Impotence Drugs Duke It Out

Nov. 17, 2003 — Start your engines: Of the medications for
erectile dysfunction, more guys say Levitra gives them better performance.

This result — from what the researcher calls the first
head-to-head study of the three drugs — is being presented at the 6th Congress
of the European Society for Sexual Medicine in Istanbul, Turkey this week.

Viagra and Levitra are to treat erectile
dysfunction. Cialis is currently under review by the FDA to treat erectile
dysfunction and a final word is expected later this year. Levitra is
by Bayer Pharmaceuticals and GlaxoSmithKline, a WebMD sponsor.
Cialis is manufactured by Eli Lilly and Company, a WebMD sponsor. Viagra’s
manufacturer is Pfizer.

Even though Cialis’ effects may last longer, nearly 50% of all
patients preferred Levitra at the recommended starting dose at 10 mg,
researcher Frank Sommer, MD, PhD, a urology specialist at the University
Medical Centre in Cologne, Germany, tells WebMD.

“What they really liked was the quick onset of action, it
was very reliable, and it produced satisfactory hardness of the erection,”
Sommer explains.

In Sommer’s study, 47 men received each of the drugs for six
weeks with a one-week drug-free period in between. Sommer also tested different
dosages of the medications. Each drug was taken prior to sexual activity.

All three of the drugs were effective in men with erectile
dysfunction. Compared to the placebo all of these drugs produced a significant
improvement in erections for vaginal penetration and completion of
intercourse.

At the maximum dose — 20 mg of Cialis, 20 mg of Levitra, 100
mg of Viagra — 43% preferred Levitra, 40% liked Cialis best, and 17% preferred
Viagra.

In the half-maximum dose group, 47% preferred Levitra, 34%
preferred Viagra, and 19% rated Cialis best.

Men who preferred Cialis did so because they felt their
erections lasted longer. And the men who preferred Levitra and Viagra listed
their main reasons as ease of getting erections and hardness of erections.

Two men taking Cialis had such severe back pain that they went
to the hospital emergency room, reports Sommer. Since no spinal problems were
evident, the pain was linked with Cialis.

Other studies have shown that between 4% to 6% of all men
taking Cialis complain about back pain, and for some people it’s very severe
back pain, says Sommer.

Another Viewpoint

The study “shows the potency of Levitra,” says Myron
Murdock, MD, who sits on the national medical advisory boards for Cialis and
Levitra.

But there’s one problem that could skew results: “These
patients knew which drug they were taking, and that makes a very big
difference,” he tells WebMD.

Also, all three drugs work through the same mechanism — and
over time, the effect becomes cumulative, he says. “The longer you take any
of these drugs, the more effective the drug becomes.” Therefore, whatever
drug a guy was taking at the study’s end may show the best results.

Another problem: There have been the reports of back pain with
Cialis. “But that typically occurs within the first 24 hours of taking the
pill, and it’s usually mild, and tends to occur in more muscular males.
Physical activity and nonsteroidal anti-inflammatory drugs (NSAIDs, like
ibuprofen) make it go away. For most men, it’s not a serious side affect, but
it can be an annoyance,” says Murdock.

Bottom line on all these erectile dysfunction drugs: “If
Viagra works well for you, and you have one or two sexual episodes a month,
stay on Viagra,” Murdock tells WebMD. If you’ve been disappointed with
Viagra, and don’t have sex frequently, if you’re a diabetic, or have had
prostate surgery — or if you don’t like the lifestyle limitations of Viagra –
then you should be on Levitra, he says.

Cialis is great for very sexually active guys — sex one or
more times a week — and who aren’t in any of the hard-to-treat categories. Of
all the erectile dysfunction drugs, “Cialis will be more
,” Murdock says.

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