PDE5 inhibitor preference

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jj21

What do you guys prefer - cialis, viagra or levitra?

I've tried cialis which had good effects however, I suspect a tolerance is building..

Once tried viagra at 100mg had a rock hard erection but didn't last the whole night, also had to watch what I ate on it.

Anyone have other experiences? Anyone tried Levitra ?

Cheers,
JJ
34 Years Old...Peyronies for 4 years. 20 Degree left and upwards curvature, major dents and narrowing, ED.

Implant + Tunica Expansion Procedure, 7th Feb 2023, Titan 22cm +1cm RTE, Partial revision 27th June 23 (fix pump, remove 10ml reservoir).

james1947

Tried all three.
The only one that helped me was Viagra. By the way, it is not supposed to last all night.
Act best one hour after taking. Food intake should be limited.

James
Age 71, Peyronies from Jan 2009 following penis fracture during sex. Severe ED.
Lost 2" length and a lot of girth. Late start, still VED, Cialis & Pentox helped. Prostate surgery 2014.
Got amazing support on the forum

skunkworks

Levitra is the strongest inhibitor of pde5, followed by viagra then cialis in third. Levitra works noticeably better for me than CIalis and slightly better than Viagra.

Cialis also inhibits pde11, variants of which are all over the body and not completely understood. Can cause neck pain and possible decrease in sperm quality.

Viagra and Levitra inhibit pde1 and pde6, not too sure what they do either but I know pde6 affects the eyes.  
This is an emotionally destructive condition, we all have it, let's be nice to each other.

Review of current treatment options by Levine and Sherer]

Hawk

I could tell no difference in the three as far as an erection was concerned.  I preferred Levitra because it's absorption is not hindered by fats that are eaten hours before.

I could not use Cialis because every time, the next day it felt like a mule kicked me in the back.
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

skunkworks

Yeah variants of pde11 are found in skeletal muscle.  
This is an emotionally destructive condition, we all have it, let's be nice to each other.

Review of current treatment options by Levine and Sherer]

philtered

 I have no problem getting an erection , but have problems keeping it. Levitra works best for this IMO and less side effects. Cialis gives me back ache also.
AGE 59
Acute since  Dec 2017
VED, traction & supplements
Went from 30 degree curve to 80 during acute stage  stabilized since May 2019
Curvature calculated at 80 degrees by Dr Ralph from emailed photo.
Titan  22cm with 1cm RTE's Prof ralph Feb 2022

TonySa

It's different for everyone, you really just have to try each.  Note Cialis has a longer half life and thus lasts longer (24 hrs) in your system.  One really doesn't quickly develop tolerance on any of them...but Erectile Dysfunction can worsen w time rendering them less effective.
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

Hawk

Correct, I know of no tolerance build-up to PDE5 inhibitors.
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

skunkworks

No tolerance over 6 months with cialis - https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1743-6109.2006.00248.x

Thing is that it is a hard one to measure, because chronic use of pde5s usually leads to you needing pde5s less. Actually I had a post about this earlier, will just quote it here:

-------------------------------------------------------------------------

Now about daily use, with regards to pharmacokinetics it might be true that a tolerance could be built up. But in effect, daily use of pde5s actually decrease the need for pde5s. This is most likely due to frequent erections being healthy for the smooth muscle and other parts of the penis, and of course blood flow.

I do not have time to find all the studies, but here is a writeup of an old one. This one is interesting because it compares nightly (every night) use vs as needed use vs no viagra at all. And in particular erectile function after all treatment in all groups had been stopped - https://www.webmd.com/erectile-dysfunction/news/20040513/nightly-viagra-may-restore-normal-erections#1

He and his co-investigators studied 76 men who had erectile dysfunction for at least six months. Group 1 took 50 mg of Viagra nightly at bedtime. Group 2 took 50-100 mg of Viagra when they wanted, presumably before sexual intercourse. The investigators also followed a third group of men with erectile dysfunction who received no treatment. The men were an average of 47 years old.

After 12 months of nightly Viagra followed by one month of no erectile dysfunction treatment, nearly 60% of men in group 1 had a return of normal erections. Less than 10% of men that took Viagra as needed had a similar return of normal erections.

At the end of a six-month period without any erectile dysfunction treatment, all but one of the men in group 1 still had normal erections. Normal erections were determined by an erectile function questionnaire completed by the men.

Researchers also measured blood flow to the penis. After one month of no erectile dysfunction treatment, group 1 had a significant improvement in blood flow. However, group 2 had no significant change and blood flow, and group 3 worsened.


This is an emotionally destructive condition, we all have it, let's be nice to each other.

Review of current treatment options by Levine and Sherer]

betterbend

Quote from: philtered on December 06, 2018, 04:17:22 PM
I have no problem getting an erection , but have problems keeping it. Levitra works best for this IMO and less side effects. Cialis gives me back ache also.

Try doing some Kegels exercise for men.  It can help you keep the blood in you penis once erect...
55 - Onset May 2017.  38 degree bend up.  Failed Xiaflex treatment.  Still functional so I decided to stop treatments.  Only take 400mg Co-Q10 and occasionally use Restorex

jj21

Skunk, that's an interesting study... So daily nighttime use of Viagra could restore sexual function?
34 Years Old...Peyronies for 4 years. 20 Degree left and upwards curvature, major dents and narrowing, ED.

Implant + Tunica Expansion Procedure, 7th Feb 2023, Titan 22cm +1cm RTE, Partial revision 27th June 23 (fix pump, remove 10ml reservoir).

skunkworks

Well in that study it did and it's not surprising. Erections are good for erections. I've been saying that for a long time now, and still get people popping up here saying they are avoiding erections as much as possible and even some that say their urologist told them to avoid them as much as possible.

There is only one time that advice is applicable with regards to Peyronie's and that is immediately post surgery.  
This is an emotionally destructive condition, we all have it, let's be nice to each other.

Review of current treatment options by Levine and Sherer]

TonySa

Other studies support that NTE due to PDE5 meds also remodel plaque to healthy tissue.  Use it or lose it!!!!
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

Hawk

I think NTE 's make for a healthier penis no matter how you get them including Trazadone or even L-Arginine if it works.
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

skunkworks

Erections on the whole, even stimulated ones will be beneficial as long as the stimulation itself is not damaging. There is probably something more beneficial to nocturnal erections, but any erection gained by means which are not physically damaging is going to be a good one for future function.
This is an emotionally destructive condition, we all have it, let's be nice to each other.

Review of current treatment options by Levine and Sherer]

Michiganguy19

Take one of each! 😂

I like levitra the best by far. Viagra stopped working for me.
Peyronies Disease December 2015.
Caused by Reactive Arthritis, November 2015.
Length before erect: 7.2in
Girth before erect: 6.5in? Just a guess. Was 5.9 after loosing girth/having hourglass and first measuring.
Length erect. 6.2in
Girth erect: 4.1

Hontas

Viagra has P-gp inhibitor effects. That makes P-gp substrate drugs a lot more effective and possibly dangerous so keep that in mind