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Cialis vs levitra. of Prostatic Symptoms, American Urologication Association, trial, John McConnell"> Erectile Dysfunction (ED) update, 2003 Viagra vs the new PDE-5 Inhibitors: Levitra and Cialis Leonard S. Marks, M.D. Medical Director, USRF Forbes Magazine Compares Viagra & Levitra Hope for Men who Fail Viagra? 4th Quarter, 2003--- Two new ED drugs, vardenafil (Levitra, Bayer) and tadalafil (Cialis, Lilly ICOS), have completed extensive clinical testing, and both drugs have gained FDA's approval. Both are inhibitors of type 5 phosphodiesterase (PDE-5), thus sharing the same basic mechanism of sildenafil (Viagra, Pfizer), which was approved in March, 1998. All three are taken orally prior to planned sexual activity, acting to increase blood flow in the penis in response to sexual stimulation. However, there are important differences between the three, differences that could influence safety, specificity, duration of action, and ultimately, public acceptance within this class of drug. Giles Brindley cialis vs

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And Drug Therapy for ED Modern drug therapy for ED was advanced enormously in 1983 when British physiologist Giles Brindley, Ph.D. dropped his trousers and demonstrated to a shocked AUA audience his phentolamine-induced erection. The drug Brindley injected into his penis was a non-specific vasodilator, an alpha-blocking agent, and the mechanism of action was clearly corporal smooth muscle relaxation. The effect that Brindley discovered, established the fundamentals for the later development of specific, safe, orally-effective drug therapies, ie, PDE-5 inhibitors. PDE Inhibition and Smooth Muscle Relaxation Phosphodiesterase (PDE) is an enzyme that causes breakdown of cyclic GMP, which is the direct intracellular mediator in the nitric oxide (nonadrenergic, noncholinergic) pathway. Discovery of this pathway led to a Nobel Prize in 1998 for the scientists responsible. The nitric oxide system causes relaxation of smooth muscle in blood vessel walls, ie, vasodilation, in various organ syst cialis vs

cialis vs levitra:

cialis vs levitra some differences between the 3 are basic: a table has been created to illustrate the major differences. An obvious proviso is that extensive data are available on Viagra (more than 20 million men treated cialis vs levitra, more than 1100 peer-reviewed articles as of Feb. & 8217;03) cialis vs levitra, but only limited data on Cialis and Levitra. Drs. Gresser and Gleiter from the U. Tubingen in Germany have compared the three drugs via literature review (Eur. J. Med. Res. 7:435 cialis vs levitra, 2002) In brief cialis vs levitra, efficacy is approximately 70% with all 3 drugs. The side effect profile is similar among the 3 drugs cialis vs levitra, except that blue discoloration of vision (overlap with PDE-6 in the retina) is seen only with Viagra cialis vs levitra.

cialis vs levitra (<0.5%) and muscle aches only with Cialis (~5%). Otherwise cialis vs levitra, vasodilatory side effects (headaches cialis vs levitra, nasal congestion cialis vs levitra, flushing) are common with all cialis vs levitra, but are mild cialis vs levitra, and only rarely cause men to drop out of clinical trials (2-3% quit rate). All 3 will carry a contra-indication in men using organic nitrates. Otherwise cialis vs levitra, the long half-life of Cialis (17.5 hours) is noteworthy cialis vs levitra, earning this drug the nickname & 8216;weekender cialis vs levitra, & 8217; as a single dose taken on Friday would still be exerting an effect Sunday (or even Monday). Conclusion Alternative PDE-5 inhibitors Cialis and Levitra will soon be in competition with Viagra cialis vs levitra, and the launch of these new drugs is certain to bring many men with ED into doctors& 8217; offices. Aside from the long half-life of Cialis cialis vs levitra, and the excellent track record of Viagra cialis vs levitra, the differences between the 3 drugs are not great. All appear to be effective and safe cialis vs levitra, provided concomitant nitrates are avoided cialis vs levitra, . A potential for serious hypotension exists should an organic nitrate be used along with any of these three PDE-5 inhibitors. Peer-reviewed References Viagra (sildenafil) Phase III Trial Data (Goldstein in NEJM cialis vs levitra, 1998) First & 8216;real-world& 8217; study of use in a clinical practice (Marks in Urology cialis vs levitra, 1999) Cialis (Lilly ICOS) Phase III Trial Data (Brock in J. Urol. cialis vs levitra, 2002) Levitra (Bayer) Pha.

cialis vs levitra to bring many men with ED into doctors& 8217; offices. Aside from the long half-life of Cialis cialis vs levitra, and the excellent track record of Viagra cialis vs levitra, the differences between the 3 drugs are not great. All appear to be effective and safe cialis vs levitra, provided concomitant nitrates are avoided cialis vs levitra, . A potential for serious hypotension exists should an organic nitrate be used along with any of these three PDE-5 inhibitors. Peer-reviewed References Viagra (sildenafil) Phase III Trial Data (Goldstein in NEJM cialis vs levitra, 1998) First & 8216;real-world& 8217; study of use in a clinical practice (Marks in Urology cialis vs levitra, 1999) Cialis (Lilly ICOS) Phase III Trial Data (Brock in J. Urol. cialis vs levitra, 2002) Levitra (Bayer) Phas.

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