Means for the treatment of erectile dysfunction

Medication for the treatment of erectile dysfunction of the first line - oral, which has an advantage due to their complementarity and effectiveness.

Today there are three effective inhibitors of PDE-5( phosphodiesterase type V inhibitors): vardenafil, tadalafil, sildenafil. It is important to remember that these medications do not cause an erection - the appearance of an erection requires the presence of sexual stimulation.

Levitra( vardenafil) - the effect of vardenafil develops half an hour after ingestion. Oily food reduces the effectiveness of vardenafil.

Cialis( tadalafil) - the action of tadalafil occurs after half an hour after administration, maximum effectiveness can be achieved after 2 hours. The drug can last up to 36 hours. The effectiveness of the drug is not dependent on eating.

Viagra( sildenafil) is the first approved inhibitor of type 5 phosphodiesterase. Erectile response occurs after half an hour-hour from the time of taking the remedy. The effectiveness of the drug, as a rule, is maintained for 12 hours. The use of fatty foods can reduce the effectiveness due to prolonged absorption.

Contraindications

The use of these treatments for erectile dysfunction is absolutely contraindicated to people taking such organic nitrates as nitroglycerin, isosorbide dinitrate, isosorbide mononitrate, and other nitro-containing agents used in the treatment of angina pectoris.

Other oral medications.

Apomorphine( uprima) is a central action that enhances erectile signals. According to comparative studies, in apomorphine in comparison with sildenafil significantly lower efficiency. The advantage of the drug is its safety. This drug is suitable for patients taking nitrates.

Yohimbine is an alpha2-adrenoblocker of central and peripheral action. According to various studies, this drug has a low level of effectiveness in the treatment of organic erectile dysfunction.

Fentolamine( Vasomax) is a remedy effectively in half the cases, but its possible carcinogenic effect has suspended further studies.

Trazodone is an antidepressant, a selective serotonin reuptake inhibitor. The efficacy of this drug in the present disease of organic genesis is comparable to placebo.

Medications for the second-line treatment of

If the oral agents are ineffective or if they can not be used due to the constant intake of nitrates, the patient may be offered intracavernous treatment. The effectiveness of intracavernous autoinjection is up to 85%.

Alprostadil( EDEX / VIRIDAL, CAVEREGECT) is the synthetic formula for endogenous prostaglandin E1, the first and only drug approved for intracavernous monotherapy. An erection occurs 5-15 minutes after the administration of the drug and lasts 1-4 hours, depending on the dose administered. The effectiveness of alprostadil is more than 70%.Alprostadil is contraindicated for use with individual intolerance, with a high risk of priapism and bleeding disorders.

Combination of intracavernous agents.

To reduce the incidence of complications, as well as to reduce the cost of therapy, combinations of cavernous preparations are often used. Most often, papaverine, phentolamine, alprostadil, vasoactive intestinal polypeptide are used to formulate combinations.

Intraurethral injection of alprostadil.

To reduce the invasiveness of alprostadil, a means( MUSE) for intraurethral injection has been developed. The effectiveness of intraurethral alprostadil is 30-66%.Possible side effects: pain and dizziness, the development of fibrosis and priapism extremely rare( less than 1%).