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Levitra versus cialis. 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 and Drug Therapy for ED Modern drug therapy for ED was advanced enormously in 1983 when British physiologist Giles Brindley, Ph.D. dropped his tro levitra versus
 

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Users 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 systems. The direct intracellular mediator of the nitric oxide pathway is cGMP. PDE catalyzes the degradation of cGMP. This pathway is active in numer levitra versus


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Tadalafil--review of the literature by Gresser U, Gleiter CH. Praxisklinik Sauerlach, Internal Medicine, Tegernseer Landstr. 8, D-82054 Sauerlach, Germany. info@praxisklinik-sauerlach.de Eur J Med Res 2002 Oct 29;7(10):435-46 ABSTRACT Since introduction of the PDE-5 inhibitor sildenafil 4 years ago, there has been a fundamental change in the treatment of erectile dysfunction (ED). Intracavernosal or intraurethral injections of vasoactive substances or penile implants as mechanical aids now play hardly any part in it. - The development of the PDE-5 inhibitors vardenafil and tadalafil prompts the question of whether and how these three substances differ in terms of their efficacy and adverse effects. - Sildenafil has proven to be a very effective medicinal product. Studies with a follow-up period of up to 6 years have been conducted. The success rate of sildenafil varies in the group of ED patients with an organic underlying disease from 43% in patients who have undergone radical prostatectomy to 85% in patients with a neurological underlying disease, and amounts to an average 82% (range 43-85%, 100mg). - In an evaluation of spontaneous reports of deaths associated with sildenafil, the FDA concluded that there was no deducible evidence of an increase in the mortality rate among sildenafil users compared to the general population. In fact, fewer deaths associated in time with the ingestion of sildenafil were reported than might have been expected purely statistically on the basis of the normal mortality rate for men in this age group. - According to the initial studies conduct

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