Best Rx Treatments for ED

Tadalafil and vardenafil for erectile dysfunction may be most effective medications

/ Author:  / Reviewed by: Chris Galloway, M.D.

(RxWiki News) Erectile dysfunction (ED) is treatable with medication. A recent study suggested that some medications are better than others in treating ED. 

ED can be treated with medication that relaxes the muscles and improves blood flow to the penis for erections. However, there are many different prescription brand names to choose from. 

A recent study found that tadalafil (Cialis), followed by vardenafil (Levitra, Staxyn) were the most effective treatments for ED compared to other medications. 

"Talk to your doctor about ED treatments."

JinQiu Yuan, PhD, of the Division of Epidemiology at The Chinese University of Hong Kong, and colleagues set out to compare the safety and effectiveness of different phosphodiesterase type 5 inhibitors (PDE5-Is). 

Researchers looked at studies that included random controlled medication trials that compared treatment with different PDE5-Is for ED. Researchers also looked at trials that compared PDE5-Is to a placebo (fake pill) for treating ED. 

Seven different types of PDE5-Is were used in the trials, including sildenafil (Viagra), tadalafil, vardenafil, udenafil (Zydeco), mirodenafil (Mvix), avanafil (Stendra) and lodenafil (not available in the US). 

Most of the trials used the recommended dosages for the medication. Not enough data was available for lodenafil to be included in the study's analysis. 

A total of 118 trials that included 31,195 participants were used in the study. Trials were found using an electronic search of published studies. The trials included were found to be quality studies with trusted results. 

Results showed that all PDE5-Is were more effective in treating ED compared to a placebo. The PDE5-Is were all safe and well tolerated.

Results from the placebo group showed that 46 percent of participants reported an improved ability to achieve erections compared to: 

  • 75 percent of tadalafil participants 
  • 73 percent of sildenafil participants 
  • 73 percent of vardenafil participants 
  • 69 percent of udenafil participants 
  • 70 percent of mirodenafil participants 
  • 46 percent of avanafil participants

Results also showed that tadalafil was the most effective medication, followed by vardenafil. "Because tadalafil also has other advantages, such as patient preference, it may be considered the first choice for ED patients," said study authors. 

The study had some limitations. The quality of this study was based on the quality of the trials researchers reviewed. Some of the trials had poor reporting and not all data was provided. There were also some problems with combining and comparing the different trials.  

This study, titled "Comparative Effectiveness and Safety of Oral Phosphodiesterase Type 5 Inhibitors for Erectile Dysfunction: A Systematic Review and Network Meta-analysis," was published in European Urology.

It was funded by the Food and Health Bureau of Hong Kong. Dr. Yuan and colleagues disclosed no conflicts of interest.

Reviewed by: 
Review Date: 
March 12, 2013
Last Updated:
March 17, 2013