Sex Drugs: Rock 'n' Roll!

Faster-acting, longer-lasting, more potent -- brace yourself for the 'Super Viagras'
Edited by Joe Kita | From Men's Health

Oct. 16, 2002 -- After surgeons removed 53-year-old Bob Rozman's cancerous prostate gland, he couldn't get an erection. He tried Viagra. He tried penile injections. And he tried penis pumps. But he and his wife still went 2 1/2 years without having sex. Rozman thought it was hopeless until he became involved in a clinical trial of a new erection drug called Cialis.

"I took one pill," he recounts. "Then my wife and I had dinner, we talked, and later on that evening we had sex. It was all very natural and spontaneous. It was unbelievable."

Within the next 12 months, two new erection-enhancing drugs could receive FDA approval. One is tadalafil (brand name Cialis) from Lilly Icos, and the other is vardenafil (brand name Levitra) from Bayer and GlaxoSmithKline. Both are taken orally and contain the same chemical agent as Viagra, but each has been molecularly tweaked to work differently, if not better. This is good news, because despite the fanfare and interest Viagra has generated, 90% of men with erectile dysfunction (ED) are reportedly still untreated. Either they're too uncomfortable discussing the problem with their doctors, or they've tried Viagra and it had little effect. These new drugs will not only expand awareness through increased advertising and publicity, but also broaden the choices available for doctors and patients.

"We'll be able to experiment a little and see which one a man best responds to," says Gregory Broderick, MD, a professor of urology at the Mayo Clinic in Jacksonville, Florida.

Below you'll find our analysis of the most important properties of each new drug. Keep in mind that there are still no completed trials pitting them against Viagra. Even given FDA approval and further study, American men will be the true lab rats. Thompson.

Waiting for Wood
It typically takes Viagra about 1 hour to take effect, which means if Hilde suddenly gets horny, you'll either have to stall or engage in some lengthy foreplay. Levitra appears to be faster acting, with peak effects usually between 30 and 45 minutes. Cialis is a bit slower than Levitra and Viagra, according to Wayne Hellstrom, MD, a professor of urology at Tulane University medical center.

A complicating factor can be the amount of food in your stomach. If it's full, oral medications may take longer to work. Viagra is like this. For best results, doctors advise taking it 3 hours after eating. Levitra appears to have the same limitation, but Cialis seems unaffected by food. "Even after a heavy, fatty meal, its absorption rate and onset of action are the same as with an empty stomach," says J. Francois Eid, MD, a clinical associate professor at Weill Cornell medical college. "This is a particular advantage for diabetics, who have a slower rate of gastric emptying." And given the connection between diabetes and impotence, that can be a saving factor.

In fact, in Europe Cialis is known as the "weekend pill." Take it Friday night and you're ready for action through Sunday. The promise of such spontaneity is a great advantage.

"Patients who've taken both describe one as a quick fix and the other as making them feel normal again," says Dr. Eid.

And the Lucky Lumberjacks Are …
Viagra is a wonderful drug for men who, shall we say, are just a little impotent. According to Dr. Broderick, it's up to 83% effective for men with one or two risk factors for ED (e.g., high blood pressure, being over 50 years of age). But when a man has additional complications, such as hypertension or diabetes, the effectiveness of Viagra declines to 50% or less. "We're hoping these new drugs will enable us to treat patients with multiple risk factors better than Viagra," he says.

These drugs could be for sale in drugstores as quickly as 3 weeks after being blessed by the FDA. The price will probably be comparable to Viagra's. Pamela Weir, director of external communications for Bayer, says her company has a "very aggressive" plan in place for promoting its drug once approved, as does Lilly Icos.

"Overall, I look at all this very positively," says Dr. Hellstrom. "Despite Viagra's great success, only one in 10 men with erectile dysfunction has talked to his doctor about it. Out of that group, only half are taking medication. There's still a huge untapped zone of guys who are sitting on the fence."

No doubt these new drugs will finally help more of them get off.

Beyond Viagra
The future of erection enhancement is all in your head

Although Levitra and Cialis are exciting developments, they still act in the same old way: by facilitating bloodflow to the penis. The next evolution in sex drugs will be dramatically different, because they'll act centrally -- n the wiring in the brain instead of the plumbing in the genitals. The first one of these drugs we'll most likely see (within 2 years) is Uprima, which has been developed by Abbott Laboratories and is already available in Europe. Its active ingredient is apomorphine, but it's not related to any opiate or narcotic. Originally used to treat Parkinson's disease, it somehow tinkers with the brain's centers for arousal and pleasure.

"You put a small amount under your tongue," explains Wayne Hellstrom, MD, "and it works very quickly [12 to 15 minutes]. There can be some side effects, though, such as nausea and vomiting. Overall, I don't think it's as effective as Viagra-type drugs, but it represents a new method of treatment. Ten years from now, I see doctors using a combination of therapies to treat erectile dysfunction."

Quick Comparison
You know what they do for you. Here's what they do to you.

Onset of Action
Viagra: about 60 minutes
Levitra: 30-45 minutes
Cialis: 45-75 minutes

Eating Beforehand
Viagra: 3 hours
Levitra: 3 hours
Cialis: anytime

Duration
Viagra: 4 hours
Vardenafil: 5 hours
Cialis: up to 36 hours

Nasal Congestion
Viagra: yes
Vardenafil: yes
Cialis: yes

Facial Flushing
Viagra: yes
Vardenafil: yes
Cialis: yes

Stomach Upset
Viagra: yes
Vardenafil: yes
Cialis: yes

Headache
Viagra: yes
Vardenafil: yes
Cialis: yes

Hazy Vision
Viagra: yes
Vardenafil: no
Cialis: no

Back Pain
Viagra: no
Vardenafil: no
Cialis: yes

General Achy Feeling
Viagra: no
Vardenafil: no
Cialis: yes

Heart Risk for Men Taking Nitrates
Viagra: yes
Vardenafil: yes
Cialis: yes


© 2002 WebMD Inc. All rights reserved.

Any chance these may be available in Mexico or possibly online from India or elsewhere before the fda gets thier slow ass around to approving them?
Putanero