Phosphodiesterase 5 inhibitors (PDE5Is) are a group of medications used to treat erectile dysfunction (ED). These medications relax the smooth muscle in the blood vessels of the penis to increase blood flow and facilitate erections. These medications do not cause an erection without sexual stimulation.
PDE5Is are the most commonly prescribed treatment for ED. All types of PDE5Is can be equally effective. The best medication for you depends on how often you desire sexual activity and your personal experience.
This group includes Sildenafil (commonly known as Viagra), Vardenafil (commercially named Levitra), and Tadalafil (commercially known as Cialis). Although these medications are considered first-line treatment for erectile dysfunction due to their proven effectiveness, they may not work in patients who have recently undergone radical prostatectomy, in which case intracavernous injection therapies are likely to be more effective.
We can state that this group of medications is very safe. However, they are contraindicated in patients taking medications for angina or heart attack (called nitrates), as the simultaneous use of both medications can cause significant drops in blood pressure and cardiovascular emergencies. Another contraindication exists for those patients who are prohibited from engaging in intense physical exercise, such as that involved in sexual intercourse. It is well-known that patients with prolonged sexual inactivity who use these medications and achieve a powerful erection may die during sexual activity, not due to the effect of the medication itself, but due to the preexisting inability of the heart to withstand such efforts.
Sildenafil
Viagra should be taken one hour before sexual activity, on an empty stomach, as food interferes with its absorption. Its duration of action is approximately 4 hours, during which time you can have sexual relations. Side effects such as a blue tint to lights or causing lights to appear brighter than normal, dizziness, or gastrointestinal problems may occur in up to 7% of patients, but they disappear once the effect of the medication wears off. There is an oral gel presentation, which contains the same substance but administered in the equivalent of half a spoonful, facilitating administration and reducing stomach acidity.
Vardenafil
Levitra is a potent medication that should be taken half an hour before sexual activity. You can consume moderately fatty foods and drink in moderation because it has little interaction with food or alcohol, and its duration of action is 4 to 5 hours. The most frequent side effects are headache, nasal congestion, and facial flushing. These discomforts will also pass once the effect of the medication wears off.
Tadalafil
Cialis should be taken 2 hours before sexual activity. You can eat and drink moderately because it has no interaction with food or alcohol, and its duration of action is approximately 36 hours. The main side effects are headache, nasal congestion, facial flushing, and back or muscle pain, discomforts that, like in the previous cases, will subside after the medication’s effect ends. The presentation is in 20 mg. However, there is also a 5 mg presentation, which is taken every night regardless of whether or not sexual activity is planned, in order to maintain a constant level of the medication to facilitate spontaneous erections every day. At the same time, this low dose reduces the occurrence of side effects.
Lodenafil
Helleva is the most recent of the oral medications. It has been developed in such a way that its absorption and efficacy are not affected by food intake or alcohol consumption, so it does not interfere with the patient’s lifestyle. Its duration of action is 6 hours, and it does not cause erections without sexual stimulation. Like its predecessors, it offers excellent cardiovascular safety and has similar but less frequent side effects.
Due to the success of PDE5Is in treating ED, there are many fake pills on the market. These medications are not approved for sale, they may be toxic, and they can harm your health. Always talk to your doctor or healthcare provider before using or purchasing medications for ED.
Reference:
-Book: “No le tenga miedo al dedo: Todo lo que un hombre debe saber sobre su próstata” Authors: Dr. René Sotelo, Dr. Juan Arriaga, Dr. Inderbir S. Gill. Editorial: VINMA, C.A; 2nd edicion
–https://patients.uroweb.org/treatments/phosphodiesterase-5-inhibitors/
– https://my.clevelandclinic.org/health/treatments/23211-phosphodiesterase-inhibitors
