Treatment for Erectile Dysfunction
"Towards a decade of detecting new analogues of sildenafil, tadalafil and vardenafil in food supplements: a history, analytical aspects and health risks".
- Definition of ED: The consistent inability to achieve or maintain an erection.
- Prevalence: Affects millions of men, with incidence increasing with age.
- Risk factors: Include diabetes, heart disease, smoking, obesity, and sedentary lifestyle.
- Types of ED: Can be psychogenic, organic (vascular, neurological, hormonal), or mixed.
- The erection process: Involves neural, vascular, hormonal, and psychological components.
- Vascular ED: Caused by problems with blood flow into or out of the penis.
- Neurogenic ED: Caused by nerve damage from diabetes, surgery, or spinal cord injury.
- Hormonal ED: Caused by imbalances in testosterone, thyroid, or other hormones.
- Psychogenic ED: Caused by mental health issues like stress, anxiety, or depression.
- Mixed ED: A combination of physical and psychological causes is very common.
"Detection of sildenafil analogues in herbal products for erectile dysfunction". Archived from the original on 4 March 2016. ^ "FDA Warns Consumers About Dangerous Ingredients in "Dietary Supplements" Promoted for Sexual Enhancement". Archived from the original on 18 January 2017. ^ "Hidden Risks of Erectile Dysfunction 'Treatments' Sold Online". Archived from the original on 23 April 2019. ^ R. Baselt, Disposition of Toxic Drugs and Chemicals in Man, 9th edition, Biomedical Publications, Seal Beach, CA, 2011, pp. Archived from the original (PDF) on 10 September 2011. "Structure of the catalytic domain of human phosphodiesterase 5 with bound drug molecules". ^ a b Webb DJ, Freestone S, Allen MJ, Muirhead GJ (March 1999). "Sildenafil citrate and blood-pressure-lowering drugs: results of drug interaction studies with an organic nitrate and a calcium antagonist". ^ Goldstein I, Lue TF, Padma-Nathan H, Rosen RC, Steers WD, Wicker PA (May 1998). "Oral sildenafil in the treatment of erectile dysfunction. Archived from cheap lovegra tablets the original on 14 January 2012. "Onset and duration of action of sildenafil for the treatment of erectile dysfunction". ^ "Scientist who developed Viagra receives knighthood in New Year's Honours". Archived from the original on 14 January 2023. "Sildenafil: from angina to erectile dysfunction to pulmonary hypertension and beyond". Archived from the original on 26 September 2008. Our clinicians regularly offer patients the opportunity to take part in trials of new drugs and treatments. Morriston Hospital in Swansea, was the first in the world to trial Viagra! ^ Boolell M, Allen MJ, Ballard SA, Gepi-Attee S, Muirhead GJ, Naylor AM, et al. "Sildenafil: an orally active type 5 cyclic GMP-specific phosphodiesterase inhibitor for the treatment of penile erectile dysfunction". "Sildenafil (Viagra), a potent and selective inhibitor of Type 5 cGMP phosphodiesterase with utility for the treatment of male erectile dysfunction". "Drug repositioning: identifying and developing new uses for existing drugs". Archived from the original on 22 April 2019. Archived from the original on 10 June 2019. "Health situation in former communist bloc is dire, says Unicef". Archived from the original on 1 November 2012. ^ Gurevich M, Cormier N, Leedham U, Brown-Bowers A (August 2018). Sexuopharmaceutical use by men as prevention and proficiency". "Spreading the Word, but What Word is That? Viagra and Male Sexuality in Popular Culture". "A new view of women's sexual problems: Why new? Archived from the original on 3 January 2009. Archived from the original on 12 October 2008.
- Amikacin: Aminoglycoside antibiotic for serious Gram-negative infections.
- Gentamicin: Treats septicemia, meningitis, and urinary tract infections.
- Tobramycin: Used for Pseudomonas infections, especially in CF patients.
- Streptomycin: An aminoglycoside for tuberculosis and plague.
- Neomycin: Topical and oral for bowel decontamination and skin infections.
- Kanamycin: Used for certain bacterial infections, often in combination therapy.
- Paromomycin: Treats intestinal parasitic infections like amoebiasis.
- Spectinomycin: Alternative treatment for gonorrhea.
- Amikacin: Potent against multidrug-resistant bacteria.
- Netilmicin: Broad-spectrum aminoglycoside for severe infections.
- Gentamicin (topical): Used for skin infections and wounds.
"Sales of Impotence Drugs Fall, Defying Expectations".
- Sildenafil food interactions: High-fat meals can delay its absorption and onset.
- Tadalafil food interactions: Not significantly affected by food intake.
- Vardenafil food interactions: High-fat meals can reduce its absorption and effectiveness.
- Avanafil food interactions: Can be taken with or without food.
- Alcohol interactions: Can increase side effects like dizziness and lower blood pressure.
- Grapefruit juice: Can interact with many medications, including some PDE5 inhibitors.
- Nitrate interactions: Absolute contraindication with any form of organic nitrates.
- Alpha-blocker interactions: Can cause additive blood pressure-lowering effects.
- Antifungal interactions: Drugs like ketoconazole can increase levels of PDE5 inhibitors.
- HIV protease inhibitor interactions: Can significantly increase levels of PDE5 inhibitors.
Archived from the original on 11 October 2007. ^ "Pfizer Courting More Controversy with Viagra 'Advergaming'". Archived from the original on 19 December 2019. Archived from the original on 6 May 2018.
Prescription ED Medications and How They Work
Archived from the original on 11 November 2020. ^ Nichols DJ, Muirhead GJ, Harness JA (6 March 2002). "Pharmacokinetics of sildenafil after single oral doses in healthy male subjects: absolute bioavailability, food effects and dose proportionality". The American Society of Health-System Pharmacists. Archived from the original on 23 April 2020.
Language matters
PDE-5 inhibitors appear to have significant but moderate efficacy in secondary [Raynaud's phenomenon]. "Sublingual sildenafil in the treatment of erectile dysfunction: faster onset of action with less dose". "The Serendipitous Story of Sildenafil: An Unexpected Oral Therapy for Erectile Dysfunction". ^ "Drug Approval Package: Viagra (sildenafil citrate) NDA #020895". U.S.
By Mode of Administration
Food and Drug Administration (FDA). Archived from the original on 31 March 2021. Archived from the original on 12 August 2025. ^ "Sildenafil Drug Usage Statistics, United States, 2014 - 2023". "Generic Viagra: Two versions of sildenafil hit the market today". Archived from the original on 9 January 2009. Archived from the original on 22 February 2021. ^ a b "Viagra now available over the counter without prescription in the UK". Archived from the original on 26 March 2021. Archived from the original on 8 December 2013. "The coming generics threat to Pfizer's Viagra brand just got scarier". Archived from the original on 9 September 2017.
| Rank | Drug Name | Estimated Sales (USD Millions) | Market Share (%) |
|---|---|---|---|
| 1 | Sildenafil | 950 | 45 |
| 2 | Tadalafil | 700 | 33 |
| 3 | Vardenafil | 150 | 7 |
| 4 | Avanafil | 100 | 5 |
^ "Viagra to go generic in 2017 according to Pfizer agreement". Archived from the original on 1 December 2017. "Sex, Drugs and That Little Blue Pill". Archived from the original on 6 December 2017. "Why Pfizer Is About to Slash Viagra's Price in Half".
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Viagra Generic | 150mg | 20 Pills | 55.02€ 52.40€ | |
| Viagra Original | 100mg | 8 Pills | 59.84€ 56.99€ | |
| Cialis Soft Tabs | 20mg | 180 + 8 Pills | 353.17€ 336.35€ | |
| Priligy Generic Dapoxetine | 60mg | 180 + 10 Pills | 494.76€ 471.20€ | |
| Priligy Generic Dapoxetine | 60mg | 10 Pills | 47.63€ 45.36€ | |
| Cialis Generic | 20mg | 360 + 10 Pills | 427.34€ 406.99€ | |
| Viagra Generic | 50mg | 90 + 6 Pills | 107.37€ 102.26€ | |
| Tadalista Super Active | 20mg | 30 + 6 Pills | 128.09€ 121.99€ | |
| Kamagra Gold | 50 mg | 120 + 6 Pills | 281.13€ 267.74€ | |
| Cialis Professional | 20mg | 10 Pills | 48.29€ 45.99€ |
Archived from the original on 7 December 2017. "Pfizer to lose patent of drug Viagra, Indian companies gear up with copycat versions: Pfizer's patent for the formulation of Viagra, used to treat impotence in men, ends in the US in 2020". Archived from the original on 17 April 2021. ^ "Set to conquer US, Indian 'Viagras' may give Pfizer a hard Time". Archived from the original on 22 December 2020. ^ a b "Pfizer Settles Viagra® Patent Litigation With Teva". "Lockout Supplements Issues Voluntary Nationwide Recall of Boner Bears Chocolate Syrup Due to Undeclared Sildenafil". Archived from the original on 19 November 2016. "Counterfeit Viagra, Cialis, Levitra: The Ultimate Guide". Archived from the original on 10 January 2017. "Online pharmacies suspected of counterfeit drug sales". ^ "Erectile Dysfunction Medication the Most Seized Drug During Global Crackdown, Interpol Says". ^ "Global illicit medicines targeted by INTERPOL operation". Archived from the original on 10 December 2023. ^ "Israeli-made AI exposes international fake Viagra network".
Key Benefits For Stakeholders
Archived from the original on 25 November 2018. Archived from the original on 12 February 2022. "With Viagra Now Available Over-The-Counter In The U.K., Will The U.S. "Phosphodiesterase inhibitors for erectile dysfunction in patients with diabetes mellitus". "Strategies for managing sexual dysfunction induced by antidepressant medication".
Watch out for side effects
The Cochrane Database of Systematic Reviews (5) CD003382. Archived from the original on 10 October 2020. "Efficacy and safety of sildenafil treatment in pulmonary arterial hypertension: a systematic review". Archived from the original on 29 August 2021. "Raynaud's phenomenon and digital ischaemia--pharmacologic approach and alternative treatment options".
Erectile dysfunction care at Mayo Clinic
"Efficacy of Sildenafil on healthy humans in high‑altitude hypoxia at rest and during exercise: A meta‑analysis". "Interventions for preventing high altitude illness: Part 1. Archived from the original on 10 June 2017. ^ "FDA Updates Labeling for Viagra, Cialis and Levitra for Rare Post-Marketing Reports of Eye Problems" (Press release). Archived from the original on 22 October 2016. ^ "Counterfeit Viagra Pills, Footwear, Belts, Car Emblems and Headphones Worth over $32 Million Seized at the LA/Long Beach Seaport U.S. Customs and Border Protection". Archived from the original on 12 October 2013.
How to Identify Safe Supplements
"The rise of Viagra among British illicit drug users: 5-year survey data". "Does marijuana use play a role in the recreational use of sildenafil?". Archived from the original on 26 January 2013. "Sildenafil accelerates reentrainment of circadian rhythms after advancing light schedules". Proceedings of the National Academy of Sciences of the United States of America.
3. Urethral suppository
"Source: Roger Clemens, host of athletes pop Viagra to help onfield performance". Archived from the original on 14 August 2020. "Bears' Brandon Marshall says some NFL players use Viagra .. on the Field". Archived from the original on 5 March 2016. "Yes, There Is a Way to Get Generic Viagra". Archived from the original on 2 May 2016. "Pfizer Wins Viagra Patent Infringement Case Against Teva Pharmaceuticals". Archived from the original on 11 January 2015. ^ "Pfizer Completes Transaction to Combine Its Upjohn Business with Mylan". Retrieved 17 June 2024 – via Business Wire. Archived from the original on 17 June 2024. "Viagra patent expires in June, says Brazilian court". Archived from the original on 17 April 2012. ^ "Revatio patent ruled invalid for lack of sound prediction and obviousness". Archived from the original on 3 March 2016. {{cite web}}: CS1 maint: deprecated archival service (link) ^ Teva Canada Ltd. v. Pfizer Canada Inc., 2012 SCC 60 at par. "Supreme Court ruling could lead to cheaper versions of Viagra". Archived from the original on 10 March 2013. "Canadian Supreme court rules Viagra patent invalid".
- Onset of action: How quickly a drug starts to work after administration.
- Duration of action: How long the drug's effects are expected to last.
- Half-life: The time it takes for the drug's concentration to reduce by half.
- Bioavailability: The proportion of the drug that enters circulation when introduced.
- Peak plasma time: The time it takes to reach the maximum concentration in the blood.
- Metabolism: How the drug is broken down, primarily by liver enzymes like CYP3A4.
- Excretion: How the drug is eliminated from the body, usually via urine or feces.
- Storage conditions: Most ED medications are stored at room temperature away from light.
- expiration date: The date after which the drug should not be used.
- Proper disposal: How to safely discard unused or expired medications.
Archived from the original on 11 November 2012. ^ "Viagra patent tossed out by Supreme Court: Decision allows generic versions of drug to be produced". Archived from the original on 18 September 2013. ^ "Pfizer Canada drops Viagra price after generic versions get Supreme Court green light". Archived from the original on 30 November 2012. Archived from the original on 27 December 2013.
Who gets ED?
"Vision disorders and phosphodiesterase type 5 inhibitors: a review of the evidence to date". ^ "FDA Announces Revisions to Labels for Cialis, Levitra and Viagra". "Drug interactions with phosphodiesterase-5 inhibitors used for the treatment of erectile dysfunction or pulmonary hypertension". "Pharmacology and drug interaction effects of the phosphodiesterase 5 inhibitors: focus on alpha-blocker interactions". Use of sildenafil (Viagra) in patients with cardiovascular disease.
Psychological impact
American College of Cardiology/American Heart Association". Journal of the American College of Cardiology. ^ "Viagra (Sildenafil Citrate): Side Effects, Interactions, Warning, Dosage & Uses". Archived from the original on 12 July 2018. "Young men add Viagra to their drug arsenal".
Mechanical devices and procedures
Archived from the original on 4 September 2014. "Recreational use and misuse of phosphodiesterase 5 inhibitors". Archived from the original on 21 August 2016. "Sildenafil does not improve sexual function in men without erectile dysfunction but does reduce the postorgasmic refractory time". ^ McCambridge J, Mitcheson L, Hunt N, Winstock A (March 2006). "In rare move, Pfizer asks Supreme Court to reconsider ruling that killed Viagra patent".