Factors to Consider When Selecting an ED Pill

Generic versions of sildenafil, vardenafil and tadalafil are available. Check with your health care team before you take any medicine for erectile dysfunction.

• Cialis for Daily Use: 2.5mg or 5mg taken daily, maintains steady medication levels in the bloodstream.
• Levitra 20mg: Higher strength for patients needing a more potent vardenafil effect.
• Kamagra (Unofficial Sildenafil): Not FDA-approved, often sold online, carries significant safety risks.
• Heart Health Assessment: Essential first step, ED can be an early sign of cardiovascular disease.
• Drug Interaction Review: Crucial before starting any ED pill, especially with nitrates or alpha-blockers.

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. 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 ed gels 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.

Be wary of 'herbal viagra'

This boosts blood flow and helps you get an erection from sexual activity. Each oral medicine for ED has a slightly different chemical makeup. These small differences affect the way each medication works, such as how quickly it takes effect and wears off, and the possible side effects. Your doctor or other health care professional can recommend one for you based on these factors, other health conditions you have and any other medicines you take. This medicine works best when you take it on an empty stomach an hour before sex.

ED medications

The body takes longer to absorb it after a high-fat meal or alcohol. Its effects often last for 4 to 5 hours. It might work longer if you have mild to moderate erectile dysfunction. This medicine also works best when you take it an hour before sex on an empty stomach. As with sildenafil, a high-fat meal or alcohol keep the body from absorbing it as quickly.

Which Medication Will Work Best for My ED?

Vardenafil usually works for 4 to 5 hours. Its effects might last longer if you have mild to moderate ED. A newer form of the medicine that dissolves on the tongue might work faster than the pill that you swallow. This medication is taken with or without food an hour before sex. It works for up to 36 hours. 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. 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. 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.

Cialis (Tadalafil)

You can take it in a small dose daily or in a larger dose as needed. You can take this medicine with or without food 30 minutes before sex, depending on the dose. It lasts 4 to 5 hours, or longer if you have mild to moderate ED. These medicines all work well for ED. When choosing one, tell your doctor or other health care professional what your preferences are, such as cost, ease of use, how long the drug's effects last and side effects. 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. 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 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. Our caring team of Mayo Clinic experts can help you with your health concerns.

2. Dehydroepiandrosterone (DHEA)

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.

Reduce stress

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. 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. (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.

Who Should Not Take Viagra™

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. 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. Visit Mayo Clinic Men's Health to get started. The best treatment for erectile dysfunction (ED) is the one that is best for you. Sildenafil (Viagra) and tadalafil (Cialis) are the most commonly-prescribed medications for ED, and they have the longest track record. For occasional use, most people start with sildenafil. Some people prefer to alternate between medications. All ED meds are equally safe and effective. In most cases, your unique relationship needs, lifestyle, and insurance coverage will help you decide between them. There are ways to save on ED medications. Many are available as lower-cost generics or have other copay savings opportunities. GoodRx can help make your prescription more affordable. GoodRx for ED can also deliver generic Viagra or generic Cialis directly to your door. You’ve likely heard of Viagra, Cialis, vardenafil (previously sold as Staxyn and Levitra), and Stendra. These are commonly-prescribed treatments for erectile dysfunction (ED) — when a person has regular difficulties getting or maintaining an erection for satisfying sexual intercourse. With all of these choices, is there one best ED medication?

• Always consult a healthcare professional before starting ED medication.
• Check for interactions with other medications or health conditions.
• Be aware of possible side effects: headaches, flushing, nasal congestion.
• ED pills do not increase sexual desire, only help with erection during arousal.
• Use as prescribed; overdose can cause serious health issues.
• Some ED medications are not suitable for heart patients.
• Alcohol can interact negatively with ED pills, reducing effectiveness.
• Maintain a healthy lifestyle for better results: exercise, diet, adequate sleep.
• Remember that psychological factors also influence erectile function.
• ED medications may lose effectiveness over time; consult doctor if needed.
• Cost varies; generic options are often more affordable than brand-name drugs.
• Ensure purchase from reputable sources to avoid counterfeit medications.

Below, we’ll discuss some key differences between ED medications to help you navigate your treatment options. There’s no single best ED medication.

What Medications Can Treat ED?

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.

Compare ED treatments

Does it happen all the time or just in certain situations? Is it with only one partner or different ones? 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.

Getting Treatments for Erectile Dysfunction

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. Medicines that you take by mouth are called oral medicines. They're often the first line of treatment for trouble getting or keeping an erection, called erectile dysfunction (ED). Oral medicines for ED usually work well and cause few side effects. The four main medicines taken by mouth for erectile dysfunction are: They enhance the effects of a chemical the body makes that relaxes muscles in the penis, called nitric oxide. But there are some differences between them that may make one treatment a better fit for you than another. Sildenafil (Viagra), tadalafil (Cialis), vardenafil (formerly sold under the brand names Levitra and Staxyn), and avanafil (Stendra) belong to a class of drugs known as phosphodiesterase 5 (PDE5) inhibitors. PDE5 inhibitors increase the amount of blood that fills the penis, helping an erection last long enough for satisfying sex. They don’t affect arousal or libido. All of these medications have been proven to be safe and effective for ED treatment. And some people even prefer to alternate between PDE5 inhibitors, depending on their lifestyle and relationship status.