Question: Dr. Hibberd, thank you for your column. I think your advice is excellent. I am a man of 60 who sometimes has trouble with erectile dysfunction. I see there are now several drugs besides Viagra for this. Is one better than another?

Dr. Hibberd’s answer:

This question is never answered by the pharmaceutical companies. In my experience, the differences relate only to longevity of the drug. Some may be taken daily, and others need to be taken on an as-needed basis one hour or so beforehand. My preference is to use a short-acting drug, as the need is just that — not an extended need.

This also minimizes any drug-drug interactions, such as the severe reactions seen when a heart-saving nitroglycerin administration can turn into a life-threatening loss of blood pressure when combined with Viagra and other Viagra-like medications. Viagra and its sister drugs that are longer-acting all act like a light switch. Once the light has been switched on, you will still need to wait for recovery no matter what agent you use. All seem equally effective in my experience.

But do not buy off the Internet. Much of the Internet "Viagra" is not the real thing, and is actually mislabeled yohumbine and other drugs unrelated to Viagra. If you have any further questions, ask your local pharmacist on other sources that may be available for discounted purchase. Often online manufacturer discount and coupon programs can save you considerable amounts also.