New Erectile Dysfunction Medications: How Do They Compare to Viagra?

Is the new Viagra effective?

Recently, it has been reported that several new medications for sexual dysfunction have been released.
How do they compare to Viagra in terms of efficacy and side effects? Which ones are superior or inferior? When will they be available for purchase in Taiwan, and what is the approximate price?

Xiao Zhou, 50~59 year old female. Ask Date: 2003/09/10

Dr. Xu Weikai reply Urology

Currently, the Taiwanese Department of Health has approved three types of PDE5 inhibitors for market use: the first being Viagra, which has been available for over four years, followed by two new medications approved this year: Cialis from Eli Lilly and Levitra from Bayer.
These medications are considered the most effective for erectile dysfunction at present.
The new drugs have higher specificity, resulting in fewer side effects related to vision and lower interactions with food, meaning they are almost unaffected by food intake.
Additionally, their duration of action is longer; according to the original manufacturers, Cialis can last up to 36 hours.
However, it is important to note that for patients who do not respond to Viagra, the new medications are also unlikely to be effective.
Currently, many of the products available in Taiwan are counterfeit, and there are numerous fake medications on the market.
It is reported that Cialis is sold for around 600-800 NTD per pill.

Reply Date: 2003/09/10

More Info

Erectile dysfunction (ED) is a common condition that affects many men, and while Viagra (sildenafil) has been a well-known treatment for years, several new medications have emerged in the market. These new medications include tadalafil (Cialis), vardenafil (Levitra), and avanafil (Stendra). Each of these medications has unique properties, effects, and side effects that can influence their suitability for individual patients.

Comparison of New ED Medications to Viagra:
1. Mechanism of Action:
All these medications work by inhibiting the enzyme phosphodiesterase type 5 (PDE5), which leads to increased blood flow to the penis during sexual stimulation. This mechanism is similar across all these drugs, but their pharmacokinetics (how the body absorbs, distributes, metabolizes, and excretes the drug) differ.

2. Onset of Action:
- Viagra (Sildenafil): Typically takes about 30-60 minutes to take effect.

- Cialis (Tadalafil): Can take effect in as little as 15 minutes and lasts up to 36 hours, which is why it is often referred to as the "weekend pill."
- Levitra (Vardenafil): Similar to Viagra, it usually takes about 30-60 minutes to work.

- Stendra (Avanafil): Has a rapid onset, often working within 15 minutes.

3. Duration of Action:
- Viagra: Lasts about 4-6 hours.

- Cialis: Lasts the longest, up to 36 hours.

- Levitra: Lasts about 4-5 hours.

- Stendra: Lasts about 6 hours.

4. Side Effects:
Common side effects for all these medications include headaches, flushing, nasal congestion, and dyspepsia. However, some differences exist:
- Viagra and Levitra: May cause more visual disturbances, such as changes in color perception.

- Cialis: Can cause muscle aches and back pain due to its longer duration of action.

- Stendra: Generally has a favorable side effect profile and is less likely to cause visual disturbances.

5. Food Interactions:
- Viagra and Levitra: Their effectiveness can be reduced if taken with a high-fat meal.

- Cialis: Less affected by food intake.

- Stendra: Can be taken with or without food, making it more convenient.

Availability and Pricing in Taiwan:
The availability of these medications in Taiwan may vary. Viagra has been available for a long time, while newer medications like Cialis, Levitra, and Stendra may have different timelines for approval and market entry. Prices can also differ based on the medication and the pharmacy. Generally, branded medications tend to be more expensive than their generic counterparts. For example, Viagra may cost around NT$1,500 for a pack of four tablets, while Cialis and Levitra may have similar pricing, with Stendra potentially being priced higher due to its newer status.

Conclusion:
When comparing new ED medications to Viagra, it is essential to consider individual patient needs, including the onset and duration of action, side effects, and personal preferences. Consulting with a healthcare provider is crucial to determine the most appropriate treatment for erectile dysfunction, as they can provide tailored advice based on medical history and specific symptoms. As new medications continue to emerge, ongoing research will help clarify their effectiveness and safety profiles compared to established treatments like Viagra.

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