Erectile Dysfunction: Medicines to Treat ED

Many men take medicine to treat erectile dysfunction. The prescription drugs that the FDA has approved to treat ED are:

  • Avanafil (Stendra),
  • Tadalafil (Cialis)
  • Vardenafil (Levitra, Staxyn)
  • Sildenafil (Viagra)

They all work by boosting blood flow to the penis to make erections easier to get.

What Are the Differences Between These Drugs?

Cialis, Levitra, Staxyn, Stendra, and Viagra work similarly. There are subtle differences in how long the drug works and how quickly it works.

Levitra works a little longer than Viagra. They both take effect in about 30 minutes. With Levitra, the effects last for about 5 hours. With Viagra, they last about 4 hours.

Cialis works much longer — up to 36 hours in some cases. Stendra can start doing its thing in as little as 15 minutes, and its effects last up to 6 hours.

Staxyn dissolves in your mouth. It contains the same active ingredient as Levitra, but it should not replace Levitra. It also can begin working in about 15 minutes.

If One of These Doesn’t Help Me, Can I Try Another?

Yes. But because these drugs work the same way, you’re likely to have similar results.

What Precautions Should I Take Before Trying One of These Drugs?

There are situations where these drugs may not be safe. Before you take them, tell your doctor:

  • If you are allergic to any drugs, including other ED medications.
  • About any prescription or nonprescription medications you take and any herbal and dietary supplements.
  • If you are scheduled for surgery, even dental surgery.
  • If you take nitroglycerin or a similar medicine for chest pain. The combination of ED medication and these drugs can cause dangerously low blood pressure.
  • If you take alpha-blockers for blood pressure or prostate problems. These can lower your blood pressure when taken with ED pills. You should not start on Staxyn unless your doctor has prescribed you Levitra before.

Always follow the directions on your prescription label carefully. Also make sure to ask your doctor or pharmacist to explain anything you don’t understand. Take these drugs exactly as directed.

Who Should Not Take These?

If you’ve had a heart attack, stroke, or life-threatening irregular heart rate within the past 6 months, you should discuss other options with your doctor. You should also avoid these drugs if you have uncontrolled high or low blood pressure or if you get chest pain while having sex.

What Are the Side Effects?

Side effects are not common, but they can happen. You may get:

  • A headache
  • Upset stomach or heartburn
  • Feeling of warmth
  • Nasal congestion
  • Changes in vision (color, glare)
  • Back pain
  • Hearing loss

Call your doctor if these symptoms are severe or if they do not go away after 4 to 8 hours.



You may need emergency treatment if you have:

  • A rash
  • Painful erection
  • An erection that last longer than 4 hours
  • Fainting
  • Chest pain
  • Itching or burning during urination

If you’re having chest pain and have taken Viagra in the past 24 hours or Cialis in the past 48 hours, don’t take nitroglycerin, and make sure you tell the EMS that arrives that you’ve taken whichever ED medicine you took.

You should also stop these medications and call your doctor right away if you have vision loss.

A rare vision problem called NAION has been reported by a few men using these drugs. NAION causes a sudden loss of eyesight becauseblood flow is blocked to the optic nerve. People who have a higher chance for NAION include those who:

  • Are over 50 years old
  • Smoke
  • Have heart disease
  • Have diabetes
  • Have high blood pressure
  • Have high cholesterol
  • Have certain eye problems


How Should I Store These Drugs?

Keep them in their original container and out of reach of children. Store them away from heat and moisture (not in the bathroom). When they expire or you don’t need them anymore, get rid of them.