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If the sildenafil response is not reliably improving erection, the physician should first check if the patient is taking the pill correctly. One investigator in Italy gave testosterone to patients with low testosterone who did not respond to sildenafil Viagra. When daily testosterone was given, subsequent sildenafil Viagra use resulted in IIEF the International Index of Erectile Function questionnaire used to determine erectile function scores improving significantly. Other risk factors for erectile dysfunction include neurologic problems multiple sclerosis, strokedepression and medications for treating diabetes, hypertension, heart disease and depression.

There are many oral therapies for erectile dysfunction, but the only approved medication in the US is the PDE 5 enzyme inhibitor sildenafil Viagra. Unapproved therapies, some of which are available in the US and some elsewhere, some of which have data to prove efficacy and some not, include tadalafil Cialisvardenafil Levitrayohimbine, phentolamine, trazodone, apomorphine and neutraceuticals. PDE5 inhibitors act to relax penile erectile tissues with sexual stimulation thus enhancing your ability to get an erection. Why is there a need for another pill? Structurally vardenafil Levitra is similar to sildenafil, while tadalafil Cialis is very different. Vardenafil Levitra is almost 10 times more biochemically potent than sildenafil, therefore a lower dose is needed to facilitate the penile erection, potentially resulting in less side effects.

Selectivity is the ability of the drug to attach to the specific enzyme PDE 5 found in penile tissues. Vardenafil Levitra is more selective than sildenafil and tadalafil Cialis to PDE5, which again means a lower dose is needed with potentially less side effects.

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Pharmacokinetics, half-life, is how long the medication stay s in the blood. Sildenafil Viagra has a half-life of 4 hours and vardenafil Levitra has a half-life of hours while tadalafil Cialis Enzymr a half-life of This means that vardenafil Levitra should act longer than sildenafil Viagra but the clinical significance is not known. Tadalafil Cialis has the longest half-life and allows you to take the medication and not relate the sexual activity to the immediate use of the medication. The drawback is if you need nitrates after using tadalafil Cialisthis medication lasts a long time in your blood stream and may place you at a higher risk. Younger people might do well treated with tadalafil, Cialis while older people with other health issues might be better off using sildenafil Viagra or vardenafil Levitra but more data are needed.

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