(HealthNewsDigest.com) - Boston, MA - For the estimated half of men between the ages of 40 and 70 who have trouble getting or sustaining an erection, taking a medication can often remedy the problem. With four erectile dysfunction drugs on the market, men have options. But their choices are often limited by cost and health insurance rules, reports the June 2014 Harvard Men's Health Watch.

Four erectile dysfunction drugs are available in the United States: avanafil (Stendra), sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra). They are meant to be taken a few hours before sexual activity. A low-dose version of tadalafil can be taken every day.

Does it make any difference which of the four erectile dysfunction drugs a man chooses? "Yes, there can be differences," says Dr. 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."

These drugs work for about 70% of men with erectile dysfunction. They generally kick in within 15 to 60 minutes (avanafil is the fastest). How long they last ranges from four hours to more than a day (tadalafil lasts longest). Side effects vary, but the most common ones are headache, flushing, upset stomach, nasal congestion, urinary tract infections, vision problems, diarrhea, dizziness, and rash. A man may experience side effects with one of these medications but not another.

The main obstacle to men using an erectile dysfunction drug is often its cost, says Dr. Liou. Some insurers limit men to as few as four pills a month. After using up his ration, a man's out-of-pocket cost for a single pill can be as high as $20.

It pays to shop around, because pharmacy prices vary. Various web-based tools can help men easily compare prices. Men may be able to save money by splitting higher-dose pills. And some manufacturer discount programs help men get a limited supply of medication not covered by insurance.

Read the full-length article: "Which drug for erectile dysfunction?"

Also in the June 2014 issue of the Harvard Men's Health Watch:

• Better health through coconut oil: myth or reality?
• Six steps to a healthy heart
• Shingles vaccination pros and cons
• Drug-free ways to soothe a sore neck

The Harvard Men's Health Watch is available from Harvard Health Publications, the publishing division of Harvard Medical School, for $20 per year. Subscribe at www.health.harvard.edu/mens or by calling 877-649-9457 (toll-free).

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