Erectile dysfunction advices.

If erection problems could be caused by a
prescribed medication, it may be possible to change
the dose or try another medication. Do not change or stop taking any medication
without first talking with your health professional.

Medication Choices

Commonly used oral include:

• 5 inhibitors (PDE-5
  inhibitors) such as Viagra, Levitra, and Cialis.

Other medications that may be used include:

• Injected medications.
• Intraurethral alprostadil (MUSE).

Hormones and other medications may be prescribed for
men who have low
testosterone or high
prolactin levels.

Some men have tried
yohimbine-a prescription medication that should not be
confused with the dietary supplement yohimbe-to treat erection problems.

For more information on medication choices, see:

Should I use phosphodiesterase-5 inhibitors
(such as Viagra, Levitra, or Cialis) for erection
problems?

Should I use injections for erection
problems?

What To Think About

PDE-5 inhibitors and heart problems

Health experts have debated the use of PDE-5 inhibitors in men
with heart disease, because deaths have been reported after use of Viagra. The
1999 American College of Cardiology/American Heart Association (ACC/AHA) Expert
Consensus Document noted that PDE-5 inhibitors may be dangerous for people
who:³

• Have
  coronary artery disease (CAD).
• Have
  heart failure and low blood pressure.
• Are
  taking many different drugs for
  high blood pressure.

However, several more recent studies have reported that some
men with heart problems may be able to take PDE-5 inhibitors safely. Talk to
your health professional about whether PDE-5 inhibitors are appropriate for
you.

• One study found no evidence of increased
  risk for
  heart attack or CAD in men who use Viagra.⁴
• Another study in men with CAD reported that
  Viagra does not lead to heart attack and that heart attacks and other
  cardiovascular problems reported after taking Viagra may be related more to the
  physical activity of intercourse than to the medication.⁵
• A study of 35 men found that Viagra is safe for
  men with moderate heart failure.⁶

Sexual activity is exercise. If you have a heart condition and
have not been sexually active for a while, talk with your health professional
to make sure you can engage in sexual activity safely.

PDE-5 inhibitors should never be used if
you may need to take a
nitrate-containing medication, such as nitroglycerin.
Taking nitroglycerin and a PDE-5 inhibitor within 24 hours of each other may
greatly lower your blood pressure, which could lead to a heart attack,
stroke, or death.

If you are taking a PDE-5 inhibitor and are going to have a test
for heart disease, be certain your doctor knows you are taking it. You should
not take a PDE-5 inhibitor for 24 hours before the test. If you develop a
problem during the test, nitrate-containing medications such as nitroglycerin
may be used.

Although oral medications for erection problems can be purchased over the Internet, you should still talk with your health professional before using this medication. This is especially important if you have a heart problem.

If you are using a combination of drugs for high blood pressure,
PDE-5 inhibitors could result in low blood pressure (hypotension). Also for
this reason, you should not take alpha to lower blood pressure
and to treat an enlarged prostate-with these medications without talking to
your health professional; the combination could cause a dangerous drop in blood
pressure.

Although the antidepressant medication trazodone has been used
for treating erection problems, there is no current evidence that it is
effective for this purpose.¹