Each erectile dysfunction medication (including Cialis, Viagra, and Levitra) has subtle variations in its onset of action and duration of action. Similarly, each medication will have a different set of side effects. The most common side effects are headache, stuffy nose, flushing of the face and rarely dizziness or lightheadedness.
More serious side effects of these medications (called the "phosphodiesterase inhibitors") have also been reported, including the association with blindness. The literature has not shown a convincing relationship between blindness and the medications, however. This is different than the "bluish hue" that can be seen by some patients due to a cross reaction with one of the phosphodiesterases that exist in the eye. A patient should discontinue the medication if this occurs. A patient should never be afraid to ask their doctor about the possible reactions. The side effect of headache can often be combated by taking a non-steroidal anti-inflammatory medication after, or at the same time of the ingestion of the ED pill.
Based on the degree of erectile dysfunction, the physician will prescribe a varying dose of the medication. Typically, a low dose will be tried first. The goal will be to give the best erectile response while minimizing the side effects. Higher doses may bring about stronger side effects (for example, worse headache or facial flushing). If the erection is not satisfactory, the dose can be raised. Anecdotally, it seems that not all medications will work the same in all people. This means that one medicine may work better than others in different people. Also, some patients may have a personal preference of the medication that they would like to try first. This may be the result of television marketing or hearing a friend's experience.
Due to the long efficacy and safety profile of this group of medications, urologists often will no longer go through the extensive, and often invasive, testing profile necessary to determine the exact diagnosis of erectile dysfunction. Since most, but not all, reasons for ED will respond to the pill form of medication, this is rarely necessary. The history of the patient (diabetes, high blood pressure, coronary artery disease, tobacco use and others) serves to be much more important. This is not to say that some patients with a difficult history will require additional testing. Some of this testing can involve needles that are placed into the penis and other uncomfortable probing. Fortunately, this is only necessary in rare cases. There is strong literature to support the use of these medications in each of the previously mentioneed medical conditions.
It is not recommended to take more than the prescribed doses of the oral medications. The maximum doses for each medication are the following: 100mg for sildenafil (Viagra), 20mg for vardenafil (Levitra) and 20mg for tadalafil (Cialis). Taking more than a prescribed dose may result in adverse cardiovascular side effects. Changing the dose of your medication without your doctor's approval is forbidden.
When the maximum dose of any given medication fails, it is common to change to another medication in the family until all three fail; some patients will respond to a change in medication.
Published On: December 10, 2007