They are likely to all have the same effect. Most of the PDE5 inhibitor side effects are due to them inhibiting other PDE's too, and given this varies between the drugs, switching drugs can often resolve it.
However, the heartburn is caused by inhibiting PDE5 itself, which is also used by the smooth muscle of the esophagus and lower esophageal sphincter. It causes them to relax (like it does the smooth muscle around the arteries in the penis). However, in some people, that's enough to allow acid reflux, and for food to be swallowed more slowly and not always completely.
There are some things that may help.
The effect is very dose-specific. See if a smaller dose works for erections, and maybe doesn't cause heartburn.
You could try leaving it long enough after eating for your stomach to have cleared, e.g. 2 hours. (PDE5 inhibitors work best on an empty stomach anyway.)
You could try taking them with an indigestion tablet, although beware that long term acid reflux can cause esophageal cancer.
Do try the forth one, but I don't hold out a lot of hope. Trying smaller doses of all of them might be worth a try too.
By the way, I've not yet come across anyone who's tried Spedra/Avanafil, although it should be available to prostate cancer patients on the NHS if the others don't work. It's the most expensive, as it's the only one still on patent (until September, anyway).
Edited by member 18 May 2020 at 17:36
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