Practical Practitioner

By: Pamela Egan, FNP-C CDE

Viagra to see competition from Levitra, Cialis

The Erectile Dysfunction (E.D.) market is about to see some new entrants. Viagra will get competition from two drugs called Levitra and Cialis. Levitra is out now. Cialis will be out later this year, and all three pretty much work the same way.

Prescribed to treat erectile dysfunction, they cause vasodilation and increase blood flow to the penis.

Levitra (vardenafil) is a “me-too” similar efficacy and cost as Viagra. There’s not much difference in onset. Men should allow about 30 minutes for either drug. Both Levitra and Viagra are effective in patients with diabetes or prostatectomy.

Cialis (tadalafil) will be a little different. It’s being dubbed “weekend Viagra” due to its 24 to 36 hour duration. But there could be a downside. The long duration could also prolong side effects and the risk of drug interactions.

The following warnings should be considered:

Watch for similar drug interactions with Viagra or Levitra. Lower doses should be taken for men who take drugs that are metabolized by the liver such as erythromycin, ketoconazole, itraconazole, ritonavir or indinavir.

Avoid these drugs if you are taking alpha-blockers…Cardura, Hytrin, Minipress, Flomax or the new Uroxatral. The combination can cause postural hypotension (sudden drop in blood pressure) and dizziness in some men.

Do nto take nitrates (Nitroglycerine) with Viagra or Levitra. With regards to “generic Viagra,” it’s being advertised on the Internet and through unsolicited e mails. These products claim to contain sildenafil- but there are no legitimate generics for Viagra in the U.S.

This article was originally published September 29, 2003 in The St. Tammany News.

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