How to Take Erectile Dysfunction Drugs for Best Results

written by Dr. Bolanle Aina - Dec 14, 2020
medically reviewed by Dr. Tolulope Olabintan, MD - Aug 3, 2021

Photo Credit: by Pixabay
Photo Credit: by Pixabay

Erectile dysfunction (ED) is the most common sexual dysfunction in men. ED is defined as consistent inability to obtain and or maintain an erection sufficient for sexual intercourse. How common is ED? ED is quite common, its prevalence increase with age. According to a Massachusetts Male Aging Study, about 39% of men aged 40 experience ED, and that number is even higher (67%) in men over 70 years old. ED may be accompanied by other male sexual dysfunctions traits such as low sexual desire, premature ejaculation or delayed ejaculation.

How do you know when be concerned or to see a doctor? Many people wonder if they can test themselves for ED. It's not that straightforward. Occasional inability to obtain erection is not sufficient to be counted as ED. However, when erectile failure occurs more than 50% of the time, then it is time to see the doctor for a review. The doctor will access your medical history and ask you important questions that will aid in confirming the diagnosis.

What causes ED?

Why does ED happen? ED happens due to insufficient blood flow to the penis. There are many factors that may contribute to development of ED. Risks for ED increases with age, obesity, inactivity and presence of other chronic illnesses such as high blood pressure, diabetes, depression or operations for prostate, bladder, and colon cancer.

Certain medications can also cause ED due to their effects on male hormone levels, blood flow and nerves in the penis. Examples of such medications are diuretics, blood pressure medications, antidepressants among others. If you take any drug in these categories, do not stop your medication abruptly, rather discuss with your doctors about your symptoms. The doctor may decide to prescribe another medication.

What are the treatment options?

After assessment by the doctor, the doctor may prescribe an oral ED medication to help improve sexual dysfunction. Successful treatment of ED helps improve self-esteem, confidence, symptoms of depression and sexual relationships. On the other side, addressing underlying medical conditions, psychological factors and reversible causes of ED may help in restoring sexual intimacy. For example some studies have shown that psychological treatment via counselling, when combined with ED drugs give better outcomes than when drugs are used alone.

The most common group of ED medications belong to a class known as PDE5 (phosphodiesterase type 5) inhibitors such as Sildenafil (Viagra), Tadalafil (Cialis) and Vardenafil (Levitra). This group of drugs enhance erection along with effective sexual stimulation and mental sexual arousal by relaxing the muscles in the penis blood vessels and increasing blood flow to the penis shaft thereby increasing penile rigidity.

How to use different ED medications

Among all ED medications, Cialis has the longest duration of action (up to 36 hours) and thus may be taken less frequently and may last for multiple cycles of sexual intercourse. Onset of action for Cialis is 30-60 minutes. Alternatively, Cialis may be taken every day at a lower dose especially in men that have other prostate issues such as difficulty in urination. Daily dosing of Cialis is not recommended in men with kidney impairment. Cialis can be taken with or without food. Do not split the dose. The entire dose should be taken at once. When used on an as-needed basis, Cialis should be taken at least 30 minutes prior to sexual activity. When used on a once-daily basis, it should be taken at the same time each day, without regard to timing of sexual activity.

Viagra begins to work after about 30 minutes, and the duration of action is at least 4 hours. This means Viagra could be taken anywhere from 30 minutes to 4 hours before sexual activity. It is important to note that the absorption of viagra is delayed by high-fat meal. Therefore for maximum effectiveness, viagra should ideally be taken on an empty stomach approximately 1 hour before the planned sexual encounter. Maximum recommended dosing is once every 24 hours.

Vardenafil (Levitra) can be taken about 60 minutes before planned sexual activity and it’s duration of action maybe up to 12 hours. Similar to sildenafil, vardenafil’s absorption is also delayed when taken with high fat food. So it would be better on an empty stomach or with a light low-fat meal. Vardenafil is available as orally disintegrating tablets (ODT) for easy dissolve below the tongue (Staxyn). Staxyn has an advantage that it can be taken discreetly without need for a glass of water and it can be absorbed faster into the blood stream when dissolved under the tongue. Staxyn can be taken 45-90 minutes before intended sexual activity. Vardenafil should not be taken with grapefruit or grapefruit juice to avoid unwanted side effects from the drug.

If you are looking for best results for any of the ED medicines, you need to remember that ED drugs do not work independently like magic. Whichever ED medicine you are using, you need to realise that they work best when used along with sexual stimulation, foreplay and within an environment where partners can share love and express love freely.

Warnings and Precautions:

ED medications should be taken with caution with other bladder or prostate medications such as Tamsulosin and alfuzosin to avoid risk of excessively low blood pressure and dizziness. ED medications should never be taken with any form of Nitrates (NitroDur, Nitrostat), drugs used to relief chest pain (angina) to avoid life threatening dizziness or fainting. ED medications should not be taken in men with low blood pressure or uncontrolled blood pressure and in men with liver or kidney disease.

Common side effects of ED drugs include headache, mild dizziness, and visual changes. Rarely, more serious side effects include sudden loss of hearing or vision and erection that does not go away on its own, lasting for more than 4 hours. Contact your doctor immediately if you experience any of these rare side effects.

Ordering ED medicines online from a Canadian Pharmacy: make sure to get a valid prescription from a licensed physician. Be sure to order from a legitimate online pharmacy such as Canadian Pharmacy World.


Bio: Dr. Bolanle Aina is a licensed pharmacist currently practicing in the community/retail sector. She also holds a Master of Science degree and Doctor of philosophy degree in Pharmacy from the University of Manitoba. She is passionate about health information and medical communication to promote healthy living and optimal drug therapy.


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While the above article is based on thorough research, we do not claim to offer a substitute for medical advice from a qualified healthcare provider. The article was written for information and educational purposes only. We aim to provide helpful information to our readers, but cannot provide a treatment, diagnosis, or consultation of any sort, and we are in no way indicating that any particular drug is safe or appropriate for you and your individual needs. To receive professional medical attention, you must see a doctor.