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Oral medications for erectile dysfunction are called PDE-5 inhibitors. Medications in this class include drugs like Viagra (Sildenafil), Levitra (Vardenafil), Cialis (Tadalafil), Stendra (Avanafil) and more. This class of drugs is considered a first-line treatment for men with ED.

In simple terminology, there are chemicals in the penis that cause erections and chemicals that inhibit erection. The drugs for PDE-5 inhibitors increase the amount of "erection-promoting chemicals". These medications do not cause an erection, but improve erection by improving blood flow to the penis, making the erection harder and more durable. These medications always require mental or physical stimulation to function. So, if you take an oral medication, you will not immediately get an erection without sexual stimulation.

The success rates for improving erections are around 70 to 80%. Medications are more effective in men with mild ED. Men with severe erectile dysfunction may not respond to these pills.

When should I take these medications? How long are they effective?

Sildenafil (Viagra) and vardenafil (Levitra) begin to act 30 to 60 minutes after ingestion. Tadalafil (Cialis) produces its effects approximately 1 to 2 hours after administration. Avanafil (Stendra), one of the newer medications, has a shorter onset time of about 15 to 30 minutes. We recommend taking these medicines on an empty stomach for optimal absorption.

The main difference between these drugs is the length of time they are active in the body. Sildenafil (Viagra), Vardenafil (Levitra) and Avanafil (Stendra) are more effective during the first 4 to 8 hours, while Tadalafil (Cialis) is effective for 18 to 36 hours.

What are the benefits of oral ED medications?

The benefits of these drugs include the simple use of a pill to support the emergency department and their effectiveness. These are also very safe drugs for most people.

What are the common interactions when taking drugs for erectile dysfunction?

Interactions with other medications can affect the effects of your medications or increase the risk of serious side effects. We do not list all possible interactions. Please keep an up-to-date list of all prescription and over-the-counter medications and supplements that you can share with our office and our pharmacist.

CAUTION: If you experience chest pain within 24 hours after Viagra, Levitra or Stendra, or within 3 days of receiving Cialis, call 911 or go to the hospital emergency department immediately. closer. The usual treatment for chest pain is the administration of a nitroglycerin tablet or a nitroglycerin patch. Mixing nitroglycerin with oral anti-ED drugs can cause a significant drop in blood pressure. A significant drop in blood pressure can cause dizziness, fainting, and rarely a heart attack or stroke.

Therefore, nitroglycerin should only be administered by a physician if you have taken a PDE5 inhibitor drug.

  • Drugs for the treatment of chest pain / angina (nitrates such as nitroglycerin, isosorbide)
  • Relaxation drugs called "poppers" containing amyl nitrate, amyl nitrite or butyl nitrite
  • Drugs for prostate hypertrophy, such as doxazosin and tamsulosin, in combination with oral ED drugs can cause a drop in blood pressure. Avoid taking a dose of the prostate medication if you are taking something like Viagra tonight.
  • Emergency drugs can be used in small doses with the following drugs: antifungals (such as itraconazole, ketoconazole), macrolide antibiotics (such as clarithromycin, erythromycin), anti-HIV drugs (such as ritonavir, saquinavir), hepatitis C, viral protease inhibitors (such as Boceprevir, telaprevir), mifepristone and rifampicin
  • Do not mix different drugs orally at the same time.
  • Do not drink excess alcohol (> 5 drinks) while taking this medicine. Excessive consumption may increase the risk of headaches or dizziness, increase heart rate or lower blood pressure.
  • Do not eat grapefruit or drink grapefruit juice while taking emergency medicine, as it may build up in your body and increase the risk of side effects.
  • Do not take more than the prescribed dose.

When is it dangerous to use emergency medicines for oral use?

The FDA has been cautious in patients who have had a heart attack, stroke or severe heart attack (atrial fibrillation) in the last 6 months, as well as in men with congestive heart failure or unstable angina in men and in men with caution Blood pressure or uncontrolled hypertension (more than 170/110 mm Hg).

In patients with severe ocular / visual problems, oral medication for oral administration is not recommended. Before taking this medication, rare cases of blindness have been reported in patients with serious eye problems. If you have vision problems, especially in the past, consult your eye doctor before taking these medications.

Oral ED drugs are known to cause no heart attack. However, it is known that violent sexual activities, like any physical exercise, cause major vascular events such as heart attacks. If you are not in good physical condition and have not had sex for some time, you MUST visit your family doctor to see if your heart can tolerate sexual activity.

How much do drugs cost?

The main disadvantage of these drugs was their cost. Most insurance companies do not cover drugs for men. However, generic options are becoming more accessible at lower prices. The Broward Urology Center works with many providers to offer competitive pricing to its patients. Please ask us for all available options.

What is Stendra?

Stendra is also known by the generic name Avanafil. It is a prescription medicine for the treatment of erectile dysfunction launched in the Singapore in March 2014.

Stendra is classified as a "PDE5 inhibitor". It is available as a pale yellow oval tablet in three strengths - Stendra 50 mg, 100 mg and 200 mg in packs of four or eight tablets.

What are the main benefits of Stendra?

Stendra has been shown to be effective in clinical trials involving more than 1,000 men. It has been tested on all types of men with erectile dysfunction, including men with erectile dysfunction caused by type 1 and type 2 diabetes and men with erectile dysfunction after radical prostatectomy with bilateral nerve sparing. Stendra has been effective in all types of men and in all their strengths.

Among men with erectile dysfunction, the average percentage of trials that resulted in successful sexual intercourse was approximately 47%, 58%, and 59% for the avanafil 50mg, 100mg, and 200mg groups, respectively. about 28% for placebo (treatment without medication).

In men with type 1 or type 2 diabetes, the mean percentage of trials that resulted in successful intercourse for the 100 mg and 200 mg avanafil groups was approximately 34% and 40%, respectively. ; against approximately 21% for the placebo. In men with ED after bilateral nerve-sparing radical prostatectomy, the mean percentage of successful sexual assays was about 23% and 26% for the 100 mg and 200 mg avanafil groups. respectively, compared to about 9%. for the placebo.

How does Stendra work?

Stendra relaxes the blood vessels in the penis, allowing better blood circulation. The work lasts between 15 and 30 minutes. Efficacy is not normally compromised by alcohol consumption prior to treatment. Sexual stimulation is necessary for Stendra to be effective.

How to take Stendra (Avanafil)?

The recommended dose is a 100 mg tablet, to be taken as needed. You should not take it more than once a day.

If you think your dose is too high or too low, talk to your doctor. You may suggest switching to another dose of this medicine. Dosage adjustments may also be necessary if Stendra is used with certain other medications. If you take medicines such as erythromycin, amprenavir, aprepitant, diltiazem, fluconazole, fosamprenavir or verapamil ("moderate CYP3A4 inhibitors"), the recommended dose of Stendra is 100 mg every two days or more.

You must take Stendra about 30 minutes before sex.

Grapefruit juice may increase drug exposure and should be avoided within 24 hours of taking Stendra. Drinking alcohol at the same time as Stendra can increase your heart rate and lower your blood pressure. You may feel dizzy (especially standing up), have a headache, or feel your heart pounding in the chest (palpitations). Alcohol consumption can also affect erection ability.

Is Stendra suitable for me?

Read the enclosed leaflet carefully before taking any medicine. Stendra should only be taken with a doctor's prescription. This can be dangerous if you take it with other medications at the same time, including those used to treat chest pain (angina pectoris) and certain recreational medications, especially alkyl nitrite (poppers). There are other medicines that can interact with Stendra and you should tell the doctor about all the medicines you take to take them into consideration.

Stendra is not suitable for men with serious heart disease who do not recommend intercourse, unstable angina or unstable angina during intercourse, low blood pressure or high blood pressure, or men who have recently had a life-threatening stroke, heart attack or irregular heartbeat 6 months. Stendra is not suitable for men with severe liver or kidney problems. Patients with known eye problems, including patients with loss of vision of an eye due to non-arterial anterior ischemic optic neuropathy (NAION), whether or not this episode has been associated with prior exposure to an inhibitor of Phosphodiesterase (PDE5) type 5 and patients with known hereditary degenerative diseases of the retina should not take Stendra.

What are the side effects of Stendra?

Stendra can cause side effects, but not everyone has them. Common side effects (1 to 10% of men) include headache, flushing, and stuffy nose. For a complete list of possible side effects and other important information, see the package leaflet before beginning treatment. The brochure can also be viewed online here.


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