Effective ED medications: Pills and alternatives

We include products we think are useful for our readers. If you buy through links on this page, we may earn a small commission or other tangible benefit. Optum Store, Optum Perks, and Healthline Media are owned by RVO Health. Here’s our process.

Medical News Today only shows you brands and products that we stand behind.

Erectile dysfunction (ED) is a treatable condition, and various medications can help, such as sildenafil and tadalafil. The pills that people find most effective will depend on their individual needs and lifestyles.

All ED pills are available via prescription only, so a person must first speak with a doctor or healthcare professional to discuss symptoms. Some companies offer telehealth consultations. The medical professional will then decide whether ED medication is appropriate.

Examples of ED pills include:

Research shows that phosphodiesterase type 5 (PDE5) inhibitors can effectively treat ED, together with other medications, such as injections.

These drugs impede the functioning of PDE5, an enzyme within the blood vessel walls that helps control blood flow.

Following arousal, the body releases enzymes that cause blood vessels in the smooth muscles to relax, allowing for more blood flow. PDE5 inhibitors block the degradation of these enzymes, increasing blood flow and resulting in an erection.

It is important to note that a person needs to be aroused for a PDE5 inhibitor to help with ED.

This article focuses on PDE5 inhibitors. It discusses what erectile dysfunction is and what may cause it and looks at the common PDE5 medications for ED in detail.

Below is a comparison table of these oral ED treatments.

Erectile dysfunction occurs when a person cannot develop or maintain an erection firm enough for sexual intercourse.

According to a 2022 overview of the condition, ED is common in individuals over 40 years of age.

ED can differ from one person to another. While some people can get an erection, they may not be able to maintain it, and they may not be able to get one every time they want to have sex. Others may not be able to get an erection at all.

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) writes that ED can be a short- or long-term health concern.

Learn more about ED.

The National Health Service (NHS) in the United Kingdom reports that ED occurs due to factors such as fatigue, stress, anxiety, or alcohol consumption. However, someone who experiences ED regularly should talk with a doctor.

Possible causes of long-term ED may include:

Below is detailed information about the PDE5 inhibitor drugs available.

Please note that the writer of this article has not tried these products. All information presented is purely research-based and correct at the time of publication.

Medical News Today follows a strict product selection and vetting process. Learn more here.

Sildenafil (Viagra) is common in the treatment of ED. It can also treat conditions such as pulmonary hypertension, a type of high blood pressure in the lungs.

The pills come in 25 mg, 50 mg, or 100 mg.

Some advantages of taking sildenafil for ED include:

Some disadvantages include:

There are also some possible side effects of sildenafil, including:

The following companies offer sildenafil:

Tadalafil (Cialis) works by increasing blood flow to the penis. Doctors also use the drug to treat high blood pressure in the lungs and enlargement of the prostate. For ED, people take it as an oral tablet.

Some advantages of tadalafil include the following:

However, disadvantages include the factors below:

There are also possible side effects from tadalafil, including:

Tadalafil is available to purchase from the following companies:

Avanafil (Stendra) is another PDE5 drug. It works similar to other drugs in its class by increasing blood flow to the penis.

Some advantages of avanafil include:

However, a disadvantage of the drug is that it is currently unavailable in generic form, making it more expensive than other PDE5 drugs.

There are also some possible side effects of taking avanafil, including:

The following companies offer avanafil (Stendra).

Similar to other PDE5 medications for ED, vardenafil (Levitra) works by increasing blood flow to the penis.

Some advantages of vardenafil include clinical trials finding it to be effective. In addition, unlike avanafil, vardenafil is available in a more affordable, generic form.

Its disadvantages are that the drug can take comparatively longer to start working, and a person needs to take it 1 hour before sexual activity. In addition, compared with tadalafil and sildenafil, vardenafil has no unique advantages.

Some possible side effects of vardenafil include:

Levitra and its generic version, vardenafil, are only available to purchase once a doctor has prescribed them.

At the time of publication, four 2.5-mg tablets cost between $29 and $178, while thirty 20-mg tablets can cost up to $442.

People can purchase ED medications at a pharmacy, provided they have a valid prescription from a doctor or healthcare professional.

Alternatively, they can purchase them online, usually after completing an online questionnaire reviewed by a doctor or healthcare team.

Individuals should check reviews of the health company before purchasing a product and consult a doctor or pharmacist if they have any concerns.

Research suggests that ED pills are safe and effective when someone takes them under a doctor’s supervision.

Results may vary between individuals, but a 2021 review found that 50 mg and 100 mg sildenafil pills were most effective compared to a placebo. However, there is currently insufficient data to compare the different PDE5 inhibitor pills.

ED pills are typically taken around 1 hour before sex. However, instructions may vary between medications.

Some pills require people to take them with food, and other pills on an empty stomach.

A person should always follow the instructions before taking any prescription medication.

While ED medications are often effective, some individuals may prefer to try other methods of ED treatment, including:

Read about some of the best available ED rings.

Individuals should keep regular contact with their doctor if they experience prolonged ED, as there may be an underlying health condition that needs exploration.

After taking ED pills, a person may experience side effects such as headaches, indigestion, dizziness, or a stuffy nose. These are common and usually subside over time.

However, a person should consult their doctor if these side effects become severe or persistent.

Although rare, ED medications can also cause more serious side effects, including:

If someone experiences any of these side effects, they should discontinue using the drug immediately and seek medical advice.

Symptoms, such as wheezing, tightness in the chest or throat, difficulty breathing, and swelling of the mouth, throat, lips, or tongue, may have links with anaphylaxis, a life threatening allergic reaction.

If a person notices any symptoms of anaphylaxis, they should call 911 or go to the nearest emergency room.

Some people should not take ED medications or should take them with caution. Some examples include:

ED medications may also interact with other drugs, including:

Additionally, individuals taking HIV protease inhibitors, such as ritonavir (Norvir), should not take avanafil. The Food and Drug Administration (FDA) advises that people with liver or kidney problems do not take avanafil.

Those who experience an erection lasting more than 4 hours should also consult their doctor.

A person should be cautious when considering herbal supplements that claim to help with ED. This is because there is very little research to prove their effectiveness, and the FDA has not approved these products.

Specifically, the FDA advises against buying “herbal Viagra” as it contains undeclared ingredients that may negatively interact with some prescription drugs.

Here are some common questions about ED and its medications.

ED can develop due to several mental or emotional issues, including stress, anxiety, depression, and relationship issues.

There are also many physical causes of ED, such as heart disease, diabetes, multiple sclerosis, and high blood pressure or cholesterol levels. Smoking tobacco, consuming high amounts of alcohol, and taking certain medications could also contribute to the condition.

A doctor or healthcare professional can determine whether a person’s ED is due to physical or mental health factors by collecting information about their medical and sexual history. They may also conduct a physical exam.

Healthcare professionals may also recommend an overnight erection test, which involves placing a device around the penis overnight to measure the number of nocturnal erections. If a person can achieve a set number of erections at night, it may indicate that their ED is due to psychological problems rather than physical conditions.

A person may also undergo an intracavernosal test. During this test, doctors inject a small amount of medication into the base of the penis to cause an erection. Imaging techniques, such as an ultrasound, can also help determine whether there are any problems with blood flow.

To get a pill for ED, a person needs a prescription from a doctor or an online telehealth service. Once the prescription is ready, the cost will depend on whether an individual’s insurance plan covers all or some of the costs.

Typically, generic versions of ED pills, such as sildenafil, cost significantly less than the brand-name versions, such as Viagra.

Each of the medications in this article is effective in treating ED. However, according to research, avanafil may be the fastest working medication with the fewest visual side effects.

It is important to note that for any of these medications to work, a person requires sexual stimulation.

The type of ED medication a person should take depends on individual needs. Each medication type may have different side effects, dosage requirements, and times to work properly.

Individuals should consider these factors before trying these medications.

All four of the main ED pills — sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra), and avanafil (Stendra) — are safe for most people to use. These drugs are FDA-approved for use in ED. A person must ensure their medication is doctor-prescribed and comes from a legitimate source.

Health experts recommend against combining ED medications unless a doctor advises otherwise.

If one medication for ED is not working, a person should consult their doctor to determine whether alternative treatment options may work better or if other underlying factors may contribute to ED.

The most commonly prescribed erectile dysfunction medications are sildenafil (Viagra) and tadalafil (Cialis).

Most ED medications require a prescription from a doctor. However, people can buy ED devices such as vacuums and rings online.

Several medications can treat ED, and many drugs — including those in this article — work by blocking the PDE5 enzyme, increasing blood flow to the penis.

The best choice of ED medication will depend on various factors. For example, people who have regular sex may prefer taking tadalafil, which is available as a daily pill. Meanwhile, others may prefer medications they can take just before having sex, such as sildenafil, avanafil, or vardenafil.

However, it is important for a person to consult a doctor before taking ED medication and only use it as directed to help prevent adverse side effects.