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Impotence
Drug
Treatments
Drugs for
treating erectile dysfunction can be taken orally, injected directly into the penis, or
inserted into the urethra at the tip of the penis. In March, 1998, the Food
and Drug Administration (FDA) approved Viagra,
the first pill to treat male impotence. In August 2003, the FDA gave approval to a
second oral medicine, vardenafil hydrochloride (Levitra) and Cialis (tadalafil). Additional oral medicines
are being tested for safety and effectiveness.
Taken an
hour before sex,
Viagra (Sildenafil Citrate), Cialis and Levitra work
by enhancing the effects of nitric oxide, a chemical that relaxes smooth
muscles in the penis during sexual stimulation and allows increased blood
flow.
While oral
impotence medicines improve the response to sexual stimulation, they do not trigger
automatic erections as injections do. The recommended dose for
Viagra
is 50 mg, and physicians may adjust this to 100 mg or 25 mg,
depending on the patient.
The recommended dose for
Levitra is 10 mg, and
physicians may adjust this to 20 mg if insufficient. Lower
doses of 5 mg and 2.5 mg are available for patients on other medicines
or have conditions that decrease the body's ability to use Levitra.
The recommended dose for
Cialis is 20mg and effects last up to 36 hours.
These impotence drugs should be not used more than once a day. Men who take nitrate-based
drugs like nitroglycerin should not use these drugs
because the combination can cause a sudden drop in blood pressure. Also, Levitra
should not be taken with any of the drugs called alpha-blockers, which are
used to treat prostate enlargement or high blood pressure.
Oral
testosterone can reduce erectile dysfunction in some men with low natural
testosterone, but is often ineffective and may cause liver damage.
Patients have also claimed other oral impotence drugs--including yohimbine
hydrochloride, dopamine and serotonin agonists, and trazodone--are
effective, but the results of scientific studies to substantiate these
claims are inconsistent. Also, Yohimbe has potentially toxic side effects.
Many men
achieve stronger erections by injecting drugs into the penis, engorging it with blood. Drugs such as papaverine hydrochloride,
phentolamine, and alprostadil (marketed as Caverject) widen blood vessels.
These drugs may cause side effects, including persistent
erection (known as priapism) and scarring. Nitroglycerin, a muscle relaxant,
can sometimes enhance an erection when rubbed on the penis.
A system
for inserting a pellet of alprostadil into the urethra is marketed as Muse.
The system uses a prefilled applicator to deliver the pellet about an inch
deep into the urethra. An erection will begin within 8 to 10 minutes and may
last 30 to 60 minutes. The most common side effects are aching in the penis,
testicles, and area between the penis and rectum; warmth or burning
sensation in the urethra; redness from increased blood flow to the penis;
and minor urethral bleeding or spotting.
Also
see Impotence Herb Treatments
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