What is erectile dysfunction?
The malady formerly known as impotence, erectile dysfunction (ED) is the inability to get or maintain an erection sufficient for satisfying sex. That might include erections that don’t last as long as you want or aren’t as firm as you’d like. ED is very prevalent among American men: Experts estimate that more than 30 million American men have experienced these kinds of erection issues (Nunes, 2012).
What Is the Erectile dysfunction Medications ?
Erectile dysfunction (ED), also called impotence, can affect your quality of life by decreasing your satisfaction from sex. ED can have many causes, both psychological and physical. ED from physical causes is fairly common in men as they age. Medications are available that can help treat ED for many men.
The most well-known ED medications include:
- tadalafil (Cialis)
- sildenafil (Viagra)
- vardenafil (Levitra)
- avanafil (Stendra)
These prescription drugs increase the levels of nitric oxide in your blood. Nitric oxide is a vasodilator, meaning it makes your blood vessels widen to help increase the blood flow. These drugs are especially effective at widening the blood vessels in your penis. More blood in your penis makes it much easier for you to get and maintain an erection when you are sexually aroused.
However, these drugs can also cause side some effects. Here are seven of the most common side effects from ED medications.
Headaches are the most common side effect associated with ED medications. The sudden change in blood flow from the increased levels of nitric oxide causes the headaches.
This side effect is common with all forms of ED medications, so switching brands won’t necessarily alleviate your symptoms. If you have headaches from your ED drug, talk to your doctor about how to prevent them.
Body aches and pains
Some people have muscle aches and pains throughout their bodies while taking ED medications. Others have reported specific pain in their lower back. If you have these types of pain while taking ED medication, over-the-counter (OTC) pain medication may help.
However, you should talk to your doctor about other possible causes of your pain. Your doctor can help you choose an OTC medication that is safe to take with your ED medications and with any other medications you take.
Digestive system problems
Your ED medication may cause uncomfortable digestive system side effects. The most common are indigestion and diarrhea.
To help relieve minor problems, consider making dietary changes to reduce upset stomach. Drinking water instead of caffeinated beverages, alcohol, or juice may help. If changing your diet doesn’t work, talk to your doctor about OTC remedies that may help.
An increase in nitric oxide can cause some men to become dizzy. The dizziness caused by ED medications is generally mild. However, any dizziness can cause discomfort during everyday activities.
In rare cases, dizziness from ED medications has led to fainting, which can become a serious health issue. You should tell your doctor if you experience dizziness while taking ED medications. If you faint while taking these medications, see your doctor right away.
ED medications can change the way you see things — literally. They can temporarily alter your eyesight and even cause blurry vision. ED medications aren’t recommended if you have had vision loss, or a retinal disorder called retinitis pigmentosa.
A complete loss of vision or changes that don’t go away can signify a more serious issue with your ED medication. Seek emergency medical care if you experience these symptoms.
Flushes are temporary periods of redness of the skin. Flushes usually develop on your face and may also spread to parts of your body. Flushes can be mild, like blotchy skin, or severe, like rashes. Although the appearance may make you uncomfortable, flushes typically aren’t harmful.
Flushes from ED medications may get worse when you:
- eat hot or spicy foods
- drink alcohol
- are outside in warm temperatures
Congestion and runny nose
Congestion or a runny or stuffy nose can be a common symptom of ED medications. In most cases, these side effects go away without treatment. Talk to your doctor if they persist.
Minor side effects are common when taking ED medication. Still, there are a few side effects that aren’t as common, and some can even be dangerous. Severe side effects of ED medications can include:
- priapism (erections that last longer than 4 hours)
- sudden changes in hearing
- vision loss
Contact your doctor immediately if you have any of these severe side effects.
Certain men are more at risk of these side effects than others. This may be because of other conditions they have or other medications they take.
Serious side effects of ED medication
Go to the emergency room immediately if you experience any of the following symptoms or side effects:
- Chest pain
- Shortness of breath
- Severe headaches
- Erections that last longer than four hours
- Visual changes (like loss of sight)
- Or anything out of the ordinary—even lightheadedness
If you notice any severe or prolonged symptoms at all, contact a healthcare provider immediately. It doesn’t matter how rare a side effect is if you’re the one experiencing it.
When discussing ED treatment with your doctor, it’s important to tell them about all drugs that you take and other health conditions you have. If ED drugs aren’t right for you, your doctor may suggest other treatment options, such as surgery or vacuum pumps.
What drugs interact with Cialis and Viagra?
The breakdown and elimination of tadalafil from the body may be decreased by erythromycin, ketoconazole (Nizoral), itraconazole (Sporanox), indinavir (Crixivan) and ritonavir (Norvir). Therefore, these drugs may increase the levels of tadalafil in the blood. If these drugs are being used at the same time as tadalafil, the dose of tadalafil should be reduced to 10 mg every 72 hours when used as needed or 2.5 mg when used daily in order to avoid side effects from high levels of tadalafil.
Rifampin, carbamazepine (Tegretol, Tegretol XR, Equerto, Carbatrol), phenytoin (Dilantin, Dilantin-125), and phenobarbital may decrease blood levels of tadalafil, possibly reducing the effect of tadalafil.
Tadalafil exaggerates the increases in heart rate and lowering of blood pressure caused by nitrates, for example, nitroglycerin, isosorbide dinitrate (Isordil), isosorbide mononitrate (Imdur, Ismo, Monoket), nitroglycerin (Nitro-Dur, Transderm-Nitro) that are used primarily for treating heart pain (angina). In patients who take nitrates for angina, tadalafil could cause heart pain or possibly even a heart attack by exaggerating the increase in heart rate and the lowering of blood pressure. Therefore, tadalafil should not be used with nitrates.
Tadalafil also exaggerates the blood pressure lowering effects of some alpha-blocking drugs for example, terazosin (Hytrin) that primarily are used for treating high blood pressure or enlargement of the prostate (BPH). Individuals who take these alpha-blockers should be on a stable dose of the alpha-blocker before tadalafil is started. In such situations, tadalafil should be started at the lowest dose. If the patient is already taking tadalafil, the alpha-blocker should be started at the lowest dose. Combining tadalafil with alpha-blockers for treatment of BPH is not recommended.
Tadalafil and alcohol both lower blood pressure. Therefore, combining tadalafil with alcohol may cause excessive drops in blood pressure and cause dizziness, headaches, and increased heart rate.
PDE5 inhibitors may affect platelet function and therefore prolong bleeding. Tadalafil should be used cautiously in patients with bleeding disorders or active ulcers. Tadalafil should not be combined with Adcirca (another form of tadalafil) or other PDE5 inhibitors, for example, vardenafil (Levitra) or sildenafil (Viagra, Revatio).
Viagra increases the effects of the blood pressure lowering medications. It also increases the blood pressure lowering effects of nitrates, for example, isosorbide dinitrate (Isordil), isosorbide mononitrate (Imdur, Ismo, Monoket), nitroglycerin (Nitro-Dur, Transderm-Nitro) that are used primarily for treating angina. Patients taking nitrates should not receive Viagra.
Patients should not combine Viagra with other PDE5 inhibitors (for example, vardenafil [Levitra], tadalafil [Cialis]).
Cimetidine (Tagamet), erythromycin, ketoconazole (Nizoral), itraconazole (Sporanox), atazanavir (Reyataz), and mibefradil (Posicor) can cause marked increases in the amount of Viagra in the body. Patients taking these medications should be observed carefully if sildenafil is used.
It is expected that rifampin will decrease blood levels of Viagra and probably reduce its effectiveness.