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This could potentially extend the duration of adverse effects or delay intervention with nitroglycerin during a cardiac event. In addition, because tadalafil inhibits PDE11, additional studies examining the effects of tadalafil on spermatogenesis as well as on pituitary and cardiac function are also needed.

These studies are expected to be forthcoming. The effects of tadalafil on sperm function are also being investigated. Studies to date have demonstrated no long-term effects of sildenafil on sperm function. Adverse Effects In general, the PDE5 inhibitors are well tolerated and have similar mild to moderate adverse effects profiles. In clinical trials, the most commonly reported adverse events were vasodilation, resulting in headache, nasal congestion, facial flushing, and dyspepsia.

There appears to be a greater incidence of myalgia and low back pain with tadalafil, although the etiology of the myalgia remains unclear. None of the PDE5 inhibitors has any significant drug interactions except for an absolute contraindication for the concomitant use of organic nitrates.

Sildenafil and all agents in this class potentiate nitrate-induced vasodilation. In addition, they are all metabolized by the cytochrome P 3A4 isoenzyme system, and concomitant administration of inhibitors of this pathway eg, cimetidine, ketoconazole, erythromycin, and protease inhibitors will prolong duration of action and raise serum concentrations of the drugs.

Tachyphylaxis The issue of tachyphylaxis with the PDE5 inhibitors, or the loss of clinical effectiveness with chronic use, has generated considerable interest. For biochemical tachyphylaxis to occur, however, cavernosal tissue needs to be exposed to PDE5 inhibitors for approximately 4 to 5 days.

Levine, please confirm. Although this is not likely to occur with sildenafil or vardenafil due to their short half-lives, the extended half-life and delayed clearance of tadalafil may pose a problem. Clinical Efficacy Once the safety of the drug has been established, clinical efficacy is clearly the most important factor for the clinician to consider when selecting a drug. Evidence suggests that all 3 PDE5 inhibitors improve the quality of erections and enable successful intercourse in men with ED of all etiologies, even those with severe ED.

The question as to whether men with certain comorbidities eg, diabetes, post—radical prostatectomy, and hypertension would be more successfully treated with one particular agent awaits further study and experience. Conclusions New oral treatments for ED will soon be available. How physicians will choose which drug to prescribe will be much the same as electing among other classes of drugs with multiple options, such as NSAIDs, alpha-blockers, or SSRIs.

Time to onset of limiting angina during treadmill exercise in men with erectile dysfunction and stable chronic angina: Effect of sildenafil citrate.

Generic vardenafil is equally as safe and effective as the brand name versions but can be significantly cheaper. Keep reading to learn everything you need to know about vardenafil, the generic version of Levitra and Staxyn. To understand how these drugs work, it helps to understand the erection process.

Once you become sexually aroused, your brain sends a message to the blood vessels in your penis to release a chemical called. Other potentially serious symptoms include: ringing in the ears, or sudden hearing loss irregular heartbeat swelling in the ankles, hands, or feet difficulty breathing chest pain The patient should stop using vardenafil if these occur.

Rarely, an allergic reaction may occur. This can lead to hives , difficulty breathing, and swelling of the face, tongue, and throat. It can lead to shock, and it can be fatal. If these symptoms appear, it should be treated as a medical emergency.

Priapism Very rare side effects may include priapism, when an erection lasts longer than 4 hours. This can damage the penis. If an erection lasts too long, the individual should seek medical attention.

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Levitra is a prescription medicine used to treat the symptoms of Erectile Dysfunction (impotence). Levitra may be used alone or with other medications. Vardenafil is a phosphodiesterase type 5 (PDE5) inhibitor with a pharmacokinetic profile and molecular configuration nearly identical to that of sildenafil. A new drug application (NDA) for.

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