Choosing the most appropriate treatment
Choosing the most
appropriate treatment
The choice between the available OTC products for ED will depend on frequency of intercourse and the customer's preference.18 However, your customer may look to you for advice to help them choose between the available treatment options.
The table below gives a pharmacokinetic comparison of tadalafil and sildenafil.13,19
| TADALAFIL | SILDENAFIL | |
|---|---|---|
Recommended time taken before sexual activity |
At least 30 minutes |
Approximately 1 hour |
Time to reach maximum plasma concentration |
Median 2 hours |
Median 1 hour (fasted state) |
Time to onset of effect |
From 30 minutes |
25 minutes (range 12-37 minutes) (fasted state) |
Duration of action |
Up to 36 hours |
Up to 4 hours |
Effect of food intake |
Rate of absorption not affected by food |
Rate of absorption reduced by mean of 60 minutes when taken with food, especially a high-fat meal |
Below are some some specific considerations that may be helpful to support your customer conversations.
ONSET OF ACTION
VIAGRA CONNECT can start to work in as little as 25 minutes.19 AVARANTE can lead to erections for successful intercourse in 30 minutes.13 Customers who favour fast onset of action may benefit from using VIAGRA CONNECT as no pill works faster for ED.19
DURATION OF ACTION
VIAGRA CONNECT is effective for up to 4 hours after administration.19 AVARANTE can work for up to 36 hours after taking it.13 Customers may benefit from AVARANTE’s longer window of opportunity on special occasions, such as a romantic getaway.
FREQUENT USERS
AVARANTE is not recommended for continuous daily use. Those who use it frequently (i.e. at least twice weekly) should discuss with their GP whether a low daily dose of tadalafil on prescription would be more suitable.13 VIAGRA CONNECT is suitable for daily use, if required.19
EFFICACY
Two network meta-analyses suggest that customers who prioritise high efficacy should use sildenafil 50mg (e.g. VIAGRA CONNECT).18
TOLERABILITY AND SIDE EFFECTS
PDE5 inhibitors are generally well tolerated. The side effect profiles are slightly different. Tadalafil has been associated with a lower occurrence of flushing14 and visual symptoms24 compared with sildenafil,13,19 but possibly a higher incidence of back and muscle pain.13,14,19