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Medications for Erectile Dysfunction (Impotence)
by Ricker Polsdorfer, MD
The information provided here is meant to give you a general idea of what to expect from each of these medications. Only the most common side effects are included, so ask your healthcare provider if there are any precautions specific to your case. Use each of these medications as recommended by your doctor or according to the instructions provided with the medication. If you have further questions about usage or side effects, contact your doctor.
Erectile dysfunction medications may be in the form of pill, urethral inserts, or injections.
Sildenafil was developed to treat heart disease, but during its clinical trials the subjects noticed they were having erections. Sildenafil works best 1-2 hours after taking it. It has been shown to be effective in men with diabetes, spinal cord injury, and medications used to treat depression.
In contrast to the other agents listed below, sildenafil does not produce an erection in the absence of sexual stimulation. It merely enhances the response. Take sildenafil about an hour before planned sexual activity.
Sildenafil should not be used in the following conditions:
Sildenafil should be used with caution in the following:
Sildenafil must be obtained by prescription. There is important information your doctor needs to know about your health before the medication is prescribed.
Possible side effects include:
Vardenafil, Tadalafil, and Avanafil
Newer drugs have the same efficacy, safety profile, and cost effectiveness as sildenafil. However, major differences from sildenafil exist and include:
There are 2 types of alprostadil:
Alprostadil acts directly on the blood vessels in the penis to cause an erection. It can be inserted into the urethra (urinary tube in the penis) with a special device or injected with a small needle. Erection occurs in 8-10 minutes and lasts 30-60 minutes. The injection is effective in about 65%-85% of users and the insert is effective in about 65%. The maximal number of injections per week is 3.
Possible side effects include:
If you are taking medications, follow these general guidelines:
When to Contact Your Doctor TOP
If 4 hours have passed and your penis still has not relaxed, seek emergency medical care.
Warning About Medications Not Prescribed by Your Doctor TOP
Use caution and talk to your doctor before taking any over-the-counter medications for erectile dysfunction. Some of them may be unsafe.
Erectile dysfunction. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated December 15, 2017. Accessed March 9, 2018.
Erectile dysfuntion. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/genitourinary-disorders/male-sexual-dysfunction/erectile-dysfunction. Updated June 2017. Accessed March 9, 2018.
How is ED treated? Urology Care Foundation website. Available at:
...(Click grey area to select URL)
Accessed March 9, 2018.
Rew KT, Heidelbaugh JJ. Erectile dysfunction. Am Fam Physician. 2016;94(10):820-827.
Treatment of erectile dysfunction. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/treatment. Updated July 2017. Accessed March 9, 2018.
Last reviewed March 2018 by EBSCO Medical Review Board Adrienne Carmack, MD
Last Updated: 3/15/2015
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