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THURSDAY, Oct. 22 (HealthDay News) -- Doctors should prescribe oral phosphodiesterase type 5 (PDE-5) inhibitor drugs, such as Viagra, Cialis and Levitra, for men with erectile dysfunction, unless the patient is on nitrate therapy, according to a clinical practice guideline issued by the American College of Physicians. Do you have any of the following conditions? How to get viagra if you haven't prescription? where to buy viagra without prescription Erectile Dysfunction: Vacuum Constriction Devices Moderate renal impairment (CrCl 30-50 mL/min): 5 mg PO qd prn initially; may increase to 10 mg PO q48h prn Smoking, which can lead to any of the above risk factors, is perhaps the most significant risk factor for impotence related to arteriosclerosis.