Oral Medications for Erectile Dysfunction
All of these come as pills; vardenafil also is made in a dissolvable version you place under your tongue.
- PDE5 inhibitors have different durations and onset times.
- Combining ED meds with other vasodilators may cause hypotension.
- ED drugs may improve self-esteem and relationships.
- Use caution with recreational drugs when on ED medications.
- Proper storage is necessary to maintain medication potency.
- Men with kidney impairment may need dose adjustments.
- ED medications are sometimes used off-label for pulmonary hypertension.
- Some drugs may cause temporary vision disturbances.
- Open communication with healthcare providers ensures safe use.
- Lifestyle modifications can sometimes eliminate the need for medication.
Chewable ED drugs are available that contain the same active ingredients of sildenafil, tadalafil, and vardenafil. However, they are made to order in compounding pharmacies and may include other ingredients. Dr.
Find Out Which ED Medications Work Best For You
Our caring team of Mayo Clinic experts can help you with your health concerns. Visit Mayo Clinic Men's Health to get started. Although the term “ED” is often associated with a complete inability to get an erection sufficient for sex, the reality of erectile dysfunction is that it can vary hugely in severity. Can get a normal erection, but find it difficult to maintain it during sex Can get a normal erection, but find it difficult to maintain it during sex Find it difficult to get an erection every time you want to have sex Find it difficult to get an erection every time you want to have sex Can’t get an erection at all, even when you’re sexually stimulated Can’t get an erection at all, even when you’re sexually stimulated A Hims medical provider will help determine which treatment is most appropriate for you. All of the active ingredients in our treatments are approved by the FDA based on extensive, high-quality clinical trials.
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These trials have uniformly demonstrated that ED medications are safe and effective for the vast majority of men. Learn more in our guide to the safest drug for erectile dysfunction.Our guide on how to know if you have ED goes more into detail about common signs that you’re affected by erectile dysfunction. Most ED medications take 15 min to 1 hour to “kick in” and start producing a noticeable effect on your ability to develop and maintain an erection, so make sure you’re timing your specific dosage accordingly. While you may experience side cheapest ed pills effects from your medication, most are mild and temporary. Your body may just need some time to get used to the effects of ED medication, so give it a few tries before making any adjustments. O'Leary advises against using these custom-made products since they are not regulated or approved by the FDA.
| Medication | Onset (minutes) | Duration (hours) | Food Interaction |
|---|---|---|---|
| Sildenafil | 30-60 | 4-6 | Fatty meals may delay absorption |
| Tadalafil | 30-60 | Up to 36 | Less affected by food |
| Vardenafil | 25-60 | 4-5 | Fatty meals may delay onset |
| Avanafil | 15-30 | Up to 6 | Less affected by food |
The four ED drugs - known medically as PDE5 inhibitors - work similarly to increase blood flow into the penis, which helps men reach and maintain an erection. They do this by inhibiting phosphodiesterase type 5 (PDE5), an enzyme in blood vessel walls that controls blood flow. When a man is aroused, his body releases molecules that relax the smooth muscles in the blood vessels, allowing more blood to flow in. ED drugs prevent PDE5 from breaking down these substances, thus keeping the blood flowing. ED drugs are effective in about 70% of men, according to Dr. O'Leary, but the results can vary. "A man with nerves or arteries damaged by prostate surgery, diabetes, or cardiovascular disease will not respond as strongly to ED drugs," he says. Also, while ED drugs can help men achieve and maintain an erection, they don't help with other sexual issues, such as low libido, premature ejaculation, or the inability to reach orgasm. The main differences between ED drugs are how quickly they act and how long the effect lasts.
| Side Effect | Commonality | Severity | Associated Medication(s) |
|---|---|---|---|
| Headache | Common | Mild | Sildenafil, Tadalafil, Vardenafil |
| Flushing | Common | Mild | Sildenafil, Vardenafil |
| Nasal Congestion | Common | Mild | Tadalafil, Vardenafil |
| Dizziness | Less common | Moderate | Sildenafil, Avanafil |
| Back Pain | Less common | Mild | Tadalafil |
Avanafil takes about 15 to 30 minutes to work and lasts six to 12 hours. Sildenafil and vardenafil take effect in 30 minutes to an hour and last four to five hours. Tadalafil kicks in after 30 to 45 minutes and can last 24 to 36 hours. "Many doctors first prescribe sildenafil because it has been around the longest and has a high success rate," says Dr.
- Tadalafil is approved for both ED and BPH (benign prostatic hyperplasia).
- Some medications may cause nasal congestion or facial flushing.
- Men with pre-existing retinal disorders should be cautious.
- Certain medications, like ritonavir, can increase ED drug levels.
- Priapism requires urgent medical attention to prevent damage.
- ED medications are not a cure but assist with symptoms.
- Men should avoid heavy meals before taking ED meds for optimal absorption.
- Side effects usually improve within a few hours.
- Psychogenic ED may require a combo of medication and therapy.
- Not all ED medications are suitable for women.
O'Leary. Men who want a longer-lasting effect might opt for tadalafil. Tadalafil is also available as a low-dose daily drug, so you have a constant amount of the drug in your bloodstream, which helps with spontaneous sex. (This version is also used to treat benign prostatic hyperplasia, or an enlarged prostate.) The maximum dosages for ED drugs vary from 20 milligrams (mg) for tadalafil and vardenafil to 100 mg for sildenafil and 200 mg for avanafil. Your doctor usually begins with a low dose and increases it as needed. "Once you reach the maximum dose, and the drug still doesn't work, taking more won't help," says Dr. O'Leary. "Also, switching to another ED drug usually won't make a difference." The most common side effects of ED drugs are headaches, upset stomach, nasal congestion, muscle pain, and facial flushing. But most of these are 10mg vardenafil online relatively mild and disappear after a few hours.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Cialis Professional | 20mg | 10 Pills | 48.29€ 45.99€ | |
| Kamagra Gold | 50 mg | 32 Pills | 103.06€ 98.15€ | |
| Cialis Generic | 5mg | 60 + 4 Pills | 86.02€ 81.92€ | |
| Super Kamagra | 160 mg | 60 + 4 Pills | 342.71€ 326.39€ | |
| Cialis Generic | 40mg | 120 + 8 Pills | 206.98€ 197.12€ | |
| Viagra Oral Jelly | 100mg | 10 Sachets | 46.36€ 44.15€ | |
| Viagra Generic | 200mg | 90 + 6 Pills | 170.79€ 162.66€ | |
| Cialis Generic | 10mg | 90 + 6 Pills | 146.17€ 139.21€ | |
| Viagra Original | 100mg | 12 Pills | 72.54€ 69.09€ | |
| Levitra Generic | 40mg | 10 Pills | 41.37€ 39.40€ | |
| Levitra Original | 20mg | 120 + 8 Pills | 528.19€ 503.04€ | |
| Kamagra Gold | 50 mg | 180 + 6 Pills | 371.27€ 353.59€ | |
| Kamagra Soft Tabs | 100 mg | 84 + 4 Pills | 233.05€ 221.95€ | |
| Kamagra Soft Tabs | 100mg | 180 + 8 Pills | 425.45€ 405.19€ | |
| Viagra Generic | 100mg | 270 + 10 Pills | 270.47€ 257.59€ | |
| Kamagra 100 mg | 100 mg | 180 + 6 Pills | 436.79€ 415.99€ |
"ED drugs can make blood pressure temporarily drop, so don't use them if you take nitrates for angina (chest pain) or other heart problems," says Dr. O'Leary. However, there's no problem with nitrates found in food - for example, leafy green vegetables (spinach, kale) and root vegetables (beets, carrots). You also need to be careful if you take alpha blockers such as tamsulosin (Flomax) and alfuzosin (Uroxatral), used to treat an enlarged prostate. "Make sure to take these medications at least four hours apart from an ED drug," says Dr. O'Leary.
What are Erectile Dysfunction Medications?
Called priapism, this rare condition can be painful. You need to get treatment for it as soon as possible to help prevent damage to your penis. If you have an erection that lasts more than four hours, call your care team right away. Treatments for erectile dysfunction are big business, and online scams abound. If you do buy medicines over the internet: Check to see if an online pharmacy is legitimate.
Patient & Visitor Support
Never order medicines from an online pharmacy that doesn't list its phone number and physical address, has prices that seem too good to be true, or tells you that no prescription is needed. Also stay away from ones that don't have a licensed pharmacist on staff to answer your questions. Some illegal businesses sell fake versions of real medicines, which can be dangerous or might not work. In the United States, the National Association of Boards of Pharmacy can tell you whether an online pharmacy is licensed and in good standing. If you live in another country, check to see if pharmacy association or regulation agencies offer services like these.
3. Urethral suppository
Make sure you get the right prescription and dose. When you order medicines and when you receive them in the mail, make sure they're the exact dose and type prescribed by your doctor or other health care professional. The dose is the vardenafil canada amount of medicine you take. Don't be fooled into buying "herbal viagra." Never take any medicines that claim to be the "herbal" or nonprescription version of an oral medicine for ED. These aren't an effective option, and some contain harmful substances. It's also best not to take sildenafil or vardenafil soon after eating, as food can block their absorption.
| Contraindication | Explanation | Usually applies to | Alternative approach |
|---|---|---|---|
| Use of Nitrates | Can cause severe hypotension | Heart patients on nitrate therapy | Psychological counseling, vacuum devices |
| Severe Liver Impairment | Reduced drug metabolism increases risk | Patients with hepatic failure | Dose adjustment, alternative therapies |
| Severe Cardiac Conditions | Risk of heart attack or arrhythmias | Unstable angina, recent MI | Medical evaluation, lifestyle changes |
| Hypotension | May worsen low blood pressure | Systolic BP <90 mm Hg | Non-pharmacological options |
(Tadalafil and avanafil don't interact with food in this manner.) Matthew Solan, Former Executive Editor, Harvard Men's Health Watch Howard E.
Levitra (Vardenafil)
Reviewed by Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing Since the 1990s, erectile dysfunction (ED) drugs have helped millions of men continue to enjoy an active sex life. "While not much has changed in how they work or the types of drugs available, there still are things men should consider when choosing which one to try," says Dr. Michael O'Leary, a urologist and former director of men's health at Harvard-affiliated Brigham and Women's Hospital's Department of Urology. There are four main FDA-approved ED drugs: sildenafil (Viagra), tadalafil (Cialis), vardenafil, and avanafil (Stendra). LeWine, MD, Chief Medical Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles.
Myth 1: All ED medications work the same way.
Oral ED medicines might not work or might be dangerous if you also take any of the following: 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). 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.
Who can prescribe ED medications?
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. Kidney disease that needs to be treated with dialysis. These include a heart attack, stroke or a serious heart rhythm disorder in the past six months. An inherited eye disease that affects the retina. Side effects of oral ED medicines are often mild.
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Visual changes, such as blue tinge to vision, sensitivity to light or blurred sight. Rarely, more-serious side effects can happen, including: Some people have suddenly lost some of their hearing or vision after taking one of these medicines. But it isn't clear whether these side effects were caused by the medicine or by health conditions that the people already had. Get medical care right away if you take oral ED medicine and have sudden loss of hearing or vision. An erection that doesn't go away on its own. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. Health care professionals treat the underlying cause of erectile dysfunction (ED) when possible. Sometimes, the exact cause of ED is not known. Health care professionals will then focus on improving sexual function. Choosing an ED treatment is a personal decision. If you have a partner, you may want to talk together about treatments that work for you as a couple. Your health care professional may suggest lifestyle changes to help improve your ED symptoms, including Health care professionals may suggest counseling if mental health or emotional issues are affecting your ED.
- Cultural Attitudes: Vary significantly across different societies and age groups.
- Media Influence: Direct-to-consumer advertising has increased awareness.
- Open Discussion: Becoming less taboo, encouraging men to seek help.
- Aging Population: Increasing prevalence as the global population ages.
- Economic Impact: A multi-billion dollar global market for medications.
- Accessibility: Still a major issue in many developing countries.
- Educational Efforts: Campaigns by healthcare providers to reduce stigma.
Counselors can help you lower anxiety and stress about sex. Your counselor may ask you to bring your partner to sessions for more support.
- Alprostadil works by relaxing blood vessels to increase blood flow.
- Udenafil is primarily used in Asian countries.
- Yohimbine's effects are less predictable than prescription meds.
- ED medications have been extensively studied for safety.
- Be aware of counterfeit ED drugs in unregulated markets.
- Some medications can cause a sudden decrease in blood pressure.
- Proper dosing is crucial; overuse can cause adverse effects.
- Men with uncontrolled high blood pressure should consult a doctor.
- Use ED medications only as prescribed by healthcare providers.
- Age-related decline can affect medication effectiveness.
