In 2010, $5 billion was spent worldwide on ED drugs.  In 2010 in the US, approximately $1.7 billion was spent on Cialis and $1.9 billion on Viagra.  This is because as many as 50 million men in the US and Europe suffer from erectile dysfunction.  The risk factors for ED include chronic disease, smoking, drinking and depression.

Chronic disease such as diabetes, hypertension, obesity, dyslipidemia, cardiovascular disease, smoking and medication use can all contribute to erectile dysfunction.  Common medications that cause impotence are antidepressants, hypertension medications, and some diuretics. Similarly, so does nicotine and alcohol use.  Sexual dysfunction can also be related to depression, stress, stroke, spinal cord or back injury, multiple sclerosis, or dementia.  Other things like hormonal abnormalities, psychological problems, neurologic disease or vascular insufficiencies can lead to erectile problems as well.

                  Fortunately, for the many men out there who suffer from ED, there are several medications that can target and treat this issue. Let’s take a look at some of the most common medications out there and how they work:

1.     Sildenafil (Viagra) and Vardenafil (Levitra)

This medication is meant to be taken one hour before planned sexual intercourse.  High-fat meals may delay the absorption by one hour and decrease the concentration of the medication. It is effective in as early as 30 minutes and up to about 4 hours after ingesting.  Side effects include lowered blood pressure, and in combination with nitrates can lead to hypotension and syncope. This medication is not recommended for use in patients with hypotension, uncontrolled hypertension, bleeding disorders, life-threatening arrhythmias, stroke or heart attack within last 6 months.  Although these medications are grouped together with how similarly they work, they do have their differences.  This is outlined below:

Viagra

1. • Recommended dosage is 50 mg, as needed
   • Based on the effectiveness/toleration, the dose may be adjusted to 100 or 25 mg
   • Recommended dosing frequency is once per day
   • Maximum effectiveness achieved when taken on an empty stomach
     • Should avoid high-fat meals to ensure maximum absorption

Levitra

1. • Available in 2.5, 5, 10 and 20 mg doses recommended for usage once daily
   • Maybe taken with or without food
     • Should avoid high-fat meals to ensure maximum absorption

2. Tadalafil (Cialis)

This medication is available in 2.5, 5, 10 or 20 mg doses. It is recommended for either as-needed or daily use depending on the person.  It can be taken with or without food, and is less affected by high-fat meals and alcohol, when compared to Viagra and Levitra. It also has a longer duration than Viagra, and is effective as early as 16 minutes after and up to 36 hours after taking it.

Side effects include headaches, dyspepsia, flushing, rhinitis.  Cialis is not recommended for use in patients with hypotension, uncontrolled hypertension, bleeding disorders, life-threatening arrhythmias, stroke within last 6 months or a heart attack within last 3 months.