The Cost and Accessibility of ED Treatments

But more times than not, there are underlying issues at play that a pill can't help. While men might have other sexual issues, such as low libido, premature ejaculation, and the inability to achieve orgasm, ED pertains explicitly to not being able to get or maintain an erection. ED drugs address only that issue, by improving blood flow into the penis and keeping the blood in place to maintain an erection. There are four ED drugs currently available: sildenafil (Viagra), avanafil (Stendra), tadalafil (Cialis), and vardenafil (Levitra). At least one ED drug works in about 70% of men, but results vary among individuals. Men who have nerves or arteries damaged by prostate surgery, diabetes, or cardiovascular disease often do not respond as strongly to ED drugs. Finding out is often a trial-and-error approach. Many doctors first prescribe Viagra because it has been around the longest and has a high success rate. If one drug doesn't work after a predetermined period, your doctor may increase the dosage or prescribe one of the others. Sometimes, you have to try all of them before knowing whether ED drugs work for you.

Step	Process Description	Effect
1	Inhibit PDE5 enzyme in smooth muscle cells	Increases cGMP levels
2	Elevated cGMP promotes relaxation of penile arteries	Enhances blood influx
3	Increased blood flow results in erection	Achieves and maintains erection

An ED drug kicks in within 15 minutes to an hour after you take it and can last anywhere from four to five hours up to 24 hours or longer depending on the drug.

What special precautions should I follow?

Nitrate medications, such as nitroglycerin (Nitrostat), can have dangerous interactions with PDE5 inhibitors. Nitrate medications are commonly given to people with heart conditions like angina or high blood pressure. If you take a nitrate medication, you should never take ED medications at the same time. There are ways to save on ED medications: Save with GoodRx: GoodRx can help you save significantly on the average retail price of the generic versions of ED meds. Generic sildenafil at certain pharmacies is as low as $11.70 for 30 tablets with a free GoodRx discount.

Before taking sildenafil,

You can find the same quantity of generic tadalafil and vardenafil for as low as $10.80 and $79.13, respectively. Exclusive GoodRx savings are also available for brand-name Viagra. Save with GoodRx: GoodRx can help you save significantly on the average retail price of the generic versions of ED meds. Save with GoodRx for ED: Get generic Viagra delivered directly to your door starting at $18 per month. Generic Cialis starts at $21 per month.

Compare ED treatments

Save with a copay savings card: If you’re eligible, you could save up to 50% off brand-name Viagra for up to 12 months using a manufacturer savings card. In general, ED medications work by relaxing smooth muscles and blood vessels in the penis. This improves blood flow, which allows for an erection to last longer. Herbal products and dietary supplements that claim to be alternatives for ED aren’t regulated by the FDA. So it’s hard to determine which is best or if they’re even safe and effective. (See "ED drugs: How soon and how long?") It's best not to take the pill with food or soon after a meal, which can block absorption. The most common side effects are headaches, upset stomach, nasal congestion, muscle pain, and facial flushing. But most of these are relatively mild and go away after a few hours. ED drugs can make blood pressure temporarily drop, so never use them if you also take medications that contain nitrates. (Nitrates found in food don't pose a problem.) You also need to be careful if you take any other drugs that lower blood pressure.

Product	Dosage	Quantity + Bonus	Price
Viagra Generic	200mg	180 + 10 Pills	277.56€ 264.34€	Buy
Viagra Generic	150mg	20 Pills	55.02€ 52.40€	Buy
Levitra Generic	20mg	10 Pills	31.49€ 29.99€	Buy
Levitra Soft Tabs	20mg	30 + 2 Pills	99.17€ 94.45€	Buy
Kamagra Soft Tabs	100 mg	12 Pills	57.55€ 54.81€	Buy
Viagra Super Active	100mg	30 + 6 Pills	64.09€ 61.04€	Buy
Cialis Generic	2.5mg	120 + 6 Pills	128.93€ 122.79€	Buy
Kamagra	100mg	60 + 4 Pills	201.34€ 191.75€	Buy
Cialis Professional	20mg	90 + 2 Pills	241.49€ 229.99€	Buy
Kamagra Gold	50 mg	12 Pills	47.30€ 45.05€	Buy

For example, alpha blockers - such as tamsulosin (Flomax) and alfuzosin (Uroxatral), which are used to treat symptoms of an enlarged prostate, lower blood pressure in some men. Make sure to take them at least four hours apart from an ED drug. It's important to realize that ED drugs don't increase sexual desire, and you have to be ready and sexually stimulated for them to work. The drugs won't work well if you are mentally or emotionally not ready for sex. You can't just take a pill, pay some bills or wash the dishes, and then go to the bedroom and think you'll be ready to go. When your mind is not there, you are not going to want sex, and no ED drug can fix that problem. Before trying an ED drug, it's best to step back and analyze your sex life and when your ED occurs. Does it happen all the time or just in certain situations? Is it with only one partner or different ones?

• Tadalafil's longer duration allows more spontaneous activity.
• Counseling may be recommended if psychological problems contribute.
• Men should avoid sudden activities after taking tablets if dizzy.
• Side effects are generally manageable but require medical attention if severe.
• Proper storage extends shelf life and maintains drug efficacy.
• Your doctor will determine the best medication based on health history.
• The effectiveness of these tablets varies from person to person.
• Always disclose all medications and supplements to your doctor.

Does it ever happen when you masturbate? Are the problems associated with stress or alcohol? Asking yourself these types of questions can help identify if your ED may be more psychological than physical. You might benefit from sex therapy with your partner, or you may need treatment for a specific condition that affects your desire and sexual arousal, like post-traumatic stress disorder, depression, or anxiety.

How do side effects compare with Viagra, Cialis, vardenafil, and Stendra?

If you’re experiencing ED symptoms, it’s a good idea to speak with a healthcare professional about your treatment options. Like all medications, ED medications also carry a risk of side effects. Speak with a healthcare professional about potential side effects and whether these medications would be safe for you to take. Phosphodiesterase 5 (PDE5) inhibitors are a class of medications used to treat erectile dysfunction (ED). The available PDE5 inhibitors include sildenafil (Viagra), tadalafil (Cialis), vardenafil (previously sold as Levitra and Staxyn), and avanafil (Stendra).

Key differences between ED medications

Currently, one PDE5 inhibitor isn’t considered the best for ED. The best ED medication for you depends on many factors such as how often you plan to use it, potential side effects, and how much they cost. Plus, many people alternate between ED medications, depending on their individual needs. Talk to a healthcare professional about which ED med would be the best choice for you. Effect of high-fat breakfast and moderate-fat evening meal on the pharmacokinetics of vardenafil, an oral phosphodiesterase-5 inhibitor for the treatment of erectile dysfunction.

Can you use baking soda for erectile dysfunction treatment?

Comparing vardenafil and sildenafil in the treatment of men with erectile dysfunction and risk factors for cardiovascular disease: A randomized, double‐blind, pooled crossover study. Oral phosphodiesterase-5 inhibitors and hormonal treatments for erectile dysfunction: A systematic review and meta-analysis. Erectile lovegra 100 mg dysfunction (ED) drugs are more readily available than ever before, and in general, men have gotten past any stigma about needing them. Yet many men still approach ED drugs the wrong way. Men feel their sex life is not good and see an ED drug as an easy, quick-fix solution. As a service to our readers, Harvard Health Publishing provides access to our library of archived content.

• Many men find tablets effective in restoring erectile function.
• Psychological support can enhance the success of medication.
• Beware of counterfeit medications which can be dangerous.
• Always obtain these tablets through licensed pharmacies.
• Combining ED tablets with other treatments can improve outcomes.
• ED tablets are not aphrodisiacs and do not increase libido.
• Regular checkups help monitor underlying health conditions.
• Overuse or misuse can lead to persistent side effects or dependence.

Please note the date of last review or update on all articles. 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.

How are oral ED drugs similar?

If that’s not possible, stick to a light, low-fat meal. You can take it as needed for occasional ED symptoms. How fast it works: Vardenafil can start working in as quickly as 15 minutes, but peak effects can take up to 1 hour. Then, it will keep working for 4 to 5 hours. Typical dose: The typical starting dosage of vardenafil is one 10 mg tablet.

Vitamins and supplements for ED

It can be cut back to 5 mg or increased to a maximum of 20 mg. Vardenafil is available as a traditional pill that you swallow and a rapidly dissolving pill (which gets to work faster). Stendra is a newer ED medication that works similarly to Viagra, Cialis, and vardenafil. How to take it: Avanafil comes in a pill, which food doesn’t affect. How fast it works: Avanafil works a little faster on average than the other ED medications.

ED overview

The usual starting dose of 100 mg works within 15 minutes. With a lower dose, you’ll need to wait about 30 to 45 minutes. Typical dose: The recommended starting avanafil dosage is 100 mg, but doses can range from 50 mg to 200 mg, depending on your need and response. Viagra, Cialis, vardenafil, and Stendra are considered to work equally well. There isn’t much data that directly compares them against each other. Sildenafil (Viagra) is used to treat erectile dysfunction (impotence; inability to get or keep an erection) in men. Sildenafil (Liqrev, Revatio) is used to improve the ability to exercise in adults (Liqrev, Revatio) and children 1 year of age and older (Revatio) with pulmonary arterial hypertension (PAH; high blood pressure in the vessels carrying blood to the lungs, causing shortness of breath, dizziness, and tiredness). Sildenafil is in a class of medications called phosphodiesterase (PDE) inhibitors. Sildenafil treats erectile dysfunction by increasing blood flow to the penis during sexual stimulation.

Buying oral erectile dysfunction medications online

Most existing studies have only looked at how well each medication compares with a placebo (a pill with no medication in it). This means no one can definitively claim that one medication works better than the other for treating ED. But a systematic review and meta-analysis of a few hundred studies found that Viagra, Cialis, and vardenafil resulted in improved erections in 67% to 89% of people with ED. In comparison, about 30% had improvement with a placebo. All PDE5 inhibitors share common side effects.

Can you permanently get rid of ED?

Most of these are mild and can include: With Viagra, there is a higher risk of vision changes than with Cialis. Among people who take Viagra, 3% get blue vision that lasts a few hours. On the other hand, Cialis has a slightly higher risk of muscle pain than Viagra and vardenafil. Overall, the immediate side effects of PDE5 inhibitors don’t last very long and aren’t much of a bother. But while the side effects of these medications are similar, the jury is still out on what the risks are of taking these medications long term over several decades.

Language matters

PDE5 inhibitors are generally safe for the heart. But there are two potentially serious side effects to know about: All PDE5 inhibitors can lower your blood pressure. This won’t necessarily affect you, but it may be a problem if you also take a blood pressure medication. A sudden drop in blood pressure can make you feel dizzy, fall, black out, or even cause more serious cardiac issues. All PDE5 inhibitors can lower your blood pressure.