FAQs

What Are the Currently Available Oral Medications and What Differentiates Them from Each Other?

The oral medications currently available for impotence are Viagra, Levitra, and Cialis.
All three medications should be taken approximately 60 minutes prior to engaging in sexual activity. Viagra and Levitra are effective for approximately 4 hours. Cialis (the weekend drug) is effective for 36 hours. Viagra is less effective if it is taken within hours of having eaten fatty foods, so those types of food should be avoided when taking Viagra. Ideally, Viagra would be taken on an empty stomach. None of these drugs affect your desire in any way. They will make your penis respond more quickly and dramatically when your penis is stimulated and you become aroused.

The maximum dosage of Levitra and Cialis is 20 mg, and of Viagra, 100 mg. This should not be exceeded in any 24-hour period. Even if a lesser dosage is used, it should only be used once in any 24-hour period.

Although all three of these medications work slightly differently, the basic functioning is the same. When a man is sexually aroused, nitric oxide is released, which causes a cascade of biochemical reactions: the blood vessels and tissue of the penis relax and dilate, allowing blood to rush in and an erection to occur. These oral medications block the enzyme, PDE5, which reverses this cascade.

Please note that all of these drugs are contraindicated for men who are currently using nitrates or who have Retinitis Pigmentosis.

Other men who may not take the available oral medications are those with a predisposition to potentially hazardous cardiovascular events. Their conditions include:

• Unstable Angina
• Congestive Heart Failure
• Multiple Antihypertensive drugs
• MI, heart attack, CVA (stroke), or life threatening arrhythmia within the last 6 months
• Hypotension, decreased blood pressure (BP<90/50) or Hypertension, increased blood pressure(BP>170/110)
• Patients on alpha blocks for high blood pressure or prostate problems should also not take Levitra/Cialis. The only alpha blocker permitted to be taken with Cialis is Flomaz (0.4mg )
• Patients on alpha blockers may take Viagra but may not take it within 4 hours of having taken the alpha blocker.

Any men who fall into the above categories should see a specialist. There are very effective alternatives available for treating impotence. Other reasons you may want to consider seeing a specialist is if there has been a sudden onset of erectile dysfunction, you are under 50, or you have Peyronie's disease. Some men may choose to start the process with a specialist even if they do not fit these criteria, as they may want the time that a specialist generally puts aside to evaluate, understand and get to know a patient. Also, a patient may want to fully understand, the physical aspects of his problem as well as the psychological issues and ramifications. Finally the atmosphere in a specialist's office may be more personal and private.