Generality
Impotence is a term widely used, improperly, as a synonym for erectile deficit, a multifaceted disorder characterized by the inability to achieve and / or maintain an erection satisfactory for sexual activity.
For about ten years now, very effective drugs have been available to solve sexual dysfunctions of this type. Unfortunately, according to a typically Western style, these products are often taken as simple solutions to a complex problem, without taking into account why this disorder. In addition to the risk of a possible "drug addiction" or of definitive resignation in the event that they do not have the desired effect, it is also necessary to take into account the side effects of these drugs, generally mild, but rather dangerous for certain individuals.
Which drug to choose?
Viagra, Levitra and Cialis are the commercial names of the drugs most commonly used in the presence of erectile dysfunction, with very often satisfactory results both in terms of efficiency and tolerability.
All the aforementioned drugs belong to the category of PDE5 phosphodiesterase inhibitors and contain, respectively, the active substances sildenafil (Viagra), vardenafil (levitra and vivanza) and tadalafil (Cialis). Recently, a new active ingredient has been added to this category, avanafil (trade name Spedra).
In-depth articles:
- Viagra - Sildenafil
- Viagra
- Sildenafil Teva
- Cialis
- Levitra
- Vivanza - vardenafil
- Vizarsin - sildenafil
- Tadalafil Lilly
- Muse - Alprostadil
- Drugs for the treatment of impotence
The mechanism of action of these drugs is very similar, but taladafil (Cialis) has a much longer duration of action, while avanafil (Spendra) stands out for its rapid onset of action, about 15 min.
This and other small differences can make a product more or less appropriate in relation to the state of health of the user; also for this reason a preventive medical examination is recommended.
Undertaking a therapeutic path to solve the problems underlying impotence helps in many cases to improve the general state of health and prevent a long series of pathologies, even very serious ones. Often, in fact, erection deficits are a symptom of atherosclerosis , or diabetes, excess smoking, as well as too much alcohol or the abuse of certain drugs, not to mention obesity and reduced exercise (increased susceptibility to cardiovascular problems, decreased plasma levels of testosterone).
These drugs inhibit the enzymatic degradation of cGMP, an enzymatic messenger that leads, among other things, to a dilation of the arterioles of the penis, with a consequent increase in the turgor and size of the organ. The cGMP is released following the increased production of nitric oxide, in response to nerve signals, triggered by tactile stimuli from the glans and other erogenous zones, or of a visual, auditory and olfactory nature.
Viagra, Levitra and Cialis are therefore not aphrodisiac drugs, because they do not increase sexual desire, but only make the erection more vigorous and lasting when it is already triggered by appropriate stimuli.
What is the best?
Drugs to combat "impotence" can differ in various respects, such as duration of action, side effects and interactions with other drugs; all these parameters must be carefully evaluated before starting therapy.
Viagra
(sildenafil)
Levitra
(vardenafil)
Cialis
(tadalafil)
How to take them
Away from meals, no more than once a day
Away from meals, no more than once a day
Away from meals, no more than once a day
When to take them
30 to 60 minutes before sexual activity
30 to 60 minutes before sexual activity
30 minutes before sexual activity
Duration of action
average
Four hours
Four hours
Thirty-six hours
When should they not be used?
Viagra, Levitra and Cialis should be used with particular caution if you suffer from hypotension (low blood pressure), heart problems (previous myocardial infarction, angina pectoris, arrhythmias) and retinal problems.
The importance of a preventive medical examination is also linked to the evaluation of possible interactions with any other medications taken by the patient, including herbal remedies.
Viagra, Levitra, and Cialis should never be used together with nitrates, which are specialty medicines for the treatment of chest pain associated with heart problems (angina). Both, in fact, act by dilating the vessels and this could cause a severe drop in blood pressure, resulting in the onset of shock. Nitrates are contained in the following drugs: nitroglycerin (Adesitrin, Deponit, Dermatrans, Epinitril, Keritrina, Minitran, Natispray, Nitraket, Nitrocor, Nitro-Dur, Nitrosylon, Nitroderm, Perganit, Top-Nitro, Triniplas, Trinitrina, Venitrin), isosorbide dinitrate (Carvasrosorbideke), Nitroderm isosorbide mononitrate (Duronitrin, Elan, Ismo Diffutab, Ismo-20, Leicester, Monocinque, Monoket, Vasdilat), amyl nitrite and similar (poppers, drug used for recreational purposes).
Caution also in the simultaneous intake of alpha blockers (terazosin, doxasozine, tamsulosin), medicines used in the treatment of prostatic hypertrophy and which, similarly to what was seen in the previous case, can cause excessive blood pressure drops. In this case the doctor will enforce compliance with certain precautions, such as taking the two drugs at a distance of not less than 4 hours or a reduction in dosages. The only exception is the combination of Cialis and tamsulosin (Omnic, Pradif), which causes no significant side effects.
