The Do’s and Don’ts of Treating Erectile Dysfunction (ED) with Pharmaceuticals

August 25, 2021

Erectile dysfunction (ED) is one of the most common reasons why men seek a urologist. It affects over 30 million men in the United States. According to a study from the Journal of Sexual Medicine, one out of every four erectile dysfunction patients is under 40 years old. ED rates have increased during the last twenty to thirty years, especially among younger men.

Most men are treated with medications called “PDE-5 Inhibitors” which is just a fancy name for the class of drugs commonly used: Viagra, Cialis, Levitra, Staxyn, Tadalafil, Sildenafil, Trimix (injectable). All of these medications work by increasing blood flow to the penis. They are safe and most men are able to use them. They typically improve erections in about 80% of patients, but in order for these medications to be used safely and effectively there are few tips to keep in mind.

Calling All ED Meds
In general, any medication prescribed for erectile dysfunction should be used exactly as prescribed. That means you don’t exceed or double down on the dosage without talking to your doctor. It’s also important to only take these medications once during a 24-hour period. Finally, don’t combine ED medications unless directed by your doctor. Why is this so important? Dosages that are too high could put you at risk of having an erection last too long (priapism). This can be a medical emergency because it might cause permanent tissue damage to the penis and prevent erections from occurring in the future – even with medication. 

These Rules Apply
Most of these mediations should be used 30 minutes before intercourse. Each medicine shares the same potential side effects. Viagra/Sildenafil is a little bit of a stickler with the rules because it is most effective if taken in a certain way. The “blue” pill works best if taken on an empty stomach.

What May Kill Your Pill?
In addition to knowing how to correctly take ED medications, it is also important to understand what other medications may decrease the effectiveness and/or cause medications not to work. Below is a list of medications that are often the biggest offenders in preventing ED medications from working effectively. If taking a medication in these classes of drugs, don’t skip a dosage or stop taking them. Often other medications in that same class of drugs can be prescribed that won’t interact with ED medications. 

  • Alcohol
  • Recreational Drugs (cocaine, amphetamines, marijuana, methadone, nicotine, opiates and barbiturates)
  • Narcotic pain medications
  • Blood pressure medications
  • Antidepressants
  • Muscle relaxers
  • Anti-anxiety medications
  • Anti-seizure medications
  • Antihistamines
  • Medications to treat or prevent hair loss/baldness
  • NSAIDS (non-steroid anti inflammatory drugs)
  • GERD or heartburn medications (Histamine H2-Receptor Agonists)
  • Prostate Cancer medications
  • Chemotherapy medications
  • Parkinson’s Disease medications

Again, not all medications used to treat these chronic conditions are going to kill the effectiveness of your ED medication. There are some medications in these drug categories that are bigger bullies than others and in some cases, a substitute can be prescribed. If you’re taking any medications for the conditions listed above and your ED medicines aren’t doing their job, contact Austin Urology Institute at 512-694-8888 to schedule a consultation.