Comparing Viagra, Levitra, and Cialis

Jay Motola Health Pro
  • The treatment of erectile dysfunction is part of our daily lives as a result of the mass media advertising campaigns that have been undertaken. Each drug can easily be identified by their association with their ad campaigns. Sildenafil (Viagra) has previously been associated with major league baseball. Their current advertising campaign subtly shows their name but is more like a public service announcement dealing with erectile dysfunction. Everyone knows that this is the little blue pill.

    Vardenafil (Levitra) has associated themselves as an advertiser of the National Football league. Their name is plastered around stadiums across the country. A lit flame is a part of their campaigns. A bathtub on the hill overlooking the valley with a couple in the tub is the visual that is associated with the campaign for tadalafil (Cialis).
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    Each of the agents has a specific pharmacologic profile. Tadalafil was approved by the FDA in 2003 and was the last of the 3 oral phosphodiesterase inhibitors approved for the treatment of erectile dysfunction. Phosphodiesterase (PDE) is found in many tissues and depending on how selectively the inhibitor is, the drugs can have effects in other body organs. PDE5 is found in the greatest concentration in the penis. PDE3 is found in cardiac tissue, and PDE6 in the retina. It is a highly selective PDE-5 inhibitor and because of its selectivity for PDE4, its effects are best seen in the penis. Because of this characteristic, this agent has less risk of cardiac side effects (less selectivity for PDE3 and cardiac tissue). Additionally because of the relatively increased selectivity for PDE5 compared to PDE6, there are less visual changes that have been reported with the use of this drug.

    It has the unique claim of being the “weekender”. In theory, if using this agent, its effects can be seen in patients 2-3 days later. It reaches its maximum blood concentration at 2 hours and has a half-life of 17.5 hours, longer than sildenafil or vardenafil, and its efficacy has been seen up to 36 hours later. Dietary factors do not affect the uptake of this drug. Similar to the other agents in this category of drugs, patients can not use this concomitantly with the use of nitroglycerine containing drugs. The drug is available in both 10 and 20 mg pills, allowing the patient to titrate the desired effect.

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Published On: November 01, 2006