What are the differences between sildenafil, tadalafil, and vardenafil? What should we pay attention to?

A friend asked Huazi, there are three commonly used drugs for treating male dysfunction, including sildenafil, tadalafil, and vardenafil. What are the differences between them and what should we pay attention to when choosing?

Hua Zi said that factors such as high blood pressure, diabetes, hyperlipidemia, aging, and smoking can lead to atherosclerosis of the arteries, which can narrow the arterial lumen, leading to insufficient blood perfusion and dysfunction of male organs. These three drugs can all be used to improve symptoms, with some differences in the duration of use and side effects.

1. The three belong to the same class of drugs: sildenafil, tadalafil, and vardenafil. These three drugs are pharmacologically classified as 5-phosphodiesterase (PDE5) inhibitors. They work by increasing the release of nitric oxide (NO) in blood vessels, increasing the level of cyclic guanosine monophosphate (cGMP), relaxing vascular smooth muscles, and increasing blood perfusion of organs.

However, it should be noted that such drugs will only work if there is sexual stimulation. If there is no stimulation, simply taking the drug will not improve the symptoms. In other words, such drugs are not "aphrodisiacs" and will not increase desire after taking them. Some people do not want to have sex psychologically, not because of functional disorders caused by diseases, and the effect of taking the drug will not be affected.

2. What are the differences between the three? 1. Time of taking: Sildenafil is rapidly absorbed after oral administration, and the median time for blood concentration to reach peak is about 1 hour, which means that taking it 1 hour in advance will have the best effect.

The median time to peak blood concentration of tadalafil is about 2 hours, and the best effect is achieved if taken 2 hours in advance.

The median time of peak blood concentration of vardenafil is about 1 hour, and the best effect is achieved if taken 1 hour in advance.

2. Duration of drug effect: The half-life of blood concentration of sildenafil and vardenafil is about 4 hours, while the half-life of blood concentration of tadalafil is 17.5 hours, so the duration of drug effect of tadalafil is the longest.

3. Dietary influence: A high-fat diet (that is, taking medicine after eating a lot of meat and fish) will affect the absorption of sildenafil and vardenafil, reduce drug absorption, and delay the peak efficacy by more than 1 hour, while tadalafil is not affected by diet.

4. Adverse reactions: transient adverse reactions such as headache, facial flushing, indigestion, dizziness, nausea, etc. may occur after taking the medicine. Sildenafil has the highest incidence of adverse reactions, dalarnafil has a lower incidence, and vardenafil has the least adverse reactions.

5. Drug price: Sildenafil has been included in the national centralized procurement, and the drug price has dropped significantly. Tadalafil and vardenafil are more expensive. In comparison, sildenafil has the highest "price-performance ratio".

3. The precautions for the three are basically the same. Nitrate drugs are nitric oxide (NO) donors. When used in combination with PDE5 inhibitors, the antihypertensive effect will be significantly increased, which may induce cardiovascular and cerebrovascular risks. Therefore, PDE5 inhibitors cannot be taken at the same time as nitrate drugs.

PDE5 inhibitors need to be metabolized by liver enzyme systems such as CYP3A4 and CYP2C9, so they will interact with diet and drugs that affect the liver enzyme system. Grapefruit has an inhibitory effect on liver enzymes, so do not eat large amounts of grapefruit or drink grapefruit juice while taking the drug.

PDE5 inhibitors will increase the antihypertensive effect of antihypertensive drugs, so those who are taking antihypertensive drugs should use PDE5 inhibitors with caution.

CYP isoenzyme inhibitors such as erythromycin, ketoconazole, cimetidine, and indinavir will slow down the metabolism of PDE5 inhibitors, which can easily cause cumulative poisoning and should be avoided in combination.

Sexual activity has a potential risk of causing cardiovascular disease, and the people who use PDE5 inhibitors are mostly middle-aged and elderly people with chronic diseases. Everyone should do it according to their ability. If you experience dizziness, angina pectoris and other discomfort during activities after taking the medicine, you should stop immediately and seek medical attention.

To sum up, in the treatment of male dysfunction, sildenafil, tadalafil, and vardenafil among PDE5 inhibitors are commonly used drugs. Sildenafil is cost-effective, tadalafil has a long duration of action, and vardenafil has few adverse reactions. It is necessary to choose to use it according to the patient's condition and under the guidance of a doctor. If you have any doubts about the use of the medicine, you should consult a doctor or pharmacist. I am pharmacist Huazi, welcome to follow me and share more health knowledge.