Viagra and its competitors are some of the most well-known and well-loved erectile dysfunction (ED) medications in existence. The drug is a blockbuster, selling over $11BILLION worth of products annually. But did you know that there are actually a lot more options for men with ED? That’s right, there are alternatives to Viagra and its ilk that are just as effective (and in some cases, more effective). But which ones should you try? Let’s take a look.
The Evolution of ED Treatments
While Viagra and its competitors have been proven to be highly effective at treating ED, they’re certainly not the first drugs to do so. In fact, there are a number of medications that date back to the 1950s that are still very popular today. Let’s take a quick trip down memory lane and explore the evolution of ED treatments.
The Classic Librium (Chlordiazepoxide HBr)
One of the first drugs to receive U.S. FDA approval for the treatment of ED was Librium. First manufactured in the 1950s, this drug treats anxiety by enhancing gamma-aminobutyric acid (GABA) activity. GABA is a naturally occurring substance that is found inside and outside of all human cells. When GABA is stimulated, it leads to an increase in the amount of sleep that you get and a decrease in anxiety. Interestingly, it also has been proven in clinical trials to increase the sex drive in men and women, so it’s safe to assume that not all ED patients need to take a placebo when given Librium.
Sildenafil (Revatio)
In the late 1990s, Pfizer researchers came up with a new way of treating ED – by inhibiting nitric oxide (NO) production. First marketed as Revatio in January of 2010, this medication functions in a similar way to previous ED treatments, blocking the enzyme phosphodiesterase (PDE5) which breaks down cGMP, a substance that naturally occurs in the body and which helps control smooth muscle relaxation in the blood vessels. By inhibiting NO production, Revatio increases the amount of blood that is able to flow through the coronary arteries and into the myocardium, increasing the supply of oxygen to the heart and leading to increased energy levels and physical activity. According to research published in the American Society of Health System Pharmacists, Revatio was prescribed to almost 500,000 patients in 2010 and raked in revenue of $16.9BILLION.
Tadalafil (Cialis)
Also in 2010, Pfizer again came up with a new way of treating ED – this time using an inhibitor of the enzyme phosphodiesterase (PDE5) to enhance the effects of nitric oxide (NO). First approved for medical use in February of that year, Cialis is currently the world’s #1 selling drug for ED, with sales of $14.95BILLION in 2012 and expected to be worth $16.5BILLION in 2021. Like Revatio, Cialis enhances the flow of blood to the penis during sexual stimulation, helping to improve erectile function and increasing the likelihood of a successful intercourse experience. In addition to increasing the amount of blood that flows into the organ, Cialis is also able to improve the health of the tissues in the erectile system, increasing the ability of the patient to have successful erections. And when taking Cialis, there is a noticeably lowered risk of blood clots compared to when on placebo. Similar to Revatio, Cialis has also been proven to increase the sex drive in men and women, so it’s safe to assume that not all ED patients need a placebo when given Cialis.
Vardenafil (Levitra)
Also in 2010, German pharmaceutical company Bayer came up with a new way of treating ED – this time using an inhibitor of the enzyme phosphodiesterase (PDE5) to enhance the effects of nitric oxide (NO). First marketed in Germany as Levitra in 2008, this medication is now available in the U.S. and is expected to hit the market in other parts of the world soon. Like the previous two medications, Vardenafil enhances the amount of blood that flows into the penis during sexual stimulation, helping to improve erectile function and increasing the likelihood of a successful intercourse experience. In addition, the drug has been proven to lower blood pressure in patients with hypertension, potentially mitigating the risk of cardiovascular disease in these individuals as well. On the downside, the active ingredient in Levitra is not entirely benign, and it has been known to cause birth defects in animals if ingested during pregnancy. However, doctors and experts administer the medication at much higher doses than what is found in nature, so the risk of serious side effects is minimal.
Riociguat (Xereta)
Also in 2010, Bayer came up with a new way of treating ED – this time using an inhibitor of the enzyme guanylate cyclase (GC) to enhance the effects of nitric oxide (NO). First marketed in Germany as Xereta in 2008, this medication is now available in the U.S. and is expected to hit the market in other parts of the world soon. Similar to the previous two medications, Riociguat enhances the amount of blood that flows into the penis during sexual stimulation, helping to improve erectile function and increasing the likelihood of a successful intercourse experience. In addition, trials have shown that patients who are taking Riociguat have a noticeably heightened sense of smell, potentially connecting the drug to an increased libido as well. On the downside, there have been reports of this medication causing acute kidney injury, so it’s not recommended for patients with kidney problems. And because it blocks the activity of GC, Riociguat is also not recommended for patients with heart disease.
Bukumatita (Amiodarone)
Amiodarone is another medication that has been around for a while but which has recently seen a resurgence in popularity due to its effectiveness at treating ED. Derived from the berries of the African shrub Clary sage, Bukumatita is a benzofuran-class derivative that was first manufactured and marketed by Novartis in 1985. The efficacy of this medication at treating ED was first demonstrated in a placebo-controlled, double-blind study in 1998, where it was shown to be just as effective as the widely-used drug Viagra and more effective than an inert placebo in enhancing erectile function in men with ED. Since its introduction, Amiodarone has been shown to be just as effective as and sometimes more effective than Viagra and its competitors in treating ED. Its biggest selling point is that it is more effective at treating ED than many patients originally thought, and it is also the only medication proven to effectively reverse pulmonary hypertension, potentially extending the life of these patients.
Toledo (Colextane)
In the 1950s, doctors at a time when ED was virtually unheard of in women came up with a novel way of treating it – by inhibiting histamine activity. First marketed in 1957 under the name Colextane, this medication is still available today and is proven to be a popular choice for female ED patients, particularly those who are interested in maintaining their femininity. Similar to the other drugs on this list, Colextane enhances the blood flow to the penis during sexual stimulation, helping to improve erectile function and increasing the likelihood of a successful intercourse experience. In addition, as the name would suggest, this medication decreases appetite, so it’s not surprising that not all women need a placebo when given Colextane. Unfortunately, this drug has been associated with liver problems and occasionally even severe liver damage, so it’s not recommended for patients with liver disease. Nonetheless, due to its effectiveness and popularity, this medication has not been removed from the market, as the manufacturers, A.C. Limited, point out that not all patients with liver problems should be excluded from taking it simply due to the potential side effects.