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Both might technically be 'refrigerated,' but one will retain 95% potency at day 28 while the other drops to 75%

Other serious risks include pancreatitis, gallbladder disease, acute kidney injury, hypoglycemia (when used with insulin or insulin secretagogues), and diabetic retinopathy complications

First-line treatments include: PDE5 inhibitors (sildenafil, tadalafil, vardenafil, avanafil): These medications enhance nitric oxide signaling and remain the most effective oral treatment for ED, with success rates of 50-65% in diabetic men (somewhat lower than in non-diabetic populations)

Off-label prescribing is legal, common, and based on clinician judgment and available evidence

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