Tips for Choosing ED Treatment Medication: A Specialist Explains the Latest ED Treatment Medication, Including Avanafil and Udenafil
ED (erectile dysfunction) refers to a state in which satisfactory intercourse cannot be obtained because an erection is not sufficient, or cannot be maintained, at the time of intercourse.
In Japan, 10 million or more people are said to suffer from ED, and recently the number of people in their 10s to 20s has also been increasing.
There are many types of ED Treatment Medication, and many people are unsure how to use them, so here we summarize how to choose ED Treatment Medication.
We can provide a variety of ED treatment medications — Viagra (sildenafil), vardenafil, Cialis (tadalafil), avanafil, udenafil, etc. — matched to patients’ requests.
We can prescribe ED Treatment Medication on the same day.
ED Treatment Medication can also be used together with HIV prevention medication, premature ejaculation medication and AGA medication.
We can provide the latest ED Treatment Medication, such as the 4th-generation and 5th-generation medications avanafil and udenafil!
For tadalafil, “daily therapy” is also available, in which the medication is taken every day regardless of sexual activity.
– ED is a common condition that affects younger people as well, and improvement can be expected with ED Treatment Medication.
– Each ED Treatment Medication formulation has its own characteristics, and it is important to choose an appropriate one based on your individual style of sexual activity, duration of action and side effects.
– ED Treatment Medication can be used together with HIV prevention medication, premature ejaculation medication and AGA medication; in particular, those with premature ejaculation can expect benefit from combined use with premature ejaculation medication.
Click any item in the table of contents to jump partway into the article.
Indications for ED Treatment
ED Treatment Medication is intended for those with symptoms of ED (erectile dysfunction).
If you have even a slight degree of not achieving satisfactory intercourse because your erection is insufficient or cannot be maintained, and you have anxiety about erections, you are fully eligible for treatment.
ED Treatment Medication is a vasodilator that assists erections, so even if you take it, an erection will not occur without sexual stimulation.
Also, once sexual stimulation ceases or after ejaculation, the erection subsides just as it normally would.
It has no aphrodisiac action, so it does not heighten libido or intensify sexual stimulation, and it is not habit-forming, so you can use it with peace of mind.
Those who cannot achieve satisfactory intercourse because their erection is insufficient or cannot be maintained during intercourse
The 4 Causes of ED
The causes of ED are broadly considered to fall into 4 categories. Because the treatment approach changes depending on the cause, please tell your doctor during your consultation if you are using any other medications.
Psychogenic ED: caused by mental stress, etc.
This is often seen in relatively young people in their 20s to 40s.
Mental stress (for example, stress at work or within the family, pressure from trying to conceive or trauma from an occasion when intercourse did not go well) becomes the cause, sexual arousal is not transmitted properly and ED results.
Because psychogenic ED often involves no physical abnormality, ED Treatment Medication tends to be effective.
Organic ED: caused by vascular or nerve disorders
This is often seen in people in their 50s and older.
Aging and lifestyle-related diseases (diabetes, hypertension, hyperlipidemia, etc.) allow arteriosclerosis (a condition in which the blood vessels harden) to progress, blood no longer flows sufficiently into the corpus cavernosum and ED results.
Taking ED Treatment Medication can be expected to improve blood flow and thereby improve ED.
Mixed ED: multiple factors are involved
This is often seen in people in their 50s and older.
In addition to vascular or nerve disorders, a combination of factors such as mental stress causes ED.
Because the causes vary, we propose a treatment approach suited to each patient. ED Treatment Medication may also be expected to be effective.
Drug-induced ED: caused by certain medications
Some medications can be a cause of ED.
If something has changed since you started a new medication, or if you take many kinds or large amounts of medication, please consult with a doctor.
– Medications acting on the central nervous system: psychotropic drugs such as antipyretic and anti-inflammatory analgesics, antidepressants and hypnotic-sedatives
– Medications acting on the peripheral nervous system: muscle relaxants, anesthetics, anticholinergics
– Medications acting on the cardiovascular system: antiarrhythmics, diuretics, antihypertensives, vasodilators, agents for hyperlipidemia
– Medications acting on the digestive tract: peptic ulcer agents, anticholinergics, antispasmodics
Types of ED Treatment Medication
We are able to provide a wide range of ED treatment medication — Viagra (sildenafil), vardenafil, Cialis (tadalafil), avanafil, udenafil, etc. — matched to each patient’s wishes.
Generic drugs are very widely available in Japan and are cheaper than the original products, so we think starting by considering generic drugs is the more affordable approach.
In addition, the generic drugs we handle use formulations that are easy to cut in half, so dose adjustment is very simple, and using a higher-strength tablet in halves can also keep the cost down!
We select an ED Treatment Medication that is easy to use according to the characteristics of each medication.
We can provide the latest ED Treatment Medication, such as the 4th-generation and 5th-generation medications avanafil and udenafil, tailored to each patient’s requests.
(sildenafil)
Recommended for: those who did not get much firmness with other ED Treatment Medication
Features: it acts quickly and its effect also wears off quickly.
Food: taking it with food halves the effect, so taking it 30 minutes before eating is recommended.
Time until effect appears: approx. 30 to 60 minutes
Duration of action: approx. 4 to 5 hours
– People who have tried other ED treatment medication without effect and want to feel the effect soon after taking it
– People who have used Viagra (sildenafil) for a long time, have no side effects and want to continue taking it as it is
– Those who want a formulation that can be taken without water (Viagra OD Film)
Recommended for: people who above all want an erection that is quick and hard
Features: Absorption is rapid, it is highly fast-acting, and hardness is the greatest of the 3 types.
Food: There is no problem taking it together with food, but taking it 30 minutes beforehand is more effective. On an empty stomach, the effect begins to appear in approx. 15 minutes.
Time until the effect appears: approx. 20 minutes to 60 minutes
Duration of action: approx. 4 to 6 hours
– People who want to feel the effect of ED treatment medication immediately and want to choose one with strong erectile power
– People who want to maintain an erection as the penetrating partner throughout sexual activity, or who want to prevent loss of erection midway (going soft during penetration)
– Those who want to feel the effect soon after taking it but may have intercourse after a meal or alcohol (vardenafil is also affected by food and drinking, but less so than sildenafil)
(tadalafil)
Recommended for: those who do not know at what point in the day they will have sex, and those who often have sex after a meal
Features: compared with the others, a milder and more natural effect can be expected. It acts over a long period and has relatively few side effects.
Food: taking it with food is not a problem, but it is more effective when used on an empty stomach.
Time until effect appears: approx. 1 to 3 hours
Duration of action: approx. 24 to 36 hours
– People who often have sexual activity after a meal or alcohol
– People whose timing for sexual activity is not fixed and who want to feel the effect whenever sexual activity occurs (while traveling, or when a partner lives far away and the timing cannot be predicted)
– Those who are not always the insertive partner during intercourse (versatile, receptive, etc.) but want to make erections easier during the act
Recommended for: people who want a quick, hard erection, people who want to take it without worrying about meal times, people who want to feel an effect but are concerned about side effects
Features: Known as the 4th ED treatment medication, it has a strong effect, is less affected by food and has relatively few side effects.
Meals: There is no problem taking it together with food, but it is more effective when used on an empty stomach.
Time until the effect appears: approx. 15 to 30 minutes
Duration of action: approx. 4 to 6 hours
– People who want to feel the merits of both vardenafil and tadalafil while keeping the cost of using ED treatment medication down
– People who want to maintain an erection as the penetrating partner throughout sexual activity, or who want to prevent loss of erection midway (going soft during penetration)
– Those who want to feel the effect soon after taking it but may have intercourse after a meal or alcohol (it is less affected by food and alcohol than sildenafil or vardenafil)
Recommended for: people who want to take it without worrying about meal times, people who want to feel an effect but are concerned about side effects
Features: Known as the 5th ED treatment medication, it is the newest ED treatment medication. A mild and natural effect can be expected; it acts within a short time and the effect lasts for a long time. Side effects are also relatively few, and compared with the long-acting Cialis (tadalafil) the time until it acts is shorter, it wears off earlier and the price is lower.
Meals: There is no problem taking it together with food, but it is more effective when used on an empty stomach.
Time until the effect appears: approx. 30 to 60 minutes
Duration of action: approx. 8 to 13 hours
– People who expect a long-lasting effect and also want the effect to come soon after taking it, or who want to keep the cost of using ED treatment medication down
– People who often have sexual activity after a meal or alcohol
– People who are not always the penetrating partner during sexual activity (versatile, receptive, etc.) but who want to have an erection more easily during the act
– Those whose timing of intercourse is not fixed and who want to feel the effect whenever intercourse occurs (such as while traveling, or when a partner lives far away and the timing of intercourse cannot be predicted)
[Definitive Guide] How to Choose ED Treatment Medication
As described above, ED Treatment Medication falls broadly into 3 types, so we think many people find it hard to understand the characteristics and feel of each.
With ED Treatment Medication, it is easier to think in this order: decide the formulation, then decide the strength.
[Deciding the formulation]
Here, we briefly summarize the recommended medication by pattern.
– Above all you want to boost erectile power ➡ vardenafil, avanafil
– You want to feel the effect right after taking it ➡ vardenafil, avanafil
– You want to feel an effect while keeping the price down ➡ avanafil, udenafil
– You want to take a medication with few side effects ➡ avanafil, udenafil, tadalafil
– You often eat or drink alcohol before the act ➡ avanafil, udenafil, tadalafil
– You are not the insertive partner but want erections to come more easily ➡ tadalafil, udenafil
– You want a formulation that can be taken without water ➡ Viagra OD Film
[The strongest effect is vardenafil]
As for the effect of ED Treatment Medication, we think it is useful to remember that vardenafil above all has strong erectile power and works quickly. It is the most potent formulation among the ED Treatment Medication currently available.
However, because vardenafil is affected by food (though not as much as Viagra or sildenafil), those who always have intercourse after eating should consider avanafil, udenafil or tadalafil.
[About sildenafil, avanafil and udenafil]
Sildenafil and vardenafil are strongly affected by food and alcohol, whereas avanafil, udenafil and tadalafil are less affected by food and are formulations with few side effects.
Avanafil is the formulation with the next highest effect after vardenafil; its effect also appears quickly, it has few side effects and it is less affected by food, making it an easy-to-use formulation for anyone.
Udenafil can be expected to give a mild and natural effect, and compared with the long-acting tadalafil, the time until it takes effect is shorter and the effect ends in approx. 8 to 13 hours, so it is popular with those who want to keep the price lower than tadalafil.
[About side effects]
Because ED Treatment Medication has a blood-vessel-dilating effect, some people experience side effects associated with vasodilation throughout the body (for example, headache or bloodshot eyes). If you are concerned about side effects, we recommend either choosing avanafil, udenafil or tadalafil, which are said to have the fewest side effects, or trying a low dose first.
Types: hot flushes, headache, palpitations, nasal congestion, bloodshot eyes, etc.
Frequency: [few] avanafil, udenafil, tadalafil << sildenafil = vardenafil [many]
For those who are not always the insertive partner during intercourse (versatile or receptive), udenafil and tadalafil are recommended.
Because erections come more easily with sexual and physical stimulation and side effects are few, these are formulations we recommend for those who want to stay moderately erect during the act.
For those whose intercourse is decided suddenly, we have Viagra OD Film as a formulation that can be taken without water. It dissolves on its own simply by being placed on the tongue, making it easy to take, but it is very strongly affected by food, so those who often have intercourse before a meal and whose sexual encounters are decided suddenly may want to consider it.
[Deciding the strength]
Once the formulation is decided, next decide the strength. Many formulations come in 2 types: a low dose and a high dose.
Our recommendation is the approach of cutting a high-dose tablet in half and taking either half or the whole depending on the situation.
Higher-dose formulations are better value, so this makes each use more economical.
Generic drugs are designed to be easy to cut in half, and we recommend cutting the tablet in half with a commercially available pill cutter and storing it.
Buy the high dose of the formulation, cut it in half and start (at a low dose)
Start by using half, and if it is effective, continue using half each time. Compared with a low-dose formulation, this lets you use ED Treatment Medication very economically. If side effects make it difficult to use, we consider switching to a low dose of avanafil, udenafil or tadalafil.
Of course, taking 1 tablet of the low dose is also perfectly fine!
If you do not feel an effect, take another half
Take a further half and check whether there is an effect. If increasing the dose causes side effects, stop use and consider switching to a low dose of avanafil, udenafil or tadalafil.
If you feel no effect even after taking the full amount, check the following
– Medications affected by food (sildenafil, vardenafil)
➡ Please try taking it before eating.
– Formulations not affected by food (avanafil, udenafil, tadalafil)
➡ Please check whether the time between taking it and intercourse is too short.
– If you still feel no effect after considering the above
➡ If you are using sildenafil or vardenafil, we consider adding avanafil, udenafil or tadalafil starting from a low dose. If you want to increase the dose of the same formulation, we adjust starting from a small amount. Those with cardiac disease (especially arrhythmia) should consult a doctor.
Taking 1.5 times or more of the high dose of a single formulation can cause strong side effects. Because a sudden drop in blood pressure and feeling unwell are also possible, please discuss it with a doctor.
For those who want to try various ED Treatment Medication to find the one that suits them, we also offer good-value trial sets.
Prices of ED Treatment Medication
The prices and characteristics of each ED Treatment Medication are shown in the table. You can purchase from 1 tablet, and buying 10 tablets or 30 tablets together is excellent value!
For those who would like to try various ED treatment medications to find what suits them best, we also offer affordable trial sets.
| Drug Name | Strength | Quantity | Fee (tax included) |
|---|---|---|---|
| (Brand) Viagra (Generic) Sildenafil |
Viagra 50mg | 1 tablet | 1,600 yen |
| 10 tablets | 14,000 yen | ||
| 30 tablets | 40,000 yen | ||
| Viagra OD Film 50mg | 1 tablet | 1,100 yen | |
| 10 tablets | 10,000 yen | ||
| 30 tablets | 27,000 yen | ||
| Sildenafil 50mg | 1 tablet | 1,000 yen | |
| 10 tablets | 9,000 yen | ||
| 30 tablets | 22,500 yen | ||
| (Brand) Levitra (Generic) Vardenafil |
*Levitra is not available | – | – |
| Vardenafil 10mg | 1 tablet | 1,500 yen | |
| 10 tablets | 13,000 yen | ||
| 30 tablets | 33,500 yen | ||
| Vardenafil 20mg | 1 tablet | 1,700 yen | |
| 10 tablets | 15,000 yen | ||
| 30 tablets | 39,500 yen | ||
| (Brand) Cialis (Generic) Tadalafil |
Cialis 10mg | 1 tablet | 1,800 yen |
| 10 tablets | 16,000 yen | ||
| 30 tablets | 45,000 yen | ||
| Cialis 20mg | 1 tablet | 2,000 yen | |
| 10 tablets | 18,000 yen | ||
| 30 tablets | 49,000 yen | ||
| Tadalafil 2.5mg (daily therapy) |
1 tablet | 300 yen | |
| 10 tablets | 2,500 yen | ||
| 30 tablets | 4,000 yen | ||
| 90 tablets | 10,000 yen | ||
| 180 tablets | 19,000 yen | ||
| 360 tablets | 35,000 yen | ||
| Tadalafil 5mg (daily therapy) |
1 tablet | 400 yen | |
| 10 tablets | 3,500 yen | ||
| 30 tablets | 8,000 yen | ||
| 90 tablets | 20,000 yen | ||
| 180 tablets | 38,000 yen | ||
| 360 tablets | 69,000 yen | ||
| Tadalafil OD 10mg | 1 tablet | 1,400 yen | |
| 10 tablets | 12,000 yen | ||
| 30 tablets | 31,500 yen | ||
| Tadalafil OD 20mg | 1 tablet | 1,600 yen | |
| 10 tablets | 14,000 yen | ||
| 30 tablets | 37,500 yen | ||
| (Brand) Stendra (Generic) Avanafil |
*Stendra is not available | – | – |
| Avanafil 100mg | 1 tablet | 1,100 yen | |
| 10 tablets | 9,000 yen | ||
| 30 tablets | 24,000 yen | ||
| Avanafil 200mg | 1 tablet | 1,200 yen | |
| 10 tablets | 10,000 yen | ||
| 30 tablets | 27,000 yen | ||
| (Brand) Zydena (Generic) Udenafil |
*Zydena is not available | – | – |
| Udenafil 100mg | 1 tablet | 1,100 yen | |
| 10 tablets | 9,000 yen | ||
| 30 tablets | 24,000 yen | ||
| Udenafil 200mg | 1 tablet | 1,200 yen | |
| 10 tablets | 10,000 yen | ||
| 30 tablets | 27,000 yen | ||
| Trial Set (Small) |
Sildenafil 50mg + Vardenafil 10mg + Tadalafil OD 10mg (3 types) |
1 set | 3,400 yen |
|
Sildenafil 50mg + Vardenafil 10mg + Tadalafil OD 10mg + Avanafil 100mg (4 types) |
1 set | 4,000 yen | |
|
Sildenafil 50mg + Vardenafil 10mg + Tadalafil OD 10mg + Avanafil 100mg + Udenafil 100mg (5 types) |
1 set | 4,500 yen | |
| Trial Set (Large) |
Sildenafil 50mg + Vardenafil 20mg + Tadalafil OD 20mg (3 types) |
1 set | 3,800 yen |
|
Sildenafil 50mg + Vardenafil 20mg + Tadalafil OD 20mg + Avanafil 200mg (4 types) |
1 set | 4,600 yen | |
|
Sildenafil 50mg + Vardenafil 20mg + Tadalafil OD 20mg + Avanafil 200mg + Udenafil 200mg (5 types) |
1 set | 5,400 yen |
ED Treatment Medication can also be used together with HIV prevention medication, premature ejaculation medication and AGA medication. At our clinic, many people use these medications in combination.
Combined Use with Premature Ejaculation Medication Is Also Effective
For those with premature ejaculation, taking ED Treatment Medication increases firmness during erection and can be expected to extend the time until ejaculation.
Taking it together with medication for premature ejaculation poses no problem; rather, when premature ejaculation has multiple causes, taking them together can be expected to produce even greater effect.
Medication for premature ejaculation and ED treatment medication are not habit-forming, so using these medications does not mean you will become unable to have sex normally.
Premature ejaculation medication is not affected by food, but it is affected by alcohol to the same degree as, or more than, premature ejaculation medication, so caution is required.
Please also see the blog below. It can be prescribed together with ED Treatment Medication!
<Dr. Daisuke Shiojiri> Director of Personal Health Clinic, Doctor of Medical Science. At the National Center for Global Health and Medicine (Shinjuku Ward, Tokyo) and at Personal Health Clinic, he provides correct, evidence-based knowledge on HIV, PrEP and other topics related to STIs and STI testing, along with care that stays close to patients' hearts. Born in Japan but raised in Kenya, Africa, he also holds a medical license there and carries out medical assistance, educational assistance and other activities locally. He also sees patients at our clinic as a part-time doctor.
