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Medicines that you take by mouth are called oral medicines. They're often the first line of treatment for trouble getting or keeping an erection, called erectile dysfunction (ED). Oral medicines for ED usually work well and cause few side effects.

The four main medicines taken by mouth for erectile dysfunction are:

• Avanafil (Stendra).
• Sildenafil (Viagra).
• Tadalafil (Cialis).
• Vardenafil.

These medicines are called PDE5 inhibitors. They enhance the effects of a chemical the body makes that relaxes muscles in the penis, called nitric oxide. This boosts blood flow and helps you get an erection from sexual activity.

Each oral medicine for ED has a slightly different chemical makeup. These small differences affect the way each medication works, such as how quickly it takes effect and wears off, and the possible side effects. Your doctor or other health care professional can recommend one for you based on these factors, other health conditions you have and any other medicines you take.

• Sildenafil (Viagra). This medicine works best when you take it on an empty stomach an hour before sex. The body takes longer to absorb it after a high-fat meal or alcohol. Its effects often last for 4 to 5 hours. It might work longer if you have mild to moderate erectile dysfunction.

• Vardenafil. This medicine also works best when you take it an hour before sex on an empty stomach. As with sildenafil, a high-fat meal or alcohol keep the body from absorbing it as quickly.

  Vardenafil usually works for 4 to 5 hours. Its effects might last longer if you have mild to moderate ED. A newer form of the medicine that dissolves on the tongue might work faster than the pill that you swallow.

• Tadalafil (Cialis). This medication is taken with or without food an hour before sex. It works for up to 36 hours. You can take it in a small dose daily or in a larger dose as needed.
• Avanafil (Stendra). You can take this medicine with or without food 30 minutes before sex, depending on the dose. It lasts 4 to 5 hours, or longer if you have mild to moderate ED.

These medicines all work well for ED. When choosing one, tell your doctor or other health care professional what your preferences are, such as cost, ease of use, how long the drug's effects last and side effects. Generic versions of sildenafil, vardenafil and tadalafil are available.

Check with your health care team before you take any medicine for erectile dysfunction. Oral ED medicines might not work or might be dangerous if you also take any of the following:

• Nitrate medicines. Often, these are prescribed for chest pain called angina. Some examples of nitrates are nitroglycerin (Nitro-Dur, Nitrostat, others), isosorbide mononitrate (Monoket) and isosorbide dinitrate (Bidil).
• Alpha-blockers. These are commonly prescribed for an enlarged prostate or male pattern baldness. They include dutasteride (Avodart, Jalyn) and finasteride (Propecia, Proscar).
• Medicines that block an enzyme called CYP3A4. These include itraconazole (Sporanox, Tolsura), ketoconazole (Extina, Ketozole, others) and ritonavir (Norvir).

Oral medicine for ED also might not be safe or work well if you have:

• Very low blood pressure, called hypotension, or uncontrolled high blood pressure, called hypertension.
• Severe liver disease.

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Buproban 150mg Tablet ER may be taken with or without food. It is advised to take this medicine at a fixed time each day. You should never skip any doses and finish the full course of treatment even if you feel better. This medication mustn't be stopped suddenly as it may worsen your symptoms.

Some common side effects of this medicine include insomnia (difficulty sleeping), allergic reaction, impaired concentration, sweating, headache, nausea, vomiting, and dry mouth. It even causes dizziness and sleepiness, so do not drive or do anything that requires mental focus. Moreover, most of the side effects are immediate and often go away with time. Please consult your doctor if these bother you or do not go away.

Before taking this medicine it is important to inform your doctor if you have any history of seizure or if you drink alcohol. Inform your doctor if you develop any unusual mood changes or if you have any suicidal thoughts.

• Depression
• Smoking addiction

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