Alternative to tadalafil

When you have tried the whole tablet, have you left enough time for it to work? None of these work immediately.

It can take a long time to get an ED referral.

You might well find your GP is happen to provide you with Sildenafil (Viaga) and Vardenafil (Levitra) to try (not at the same time). Actually, I think all the PDE5 inhibitors say not to be taken with any other ED drugs, but all urologists I've come across seem fine with taking the 5mg daily low dose Tadalafil with any others.

I would agree with Lyn - try all the tablets (PDE5 inhibitors) before going on to the injections and creams (vasolidators). Some ED clinics seem to take a totally random approach, and I have to wonder if the clinician has any idea what they're doing or how the drugs work.

I have also read about combining certain tablets-5mg tadalafil dailies in the morning and taking 50mg-100mg sildenafil and hour before any special event if you know what I mean. Has any taken the above and what results did they have. As far as Tadalafil goes I have had none of the classic side effects.

Hi Lyn

As usual. very helpful info.  Due to a new relationship and accompanying sex life (woohoo!), I'm now trying out different PDS5s to see what suits best.  Your posting of:

"At first, the GP refused to prescribe both at the same time but backed down under pressure from the ED nurse. The absolute rule the ED nurse gave us was to never take the Cialis in the same evening that he was intending on using the Viagra / Levitra or Caverject or, if he was taking Cialis in the morning, to not take it if he had used the Viagra or Caverject the night before" 

was most detailed, and gratefully received.  My query is...  why?  Is it due to priapism risk, blood pressure risk, or something else?  Tis true, I would like to experiment, and any tips beforehand would be most welcomed.  For me currently, a more-or-less daily top up of 5mg tadalafil interspersed with a special day dose of 100mg sildenafil works perfectly, although I suspect 50mg Sildenafil might work equally well.  But could I take 5mg tadalafil and 50mg sildenafil daily?  That's my new target, but I'd prefer to avoid the priapism of heart failure! Next up, Invicorp 25....

Thanks, G

It’s all a weird science. I now 5 yrs on just need the daily Cialis and a durex  cock ring. I can’t explain the difference between ring and no ring , but it turns a 90% into a 100%.
They say not to mix drugs as they have to , and essentially it’s unsafe for all the reasons you describe. If something is gonna work then it will despite mixing. I tried Invicorp privately having had zero success with Caverject but I ensured I dropped the Cialis. It was truly brilliant. Back to pre op even if shorter yet fatter from all the pump use. However it got me so hard each time it gave me a tiny bit of incontinence. The erection went soon after sex but was back for a second round a while later normally.

Edited by member 24 May 2020 at 08:34  | Reason: Not specified

Two effects.

The cock ring exerts pressure on the veins draining blood from the corpus cavernosum, reducing the draining, so you can build up more blood in the corpus cavernosums.

If it's a vibrating ring, the extra stimulation generates additional arousal, both to the brain which may increase the arousal back down the erection nerves, and also via a spinal arc reflex, bypassing the brain and direct to the erection nerves.

I have been on the usual websites and are there any recommendations on which cock ring to buy. I've never used one just never had to until now.. do the vibrating ones stimulate and arouse you more or do the normal ones work just as good..

I think that you have hit the nail on the head with visual stimulation. I lost my wife in 2018 just after being diagnosed. So since the op in May 2019 there has been no one until the last couple of weeks..I'm trying sildenafil next instead of Tadalafil and a ring so hopefully get some life back into the old fella. I was told by the ED nurse that you can lack confidence and nervous with a new partner even without feeling it.

Regarding stimulation I find for a given hardness you need several magnitudes of stimulation more to achieve the same result as prior to RP. You also need more to keep it up. The Durex cock ring helps get it harder and keep it that way so is a real help.

Yes got to be up front, if you aren't they will find out anyway!

I think caverject is useful rather than a pump and construction rings. I found the latter is a real passion killer in its use and the point at which you need to use it. Whereas the injection can be given quickly and the results are really natural.

Pills are hit and miss so you risk failure which reinforces the mental anguish. 

As opposed to the pump where you have to pump it before hand or stop to pump, yes I know some couples make this part of the foreplay but in a new relationship that never worked for me..

HI,

My husband Ian, who had prostectomy in February, pumps every day. He takes his daily Cialis and Viagra 2-3 times a week. The viagra helps a little bit, but not enough to have intercourse. Of course it's quite early after the operation to expect too much. And the fact that he's had non-nerve sparing, makes us think he's being very lucky. When he got his pump, the healthcare professional thought he would be able to get natural erections eventually, so we'll see. We've managed to have semi-intercourse twice after he used the pump as well. Should he try a cock ring, or is it too soon? In August Ian's got an appointment at the ED clinic, and we'll see what they say, if they want him to try injections.

The fact that you've had some response means you did have some nerve sparing, even if the surgeon didn't realise. So it's good to do penile rehabilitation as for nerve sparing, because if you get that working, that's the least intrusive way to get sexual function back.

I'm wondering if you really mean a cock ring, or a pump constriction ring, as they're completely different things?

A cock ring is much looser, and will amplify the effect of an erection by constricting the veins that drain the corpus cavernosum (the erectile part of the penis), while still allowing blood in via the arteries. The ring can go around base of penis, or base of penis and scrotum, but it doesn't need to be tight. You can use cock rings with a PDE5 inhibitor which amplify the effect by boosting blood flow in the penile arteries too.

A pump constriction ring is much tighter and blocks off both the veins and arteries in the penis, to retain an erection generated by the pump (and you definitely don't want it around the scrotum too - that's a nasty accident!

You should be able to do either of these. It's generally suggested you don't use the constriction rings until you've done the initial pump exercises and some penile rehabilitation (pumping up, holding, and releasing, without using the constriction rings). You should have had some training on using the pump.

Edited by member 09 Jul 2020 at 17:52  | Reason: Not specified