meet the needs of male friends, many drugs for the treatment of erectile dysfunction are now on the market. Today, four common medications are widely used to treat erectile dysfunction (ED) symptoms.
These drugs are phosphodiesterase 5 (PDE5) inhibitors, known by the brand and generic names Viagra (Sildenafil), Cialis (Tadalafil), Levitra (Vardenafil), and Stendra (Avanafil).
I believe that many male friends are more concerned about this. Many male friends are ashamed to talk about the problem of erectile dysfunction due to face, and do not want to go to the hospital for examination. They have a certain psychological burden, which also has a negative impact on their sexual life. PDE5 inhibitors are all drugs used to treat male erectile dysfunction. So, which of the four commonly used drugs is better? What’s the difference?
How ED Drugs Work?
In terms of drug classification, Viagra, Cialis, Levitra, and Stendra are all drugs that improve male erectile dysfunction. All four drugs are PDE5 inhibitors and are highly selective for PDE5.
This type of drug inhibits the activity of PDE5, thereby reducing the decomposition of cGMP, a subsequent substance in cell physiology, increasing cGMP levels, and regulating and increasing local blood flow.
Namely, they help relax muscles and increase blood flow to the body. This makes it easier for blood to enter the penis and allows people with ED to experience long-lasting erections during sexual activity. Thereby achieving the pharmacological effect of improving male function.
These drugs are highly specific and work directly by acting on receptors in male-related parts. For male with erectile dysfunction problems, in most cases, they have good improvement effects.
However, each drug differs in side effects, dosage regimens, and other factors. Please talk to your doctor or health care professional first to learn more about the risks, benefits, and potential drug interactions.
What’s The Difference Between Them?
They are both approved by the U.S. Food and Drug Administration (FDA) and have the same functionality. However, there are some differences between them. The main differences between these drugs:
- Dose size
- Duration
- Is it affected by food?
- Types of main ingredients
- The speed of onset of effect
For occasional use, most people start with Viagra. For regular use, Cialis is more suitable. Some people like to alternate medications based on their lifestyle and relationship status. Your healthcare provider may also make a recommendation based on whether your ED is mild or more severe.
The table below compares the differences between the four drugs:
| Main ingredients | Dosage | Generic available? | Onset of effect | Effects last | Affected by food? | |
| Viagra | Sildenafil | 25 mg, 50 mg, 100 mg | yes | around 30 minutes | around 4 hours | take it 1 to 2 hours after eating, or with a low-fat meal. |
| Cialis | Tadalafil | 2.5 mg, 5 mg, 10 mg, 20 mg | yes | around 30 minutes | around 36 hours | No |
| Levitra | Vardenafil | 5 mg, 10 mg, 20mg | yes | around 60 minutes | around 5 hours | take it 1 to 2 hours after eating, or with a low-fat meal. |
| Stendra | Avanafil | 50 mg, 100 mg, 200 mg | yes | around 15 minutes | around 6 hours | No |
Common Side Effects of ED Drugs?
Anyone considering using these drugs should first consult a doctor. These drugs may not be suitable for everyone as they may affect a person’s existing health condition or interact with other medications they are taking.
The side effects of these drugs are mostly similar and usually very mild. If you have any persistent side effects that will not disappear on their own, please inform your doctor.
The most common adverse events are:
- Indigestion
- Headache
- Flushing
- Back pain
- Dizziness
Among them: Indigestion had the lowest reporting rate in the avanafil group; flushing had the lowest reporting rate in the tadalafil group; myalgia had the lowest reporting rate in the vardenafil and avanafil group; visual impairment was considered sildenafil and vardenafil side effects.
It is worth noting that side effects include sustained erection (known as abnormal penile erection). If an erection lasts for 4 hours or longer, please immediately call a healthcare professional.
A small number of men experience visual or hearing loss after taking oral ED medication. If you encounter these issues, please call your healthcare professional immediately.
The incidence of adverse reactions to other drugs is similar, and the occurrence of adverse reactions is positively correlated with the dosage.
Medicine Interactions
In men with mild to moderate hepatic or renal impairment or spinal cord injury, PDE5i should be used with caution, at least initially, at reduced doses and as directed by a physician due to potential delayed metabolism. PDE5i is generally not recommended for men with severe kidney or liver disease.
If you take medication on a daily basis, be sure to consult your doctor before taking the medication. After all, some medications may enhance or offset their effects. Requires attention:
- Nitrates: All PDE5 inhibitors are contraindicated in combination with nitrates. It can cause an unpredictable drop in blood pressure (hypotension) that can be life-threatening;
- Antihypertensive drugs: Taking antihypertensive drugs together may cause a slight additional antihypertensive effect, but it is very mild and generally does not cause malignant adverse reactions.
- Alpha-blockers: Concomitant use with alpha-blockers may cause orthostatic hypotension under certain conditions, usually within 4 hours of alpha-blocker treatment. It is recommended to combine after stable treatment.
- CYP4 inhibitors: PDE5 inhibitors are metabolized by hepatic enzymes CYP3A4 and CYP2C9, so avoid taking them with inhibitors that inhibit these enzymes, such as ketoconazole, erythromycin, itraconazole, cimetidine, and saline. Quinavir et al.
Cialis’s longer duration of action means there is a higher risk of drug interactions, and men with kidney or liver disease may need to reduce their dose.
PDE5 inhibitors are not recommended for men who have had a heart attack or stroke within the past 6 months, have uncontrolled high blood pressure or severe hypotension, unstable angina, or other conditions that preclude sexual activity.
Because sexual intercourse can bring potential heart risks to patients with heart disease, it is best not to take these drugs for people with heart disease.
Individuals should also pay attention to whether their products are FDA-approved versions and follow their doctor’s instructions when purchasing any of these medications.
Questions About ED Drugs
Which is better: Viagra, Cialis, Levitra or Stendra?
The choice depends on individuals and various factors, such as whether the person regularly engages in sexual activity, other medications being taken, and the cost and availability of ED drugs, as well as the level of acceptance of potential side effects. Individuals should consult healthcare professionals to help them make decisions.
Can ED drugs become addictive if taken long-term?
Won’t. Drug addiction refers to the physiological dependence on drugs. This state is related to brain changes. Once the drug is stopped, a series of uncomfortable symptoms will appear, also called withdrawal reaction.
All addictive drugs used act on the central nervous system. Cialis acts on the corpus cavernosum and has nothing to do with the brain. There is no withdrawal reaction, so it is not addictive. Although it is not addictive, patients still need to follow the doctor’s advice and use the medication rationally.
Can we take it together?
There is no need to take it together. They are all PDE5 inhibitors that help achieve the same goal. Your doctor can help you decide which one is most suitable for you, but it’s not necessary to take it all.
Which one to choose for fast onset of action?
Stendra (Avanafil), due to the above pharmacokinetic indications, the onset of action of this drug is as follows: Avanafil (15 minutes) > Sildenafil (30 minutes) > Tadalafil (30 minutes to 1 hour) >Vardenafil (1- 2 hours).
Which should patients with ED and chronic illness choose?
Viagra (Sildenafil), because the pharmacokinetic parameters of sildenafil are relatively average, for this type of ED patients, while ensuring blood drug concentration, it can also reduce irritation to the body and reduce harm to the human body, which can be better To ensure the safety of medication for these patients.
Which one should ED patients with endothelial dysfunction choose?
Cialis (Tadalafil), according to relevant research findings, shows that tadalafil has long-term and lasting effects. Taking tadalafil regularly for a period of time at low doses every day can effectively improve vascular endothelial function and treat lower urinary tract symptoms in middle-aged and elderly patients/ Benign prostatic hyperplasia can also improve benign prostatic hyperplasia. Therefore, it is recommended that middle-aged and elderly patients with endothelial dysfunction choose tadalafil.
Which should be chosen in patients without vascular disease?
Levitra (Vardenafil) is recommended for middle-aged and older men who are relatively simple and prone to ED, mainly caused by decreased fertility, decreased neuroregulatory function, or decreased hormone secretion capacity, and are not accompanied by underlying vascular diseases. Vardenafil is recommended.
Vardenafil has light effects, rapid onset of action, and low bioavailability, resulting in relatively few adverse reactions. Therefore, patients with simple ED are more willing to use vardenafil.
Which one should be chosen for patients with ED that has no obvious organic cause?
Viagra (Sildenafil). Most young and middle-aged people do not have cardiovascular organic diseases, which are mainly caused by psychological factors such as stress. Compared with other drugs, sildenafil can increase blood filling and effectively improve ED caused by psychological factors. It is suitable for people with irregular cohabitation. Young and middle-aged people, people with high pressure and high rhythm.
Which one should patients with visual dysfunction and ED choose?
Cialis (Tadalafil). Among the four PDE5 inhibitors, tadalafil does not cause visual abnormalities, while the other three have a certain probability of occurrence.
If you want to take medication after a heavy meal, which one is recommended?
The absorption rate of Cialis and Stendra is not easily affected by food. Whether you take Cialis or Stendra on an empty stomach or with a full stomach, there is almost no effect on the drug absorption rate, and even a small amount of alcohol will not affect the efficacy and absorption rate.
However, the absorption rate of Sildenafil and Vardenafil is affected by food, so it is recommended to take Sildenafil and Vardenafil on an empty stomach.
Bottom Line
When taking the four drugs Viagra, Cialis, Levitra, and Stendra, you should take the drugs reasonably according to the doctor’s guidance and recommendations to avoid unnecessary side effects caused by incorrect use.
When used correctly, each of these medications has been shown to help people with ED. Take it exactly as prescribed by your doctor, and be sure to let them know if you have any questions or concerns.