Erectile dysfunction is a very common problem among men. According to the NIH, nearly half of all men between age 40 and 70 experience erectile dysfunction to some degree. There are many medication based remedies for overcoming ED, and naturally some work better than others.
The only FDA approved drugs used to treat erectile dysfunction are known as Phosphodiesterase type 5 inhibitors (PDE5-Is). They work by blocking the PDE-5 enzyme, an action which relaxes the smooth muscles of the penis and blood vessels so more blood rushes into the penis to create an erection. These drugs are avanafil (Stendra), verdenafil (Levitra), tadalafil (Cialis), and sildenafil (Viagra).
Measuring the effectiveness of these drugs to determine which erectile dysfunction medication works best depends on a number of criteria including how quickly they take effect, how long effects last, and patient preference.
A research effort conducted at the University of Zurich reviewing 82 studies on the efficacy of each drug, as well as their side effects, found Viagra taken in doses of 50 to 100 ml appeared to be the most efficient treatment, with over 50% of subjects performing better than those who took a placebo. In contrast, Stendra taken in doses of 50 to 200ml was found to be the least effective, with only 20 percent of subjects reporting improvement.
The action time of the PDE5 inhibitors also varies from one medication to the next and is another factor to use in determining which ED medication works best.
The mean time to maximum plasma concentration is a good indicator of the time the drug takes to reach maximum effect. One study measured this value at 1 hour for sildenafil and vardenafil, and 2 hours for tadalafil. The half-life of the drug indicates how long its effects last. According to the study, the average half-life for avanafil is 3 hours, 4 hours for sildenafil and vardenafil, and 17.5 hours for tadalafil.
Other factors affect the efficacy of PDE5 inhibitors and, once again, these vary across the different medications. The most prominent of these factors is the consumption of fatty foods. Food high in fat reduces the absorption of verdanafil and sildenafil, but the rate of absorption of tadalafil remains unchanged. The uniqueness of tadalafil in this regard is attributed to its different pharmacokinetic structure.
Early on, Viagra was the most popular ED medication, commanding about 60% of the market while Cialis controlled a distant second with 26%. Viagra was the first to hit the market and gained market share and a strong following as the only approved medication available for ED. It was introduced 12 years earlier than Cialis and Levitra and had time to build up a reputation among users before the other two hit the market.
Despite Viagra’s head start, Cialis has gained popularity in recent years due to its impressive duration of action. Although it takes a bit longer than Viagra and Levitra to kick in, Cialis’ ability to be absorbed on a full stomach and its longer lasting erections make it arguably the most effective medication for ED.
And what about the most effective erectile dysfunction treatment that doesn’t involve medications? Well, that’s debatable too, but we tend to like this one.