Generality
Impotence is a term widely used, improperly, as a synonym for erectile deficit, a disorder with many facets, characterized by the inability to achieve and / or maintain a satisfactory erection for sexual activity.
For the past ten years, there have been very effective drugs available to resolve this type of sexual dysfunction. Unfortunately, according to a typically western style, these products are often assumed as simple solutions to a complex problem, without taking charge of why this disorder occurred. In addition to the risk of a possible "pharmacodependence" or the definitive resignation if they do not have the desired effect, the side effects of these drugs, generally mild but rather dangerous for certain individuals, must also be taken into account.
Which drug to choose?
Viagra, Levitra and Cialis are the trade names of the most commonly used drugs 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 phosphodiesterase PDE5 inhibitors and contain, respectively, the active principles sildenafil (Viagra), vardenafil (levitra and vivanza) and tadalafil (Cialis). Recently, a new active ingredient, avanafil ( Spedra trade name), has been added to this category.
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 medicines is very similar, but the taladafil (Cialis) has a clearly superior duration of action, while the avanafil (Spendra) stands out for a rapid onset of action, about 15 min.
This and other small differences can make a product more or less appropriate in relation to the user's health; also for this reason a preventive medical examination is advisable .
Taking a therapeutic path to solve the problems underlying impotence helps in many cases to improve the general state of health and to prevent a long series of pathologies, even very serious ones. In fact, erection deficits are often 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 drugs physical exercise (increased susceptibility to cardiovascular problems, decreased testosterone plasma levels).
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 turgor and the 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 visual, auditory and olfactory nature.
Viagra, Levitra and Cialis are therefore not aphrodisiac medicines, because they do not increase sexual desire, but merely make the erection more vigorous and lasting when it is already triggered by appropriate stimuli.
What is the best?
Drugs to combat "impotence" may differ in various aspects, such as duration of action, side effects and interactions with other medicines; all these parameters must be carefully evaluated before starting the therapy.
Viagra (Sildenafil) | Levitra (Vardenafil) | Cialis (Tadalafil) | Spedra ( avanafil ) | |
How to hire them | Away from meals, not more than once a day | Away from meals, not more than once a day | Away from meals, not more than once a day | Away from meals, not more than once a day |
When to hire them | 30 to 60 minutes before sexual activity | 30 to 60 minutes before sexual activity | 30 minutes before sexual activity | From 15 to 30 minutes before sexual activity |
Duration of action average | Four hours | Four hours | Thirty-six hours | 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.
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, a medicinal product intended 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 appearance 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) dinitrate (Carvasin, Dinike, Nitrosorbide), isosorbide mononitrate (Duronitrin, Elan, Ismo Diffutab, Ismo-20, Leicester, Monocinque, Monoket, Vasdilat), amyl nitrite and the like ( poppers, a drug used for recreational purposes).
Prudence also in concomitant intake of alpha blockers (terazosin, doxasozine, tamsulosin), medicines used in the treatment of prostatic hypertrophy and which, similarly to what we saw in the previous case, can cause excessive blood pressure drops. In this case the doctor will require compliance with certain precautions, such as taking the two drugs at a distance of time not less than 4 hours or a reduction in dosages. The only exception is the combination of Cialis and tamsulosin (Omnic, Pradif), which does not cause any significant side effects.
