Levitra Vs Cialis

For the most part, Viagra, Levitra and Cialis are fine for patients with erectile dysfunction, according to guidelines out today from the American College of Physicians, a big group of primary care docs.

But there’s not much good evidence to allow doctors to figure out which drug is best for which patient, so doctors should base their choice on factors such as patient preference, which may be determined in part by cost, the guidelines say.

“The evidence is insufficient to compare the efficacy and adverse effects” of the drugs because “few head-to-head trials are available,” the guidelines say. This lack of evidence comparing one drug against another is familiar. Companies often launch studies comparing new drugs to placebos, rather than to existing drugs; without head-to-head trials, it can be tough to know how competing drugs stack up.

All of the drugs do have some side effects, including headache, flushing and stomach pain, the guidelines note. And they shouldn’t be taken by certain patients, including those taking nitrate drugs for angina.

The guidelines also said there is not enough evidence to recommend for or against hormonal blood tests (which typically look at testosterone levels) or hormonal treatment for men with erectile dysfunction.