Erectile dysfunction drugs: Difference between revisions

Erectile dysfunction drugs
Other names	sildenafil citrate, Viagra
Health risk	Mild
Addiction risk	Mild
Legal risk	Mild

VisualWikitext

Latest revision as of 20:10, 16 November 2025

Several oral medications are available for treating erectile dysfunction (the inability to get or keep an erection). The four most common are sildenafil (Viagra), tadalafil (Cialis), avanafil (Stendra), and vardenafil (Levitra). These medications all improve blood flow to the penis when combined with sexual stimulation and are collectively known as phosphodiesterase 5 (PDE5) inhibitors. PDE5 inhibitors do not cause erections without sexual arousal, and do not increase arousal.

PDE5 inhibitors all work the same way, so they have similar effects, risks, and risk mitigation strategies. However, they differ in how quickly and how long they work:

Differences between oral PDE5 inhibitors for treatment of erectile dysfunction
Drug	Common brand name(s)	Time to take effect^[1]	Duration of effect^[1]	Instructions^[2]
Sildenafil	Viagra, Kamagra	30-60 minutes	4-5 hours	Take on an empty stomach before sex. High-fat foods and alcohol increase time to take effect
Tadalafil	Cialis, Cialis Daily, Adcirca	30-45 minutes	24-36 hours	Take with or without food before sex. Can also be prescribed as a lower dose taken daily for continuous effect.
Avanafil	Stendra, Spedra	15-30 minutes	6-12 hours	Take with or without food before sex.
Vardenafil	Levitra, Staxyn	30-60 minutes	4-5 hours	Take on an empty stomach before sex. High-fat foods and alcohol increase time to take effect

Background

Mechanism of action

Oral erectile dysfunction medications increase blood flow (vasodilation) by inhibiting the enzyme phosphodiesterase 5 (PDE5).^[3] They also inhibit PDE5 elsewhere in the body, particularly the lungs, and can cause systemic vasodilation.

Erections occur when spongy tissue in the penis (the corpora cavernosa and corpus spongiosum) fill with blood, expand, and become rigid. The erectile tissue is surrounded by smooth muscle that is tonically (usually) contracted, and the muscle must relax (vasodilation) for sufficient blood to enter the penis. During arousal, the body increases production of cyclic guanosine monophosphate (cGMP), a molecule that triggers smooth muscle relaxation. Sildenafil increases the amount of cGMP in the corpora cavernosa by protecting cGMP from degradation by PDE5. Sildenafil has a similar molecular shape to cGMP and can bind strongly to PDE5, blocking cGMP from entering the enzyme's active site.

Other medical uses

In addition to erectile dysfunction, sildenafil is used to treat pulmonary arterial hypertension (a type of high blood pressure) in men and women.^[4]

Risks

Check the notes in the medication for side effects. Different "fillers" for tablets can have different side effects.

If it affects your blood pressure, it can make you feel spaced out and other symptoms (feeling weak, sick blurred vision, fainting), in this case you should stop further sexual and BDSM activities, and ensure you are somewhere safe in case you pass out.

If experiencing prolonged or painful erection, especially if it lasts for more than 2 hours, call emergency services^[5].

Drug interactions

Addiction

Risk mitigation

Erectile dysfunction drugs should never be used with poppers as together they can cause fatal drop in blood pressure. They should also not be used in combination with other medicines being used to treat blood pressure.

If the user is feeling symptoms of low blood pressure:

Seek medical attention
Lay down
Sitting up or standing up suddenly can worsen lightheadedness or cause fainting.
Drink water
Do not consume alcohol or other substances

Known incidents

Medical case reports

RACKWiki incident reports

References

https://www.nhs.uk/conditions/low-blood-pressure-hypotension/

↑ ^1.0 ^1.1 "Which drug for erectile dysfunction?". Harvard Health. 2014-05-12. Retrieved 2025-11-17.
↑ "What to know about oral meds for erectile dysfunction". Mayo Clinic. Retrieved 2025-11-17.
↑ "Sildenafil". go.drugbank.com. Retrieved 2025-11-06.
↑ "Sildenafil (oral route) - Side effects & dosage". Mayo Clinic. Retrieved 2025-11-06.
↑ "Side effects of sildenafil". nhs.uk. 2022-03-03. Retrieved 2024-02-16.

[:0-1] 1.0 ^1.1 "Which drug for erectile dysfunction?". Harvard Health. 2014-05-12. Retrieved 2025-11-17.

[2] "What to know about oral meds for erectile dysfunction". Mayo Clinic. Retrieved 2025-11-17.

[3] "Sildenafil". go.drugbank.com. Retrieved 2025-11-06.

[4] "Sildenafil (oral route) - Side effects & dosage". Mayo Clinic. Retrieved 2025-11-06.

[5] "Side effects of sildenafil". nhs.uk. 2022-03-03. Retrieved 2024-02-16.

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@@ Line 1: / Line 1: @@
-'''Sildenafil''' (brand name(s): '''Viagra, Kamagra''') is a drug used to treat erectile dysfunction.
+{{Infobox drug
+| other_names = sildenafil citrate, Viagra
+| image_file =
+| image_caption =
+| health_risk = Mild
+| addiction_risk = Mild
+| legal_risk = Mild
+| link_psychonautwiki =
+| link_erowid =
+}}
-== Risks ==
+{{Hatnote|This page is about oral medications. For the injectable medication, see [[Trimix]].}}
-You should check the notes in the medication for side effects, different "fillers" for tablets can have different side effects.
-If it affects your blood pressure, it can make you feel spaced out and other symptoms (feeling weak, sick blurred vision, fainting), in this case you should stop further sexual and BDSM activities and ensure you are somewhere safe in case you do blackout.
+Several oral medications are available for treating erectile dysfunction (the inability to get or keep an erection). The four most common are '''sildenafil '''('''Viagra'''), '''tadalafil '''('''Cialis'''), '''avanafil '''('''Stendra'''), and '''vardenafil '''('''Levitra'''). These medications all improve blood flow to the penis when combined with sexual stimulation and are collectively known as '''phosphodiesterase 5 (PDE5) inhibitors'''. PDE5 inhibitors do not cause erections without sexual arousal, and do not increase arousal.
-if you have a prolonged or sometimes painful erection, especially if it lasts for more than 2 hours, call emergency services.<ref>{{Cite web |date=2022-03-03 |title=Side effects of sildenafil |url=https://www.nhs.uk/medicines/sildenafil-viagra/side-effects-of-sildenafil/ |access-date=2024-02-16 |website=nhs.uk |language=en}}</ref>
+PDE5 inhibitors all work the same way, so they have similar effects, risks, and risk mitigation strategies. However, they differ in how quickly and how long they work:
+{| class="wikitable"
+|+Differences between oral PDE5 inhibitors for treatment of erectile dysfunction
+!Drug
+!Common
+brand name(s)
+!Time to
+take effect<ref name=":0">{{Cite web |date=2014-05-12 |title=Which drug for erectile dysfunction? |url=https://www.health.harvard.edu/mens-health/which-drug-for-erectile-dysfunction |access-date=2025-11-17 |website=Harvard Health |language=en}}</ref>
+!Duration
+of effect<ref name=":0" />
+!Instructions<ref>{{Cite web |title=What to know about oral meds for erectile dysfunction |url=https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/in-depth/erectile-dysfunction/art-20047821 |access-date=2025-11-17 |website=Mayo Clinic |language=en}}</ref>
+|-
+|Sildenafil
+|Viagra, Kamagra
+|30-60 minutes
+|4-5 hours
+|Take on an empty stomach before sex. High-fat foods and
+alcohol increase time to take effect
+|-
+|Tadalafil
+|Cialis, Cialis Daily,
+Adcirca
+|30-45 minutes
+|24-36 hours
+|Take with or without food before sex. Can also be prescribed
+as a lower dose taken daily for continuous effect.
+|-
+|Avanafil
+|Stendra, Spedra
+|15-30 minutes
+|6-12 hours
+|Take with or without food before sex.
+|-
+|Vardenafil
+|Levitra, Staxyn
+|30-60 minutes
+|4-5 hours
+|Take on an empty stomach before sex. High-fat foods and
+alcohol increase time to take effect
+|}
-== Risk Mitigation ==
-Sildenafil should never be used with poppers as together they can cause fatal drop in blood pressure.
-It should also not be used in combination with other medicines being used to treat blood pressure.
+== Background<!-- Provide background information for this drug. --> ==
-If you are feeling symptoms of low blood pressure, you should ensure you:
+=== Mechanism of action ===
+Oral erectile dysfunction medications increase blood flow (vasodilation) by inhibiting the enzyme phosphodiesterase 5 (PDE5).<ref>{{Cite web |title=Sildenafil |url=https://go.drugbank.com/drugs/DB00203 |access-date=2025-11-06 |website=go.drugbank.com |language=en}}</ref> They also inhibit PDE5 elsewhere in the body, particularly the lungs, and can cause systemic vasodilation.
-* Get up, sit down and move slowly
+Erections occur when spongy tissue in the penis (the corpora cavernosa and corpus spongiosum) fill with blood, expand, and become rigid. The erectile tissue is surrounded by smooth muscle that is tonically (usually) contracted, and the muscle must relax (vasodilation) for sufficient blood to enter the penis. During arousal, the body increases production of cyclic guanosine monophosphate (cGMP), a molecule that triggers smooth muscle relaxation. Sildenafil increases the amount of cGMP in the corpora cavernosa by protecting cGMP from degradation by PDE5. Sildenafil has a similar molecular shape to cGMP and can bind strongly to PDE5, blocking cGMP from entering the enzyme's active site.
-* Eat small amounts of food more frequently
-* Increase the amount of water you drink
+=== Other medical uses ===
-* Do not move suddenly
+In addition to erectile dysfunction, sildenafil is used to treat pulmonary arterial hypertension (a type of high blood pressure) in men and women.<ref>{{Cite web |title=Sildenafil (oral route) - Side effects & dosage |url=https://www.mayoclinic.org/drugs-supplements/sildenafil-oral-route/description/drg-20066989 |access-date=2025-11-06 |website=Mayo Clinic |language=en}}</ref>
+== Risks<!-- Describe the risks of this drug. --> ==
+Check the notes in the medication for side effects. Different "fillers" for tablets can have different side effects.
+If it affects your blood pressure, it can make you feel spaced out and other symptoms (feeling weak, sick blurred vision, fainting), in this case you should stop further sexual and BDSM activities, and ensure you are somewhere safe in case you pass out.
+If experiencing prolonged or painful erection, especially if it lasts for more than 2 hours, call emergency services<ref>{{Cite web |date=2022-03-03 |title=Side effects of sildenafil |url=https://www.nhs.uk/medicines/sildenafil-viagra/side-effects-of-sildenafil/ |access-date=2024-02-16 |website=nhs.uk}}</ref>.
+=== Drug interactions<!-- Describe the interactions of this drug. --> ===
+=== Addiction<!-- Describe the addiction risk for this drug. --> ===
+== Risk mitigation<!-- Describe the risk mitigation for this drug. --> ==
+Erectile dysfunction drugs should never be used with [[poppers]] as together they can cause fatal drop in blood pressure. They should also not be used in combination with other medicines being used to treat blood pressure.
+If the user is feeling symptoms of low blood pressure:
+* Seek medical attention
+* Lay down
+* Sitting up or standing up suddenly can worsen lightheadedness or cause fainting.
+* Drink water
 * Do not consume alcohol or other substances
+== Known incidents<!-- Provide a list of links to articles describing incidents involving this drug. --> ==
+=== Medical case reports<!-- List medical case reports related to the use of this drug. --> ===
+=== RACKWiki incident reports<!-- List RACKWiki incident reports related to the use of this drug. --> ===
 == References ==
 https://www.nhs.uk/conditions/low-blood-pressure-hypotension/
+<references />
-[[Category:Drugs]]