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Medications for Erectile Dysfunction (Impotence)
- Sildenafil (Viagra)
- Vardenafil (Levitra)
- Tadalafil (Cialis)
- Transurethral alprostadil (MUSE)
- Intracavernosal alprostadil (Caverject)
- Recent heart attack or stroke
- Heart failure
- Concurrent use of nitrate
- Concurrent use of other medications for erectile dysfunction
- Hereditary retinal disorders, such as retinitis pigmentosa
- Liver or kidney failure
- Bleeding disorders
- Ulcer disease
- Heart disease
- Concurrent use of blood pressure medications, especially alpha-blockers
- The elderly
- Visual disturbances, a condition known as nonarteritic anterior ischemic optic neuropathy (NAION) that can cause sudden blindness
- Drug interactions
- Food, especially fatty food, can delay the absorption of sildenafil and vardenafil, but not tadalafil.
The duration of action of these drugs are different:
- 4 to 5 hours for sildenafil and vardenafil
- Up to 36 hours for tadalafil
- Transurethral alprostadil
- Intracavernosal alprostadil
- Low blood pressure
- Pain in the penis
- Problems from the injecting needle
- Prolonged, painful erection (priapism) (0.4% of users)
- Bleeding in patients on blood thinners
- Take them as directed—not more, not less, not at a different time.
- Do not stop taking them without consulting your healthcare provider.
- Do not share them with anyone else.
- Ask what effects and side effects to expect. Report them to your doctor.
- If you are taking more than one drug, even if it is over-the-counter, be sure to check with a physician or pharmacist about drug interactions.
- Plan ahead for refills so you do not run out.
When to Contact Your Doctor
- A side effect that troubles you
- Priapism (prolonged, painful erection)—This condition can be dangerous. If four hours have passed and your penis still has not relaxed, seek emergency medical care.
Warning About Medications Not Prescribed by Your Doctor
Erectile dysfunction. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated July 25, 2012. Accessed September 14, 2012.
Erectile dysfunction. National Institute of Diabetes & Digestive & Kidney Diseases website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/ED/index.aspx. Updated March 28, 2012. Accessed September 14, 2012.
Erectile Dysfunction. Urology Care Foundation website. Available at: http://www.urologyhealth.org/content/moreinfo/ed-factsheet.pdf. Updated 2009. Accessed September 14, 2012.
Guay AT, Spark RF, et al. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of male sexual dysfunction: a couple’s problem: 2003 update. Endocr Pract. 2003;9:77-95.
McMahon CN. Treating erectile dysfunction when PDE5 inhibitors fail. Brit Med J. 2006;332:589-592.
Montorsi F, Padma-Nathan H, et al. Erectile function and assessments of erection hardness correlate positively with measures of emotional well-being, sexual satisfaction, and treatment satisfaction in men with erectile dysfunction treated with sildenafil citrate (Viagra). Urology. 2006;68:26-37.
Sivalingam S, Hashim H, et al. An overview of the diagnosis and treatment of erectile dysfunction. Drugs. 2006;66:2339-2355.
Webber R. Erectile dysfunction. Clinical Evidence. 2005;13:1120-1127.
- Reviewer: Adrienne Carmack, MD
- Review Date: 09/2013
- Update Date: 09/30/2013