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Image: Thinkstock, there are some potentially helpful differences between these medications, but price can limit your choices. About half of men ages 40 to 70 have erectile dysfunction (ED) to some degree, although only one in 10 report a complete inability to have erections. Taking an ED drug produces an erection sufficient to start intercourse in about 70 of otherwise healthy men. Does it make any difference which of the four drugs for erectile dysfunction you take? "Yes, there can be differences says. Louis Liou, chief of urology at Harvard-affiliated Cambridge Health Alliance in Boston. "For new patients, I have them try different ones to see what works best.". Sildenafil (Viagra) is often the first drug your doctor offers. It's been on the market longest and its side effects and the medications and foods it interacts with are well known. The latest drug to be approved, avanafil (Stendra may have fewer side effects than the other drugs. But the main challenge to finding the best ED drug for you may turn out to be health insurance rulesnot biochemistry. It's a common practice among insurers to limit the number of pills you can obtain per month. After you hit your limit, the out-of-pocket cost for a single pill can be as high. "The main obstacle in my practice is the cost. You'll need to work with your doctor to get the pill you need at a price you can afford. In addition to Viagra and Stendra, the two other ED drugs available in the United States are tadalafil (Cialis) and vardenafil does viagra lower your blood pressure (Levitra). These all improve blood supply to the penis. In combination with sexual stimulation, the drugs can produce an erection sufficient to initiate and complete intercourse. There is also a fast-dissolving form of Levitra, called Staxyn, that you put under your tongue. One ED drug, Cialis, is FDA-approved for use daily in a dose.5 or 5 milligrams. This helps to produce erections on demand and may also help relieve urinary problems, like difficulty starting urination, that result from an enlarged prostate. How does viagra lower your blood pressure to control the cost, the cost to you for ED drug therapy varies considerably, depending on the pharmacy price, prescription co-pays, and your level of health plan coverage. Nationally, the out-of-pocket cost per pill ranges from approximately 15. Even if private insurance covers it, you may be limited to four doses per month. Here are a few things you can do to contain costs: Shop around, because pharmacy prices vary. Various web-based tools can help you compare prices easily. One of them. Ask your doctor about pill splitting, where you get the pills at a higher dose than you need and divide them. Explore manufacturer discount programs. These allow you to obtain a limited supply of medications not covered by your insurance. How well do they work? ED drugs produce an erection sufficient for intercourse in about 70 of men. But the results vary quite a bit from one individual to another. A man with nerves or arteries damaged by prostate surgery, diabetes, or cardiovascular disease will not respond as strongly to ED drugs. "There are some men in whom none of these drugs work. How quickly do they work? How soon the drugs start working ranges from 15 to 60 minutes. Neither Viagra nor Levitra will work at all if you take them after a meal, which blocks their absorption. However, neither Cialis nor Stendra interact with food this way. The onset time determines how soon you can engage in intercourse. Stendra and daily-use Cialis are closest to being an "on does viagra lower your blood pressure demand" erectile drug; using the others requires more planning. How to use them properly,. Liou says that some men come to him after getting a prescription from their primary care doctors, claiming that the drug doesn't work.

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