What Are the Differences Between Cialis, Levitra, Staxyn, and Viagra?

Cialis, Levitra, Staxyn, and Viagra work by a similar mechanism to cause erections. There are subtle differences in how long the drug works and how quickly it works. Levitra works a little longer than Viagra. They both take effect in about 30 minutes. With Levitra, the effects last for about 5 hours. With Viagra, the effects last approximately 4 hours.

Cialis works a bit faster (within about 15 minutes), and the effects last much longer -- up to 36 hours in some cases. Staxyn is an orally disintegrating tablet that contains the same active ingredient as Levitra but is not interchangeable with Levitra tablets. 

If One of These Drugs Isn't Effective for Erectile Dysfunction, Can I Try Another?

Yes, but because these drugs work the same way, it's unlikely that you'll have success with one if you've failed to achieve an adequate erection with another.

What Precautions Should I Take Before Taking One of These Drugs?

There are certain situations in which these drugs may not be safe to take. Before taking them, tell your doctor:

• If you are allergic to any drugs, including Viagra or other ED medications.
• About any prescription or nonprescription medications you are currently taking, including herbal and dietary supplements.
• If you are scheduled for surgery, including dental surgery.
• If you take nitroglycerin or a long-acting nitrate to treat chest pain. The combination of Cialis, Levitra, Staxyn, or Viagra with these drugs can cause dangerously low blood pressure.
• If you take alpha-blockers for blood pressure or prostate problems. The combination of Cialis, Levitra, Staxyn, or Viagra with these drugs can also cause dangerously low blood pressure. Patients should not be started on Staxyn unless they have previously taken Levitra as directed by their doctor.

In addition, always follow the directions on your prescription label carefully and ask your doctor or pharmacist to explain any part that you do not understand. Take these drugs exactly as directed. Do not take more or less or take it more often than prescribed by your doctor. Do not take these drugs more than once a day.

Who Should Not Take Cialis, Levitra, Staxyn, or Viagra?

If you have suffered from a heart attack, stroke or life threatening arrhythmia (irregular heart rate) within the last 6 months you should discuss other options with your doctor. It is also advised to avoid these drugs if you have uncontrolled high or low blood pressure or if you experience chest pain with sex.
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Does Injection Therapy Work?

Alprostadil delivered via the injection method causes an erection firm enough for sexual intercourse in over 80% of men with erectile dysfunction, regardless of their age or the cause of their problem. Alprostadil delivered via a suppository is not as effective as the injection -- it produces an erection in approximately 30%-40% of men with ED.

How Quickly Will Alprostadil Work?

Alprostadil usually begins to work in about five to 20 minutes. Intercourse should be attempted within 10 to 30 minutes after using the medication.  This will produce an erection that lasts about an hour. An erection may continue after ejaculation. It is advised to use no more than three times per week with at least 24 hours between each use.

Who Should Not Take Alprostadil?

This drug is not right for everyone. Before taking alprostadil, tell your doctor:

• If you have ever had an allergic reaction to alprostadil.
• If you are allergic to any other substances such as medicine, foods, preservatives, or dyes.
• If you are taking any prescription or over-the-counter medicine including herbal and dietary supplements.
• If you have a penile implant.
• If you have a history of priampism (a painful and prolonged erection not associated with sexual stimulation).

Also, tell your doctor if you have any medical problems, especially:

• Abnormalities to your penis such as curvature or birth defects.
• Bleeding problems.
• Penile infection.
• Red or itchy penis.
• Conditions that cause thickened or slower blood flow such as leukemia (cancer of the blood), sickle cell disease or trait, or thrombocythemia (large number of platelets).
• Peyronie's disease

If alprostadil is not safe for you to take, your doctor can recommend other treatment options that are
appropriate based on your health and medical history.

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How Does the Penile Prosthesis Work?

The inflatable penile prosthesis consists of two attached cylinders -- a reservoir and a pump -- which are placed surgically in the body. The two cylinders are inserted in the penis and connected by tubing to a separate reservoir of fluid. The reservoir is implanted under the groin muscles. A pump is also connected to the system and sits under the loose skin of the scrotal sac, between the testicles.

This penile prosthesis is referred to as a 3-piece inflatable penile prosthesis, due to the three different components. A 2-piece inflatable penile prosthesis consists of only two components: the attached cylinders and the combined reservoir and pump unit. Instead of the reservoir being placed behind the groin, it is combined with the pump into one housing unit that fits comfortably within the scrotum. The advantage of a 2-piece prosthesis in that the surgery is shorter and less complicated and there is no device parts in the abdomen. The disadvantage of the 2-piece prosthesis is that the smaller reservoir may not result in adequate erections in some men. 

To inflate the prosthesis, the man presses on the pump. The pump transfers fluid from the reservoir to the cylinders in the penis, inflating them and causing an erection. Pressing on a deflation valve at the base of the pump returns the fluid to the reservoir, deflating the penis and returning it to the normal flaccid state.

Is the Prosthesis Noticeable?

While men who have had the prosthesis surgery can see the small surgical scar where the bottom of the penis meets the scrotal sac, other people probably will be unable to tell that a man has an inflatable penile prosthesis. Most men would not be embarrassed in a locker room or public restroom, for example.

What Is Sex Like With the Prosthesis?

When the penis is inflated, the prosthesis makes the penis stiff and thick, similar to a natural erection. Most men rate the erection as shorter than their normal erection; however, newer models have cylinders that may increase the length, thickness, and stiffness of the penis.

A penile prosthesis does not change sensation on the skin of the penis or a man's ability to reach orgasm. Ejaculation is not affected. Once a penile prosthesis is put in, however, it may destroy the natural erection reflex. Men usually cannot get an erection without inflating the implant. If the implant is removed, the man may never again have natural erections.

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