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If prescription medicines are thought to be causing or contributing to ED, it may be possible to switch to an alternative treatment. If hormone levels are found to be low, then replacement therapy with testosterone is often very useful.
In most other circumstances, a trial with a medicine that helps men obtain and keep an erection is the next step. There are now three different brands of tablets known as phosphodiesterase type -f (PDE5) inhibitors. The two newer drugs tadalfil (Cialis) and vardenafil (Levitra) work in a similar way to sildenafil (Viagra), the first drug of this type, but take effect more quickly. Men taking nitrate drugs (e.g., glyceryl trinitrate) for angina must not use PDE5 inhibitors at the same time as they can dangerously lower the blood pressure.
For all three medicines, sexual foreplay is needed to start the arousal process. The ability to have erections can last for several hours or with tadalafil for up to about 24 hours.
Side-effects with these treatments tend to be minor and include headaches, nausea, indigestion and a stuffy nose. However, they are prescription only drugs and are not suitable for everyone. There have been rare but serious complications.
In more severe cases of ED, medicines such as alprostadil (contained in Caverject, Viridal Duo and MUSE) can be injected directly into the side of the penis or inserted, as a pellet, into the penis tip. These treatments require instruction by the doctor.
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Medicines
Alternative treatment
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