| Medication |
Action |
Use |
Pros and Cons |
| Viagra (sildenafil) |
Relaxes smooth muscle in corpora |
Taken 1 hour before sex, requires stimulation |
Headache, diarrhea, flushing, hypotension, disturbed color vision.
Greatest help with partial ED |
Spontane (apomorphine)
In final trials |
CNS stimulant that triggers erections (dopa-minergic) |
Works in up to one-third of mild cases |
Requires stimulation. |
Vasomax (phentolamine)
Under FDA review |
Alpha-adrenergic antagonist relaxes smooth muscle and increases blood
flow |
Taken 20–40 minutes before sex. Helps 60–80% of those tested. |
Requires stimulation.
Fewer side effects than sildenafil. |
MUSE (alprostadil)
Approved 1997 |
Applicator inserted into urethra |
Applied 5–10 minutes before sex. Erection lasts 1 hour |
Can be used 2 times/day.
Not for use with pregnant partner. |
Caverject (alprostadil)
Approved 1997 |
Injected into corpus cavernosa. Relaxes smooth muscle and dilates blood
vessels |
Injected 20 minutes before sex. Lasts >1 hour. Effective >50%. |
May be very painful.
Cannot be used every day. |
| Edex (alprostadil) |
Different formulation alprostadil |
Injected with smaller needle. Injected 10 minutes to 2 hours before sex.
Erections last >1 hour. |
Cheaper than Caverject. |
Invicorp (VIP and phentolamine).
FDA submission 1998 |
Relaxes smooth muscle |
Just before sex. More effective than either agent above. |
Requires stimulation.
No pain. |
Vacuum pumps
Approved 1982 |
Draws blood into corpora by negative pressure |
Just before sex.
Erections last until elastic ring removed |
Clumsy. Interferes with foreplay. Difficult ejaculation. |
Penile implants
Since 1966 |
Rigid or malleable rod or inflatable |
Bent or pumped into erect state |
Destroys erectile tissue. Complications high in diabetes.
Rods embarrassing. |
| (from "Erectile Dysfunction in Diabetes:
Pills for Penile Failure" in Clinical Diabetes journal, 1998, No. 3). Go to the resources page for the URL of the journal. |
