 Four prescription medications have been proven to help with impotence, a condition in which men have difficulty getting or keeping an erection. These medications are sildenafil (brand name Viagra), alprostadil (>Caverject, >Edex, >Muse, and tadalafil (brand name >Cialis).According to reports, Viagra increases sexual ability in 65 percent to 88 percent of men who use it. Typically, you take a 50-mg dose one hour before sexual activity. Sometimes, doses have to be adjusted to improve Viagra's effectiveness or avoid side effects. People with heart conditions, bleeding disorders, or stomach ulcers should not take Viagra. Also, Viagra can interact with medications for chest pain, such as nitroglycerin (Nitrostat) or isosorbide mononitrate (ISMO). Edex, Muse and Caverject are prescription medications with the same active ingredient, alprostadil. Edex and Caverject are liquid medications that you self-inject into the penis using a syringe and needle. Muse is a suppository that you insert into the opening in the tip of the penis. Use Muse or Caverject approximately ten minutes before sexual activity to help achieve an erection. Reports claim that Muse works in approximately 65 percent of men, Edex works in about 75% of men, and Caverject works in up to 87 percent of men. The effects of these medications generally last 30 to 60 minutes. The actual time will vary from person to person, though. You should take only one of these two drugs in any 24-hour period. Cialis is a new medication for the treatment of impotence. Research has shown that up to eighty percent of men taking 10-20 mg of Cialis orally had improved erections. The most common adverse events are headache and stomach upset. Several other prescription medications are also in pharmaceutical development. One tablet, called Vasomax, contains phentolamine which is believed to open blood vessels in the penis, helping men to achieve an erection. Very little is known about the efficacy of this compound but more information should be available within the near future. Another product currently under investigation is a skin gel called Topiglan. The gel contains alprostadil, the same active ingredient in Muse and Caverject. In a recent publication, the gel was reported to help about 50 percent of men who used it. More medical research is needed before the U.S. Food and Drug Administration will approve Topiglan for general use. Other drugs in development for the treatment of impotence are vardenafil and a drug combination containing yohimbine and L-arginine. Additional research is needed before these medicines become available. Sources:
The Merck Manual of Medical Information: Home Edition. Merck & Co., 1997.
McCann, J. "Men's Health and Pharmacy," Drug Topics 142 (1998).
Micromedex Healthcare Series. Micromedex, Inc., 2001.
Edex Product Information. www.edex.com Schwarz Pharma, Inc. Last accessed 7/24/01.
Harin-Padma, N. “Oral Drug Therapy for Erectile Dysfunction.” Urologic Clinics of North America 28 (2001).
This answer prepared 12/10/03.
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