Oral Medications for Erectile Dysfunction
May improve outcomes in men resistant to monotherapies Can offer treatment outside of just PDE5 inhibitors May increase the risk of side effects Combination therapies are exactly what they sound like: some combination of commonly prescribed ED medications.
Other uses for this medicine
If you’re one of the many men who already use Hims for hair loss treatment or another service, then it could be convenient to use the same provider for ED treatment as well. Hims offers classic, brand-name Viagra or an authorized generic for men who want it. Hims is also the only company we recommend that sells an authorized generic Viagra. Interestingly, Roman lists their options as “Branded Viagra” and “Generic Viagra.” That second option is actually generic sildenafil — it is not an authorized generic made by Pfizer. Roman lists their sildenafil this way out of the belief that it makes it easier for potential patients to understand that the two drugs are practically identical.
Can you permanently get rid of ED?
Visit our Roman review to learn more. Starts working in as little as 30 minutes Doesn’t cause a particular — but rare — side effect of sildenafil Available in chewable form from BlueChew and Hims While it isn’t the most widely available option from telemedicine providers, vardenafil is an important option for the few men who might not have success taking sildenafil but still want an effective medicine they can take on demand 30-60 minutes before sex. Studies show that vardenafil behaves the same way in the body as sildenafil, with one known exception. A rare side effect of sildenafil is an alteration in color perception due to the drug’s inhibition of PDE6 in addition to PDE5.13 Vardenafil is somewhat more selective in this regard, having no known effect on PDE6 and, therefore, no known effect on color perception. And while vardenafil is less thoroughly researched than sildenafil, there are still numerous studies looking at thousands of users over nearly two decades, so its safety and efficacy are without question.14 For a while, BlueChew was the only provider among our top picks to offer vardenafil, but Hims has included it in its recent development of chewable mint tablets. Studies have shown that certain combinations can be more effective than a monotherapy on its own.23 As with monotherapies, the exact bayer vardenafil combination and dosing will be a matter for your physician to prescribe. Combination therapies have become more popular among the providers in this guide.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Cialis Professional | 40mg | 20 Pills | 110.24€ 104.99€ | |
| Viagra Generic | 100mg | 90 + 6 Pills | 129.02€ 122.88€ | |
| Viagra Oral Jelly | 100mg | 10 Sachets | 46.36€ 44.15€ | |
| Viagra Super Active | 100mg | 90 + 10 Pills | 165.61€ 157.72€ | |
| Priligy Generic Dapoxetine | 60mg | 180 + 10 Pills | 494.76€ 471.20€ | |
| Kamagra Soft Tabs | 100 mg | 32 Pills | 120.11€ 114.39€ | |
| Viagra Oral Jelly | 100mg | 110 + 9 Sachets | 284.63€ 271.08€ | |
| Cialis Generic | 20mg | 30 + 4 Pills | 68.05€ 64.81€ | |
| Levitra Original | 20mg | 12 Pills | 81.99€ 78.09€ | |
| Tadalista Super Active | 20mg | 120 + 16 Pills | 382.15€ 363.95€ | |
| Cialis Generic | 20mg | 90 + 6 Pills | 154.71€ 147.34€ | |
| Kamagra | 100mg | 180 + 6 Pills | 436.79€ 415.99€ | |
| Viagra Generic | 100mg | 60 + 4 Pills | 96.36€ 91.77€ | |
| Kamagra Soft Tabs | 100 mg | 12 Pills | 57.55€ 54.81€ | |
| Cialis Generic | 2.5mg | 90 + 6 Pills | 112.43€ 107.08€ | |
| Cialis Soft Tabs | 20mg | 10 Pills | 39.03€ 37.17€ | |
| Cialis Original | 20mg | 4 Pills | 41.99€ 39.99€ |
Rugiet was the first to offer multiple drugs in a single product with its lozenges, but Hims and Roman soon followed suit. And BlueChew’s recently developed Max and Gold products combine several ED therapies into a single chewable tablet. Let’s start with Rugiet since it kicked off the combination craze with its product, Rugiet Ready.
When oral medications might not be safe
Despite not typically being a daily medication, Hims offers a 30-day supply of vardenafil that bears the same low price as its daily tadalafil. As a result, you can get 8.5mg vardenafil chews from Hims for significantly less than you can from BlueChew. Hims’ low price on vardenafil reflects their pricing for a 150-day supply. If you don’t want to stockpile vardenafil like that, the next-lowest price per dose you can get from Hims on smaller quantities of vardenafil is $6, which is more expensive than even the highest price per dose from BlueChew. BlueChew's free trial still makes it the best starting place for men new to ED treatments.
Key differences between ED medications
After that, you can use the low price of Hims’ 30, 90-, and 150-day supplies to stock up on vardenafil chews at a lower cost (as long as you plan to finish your supply before it expires). But men seeking smaller quantities for as-needed use should stick with BlueChew. Per-dose cost via Hims is cheaper than fildena pill Viagra Can take it with or without meals Not as affordable as sildenafil or tadalafil Many men prefer to take an ED medication only when they need it rather than at the start of a day when they may or may not have sex. Understandably, these men also want that drug to take effect as quickly as possible and with the lowest chance of side effects. Avanafil (brand-name Stendra) is a newer medication in the landscape of ED treatments. The specific combinations available to you from Rugiet depend on the results of your doctor’s consultation, but here’s a look at their standard mixes: As you can imagine, combining these three medications theoretically increases the chances that they will work for you quickly and remain active in your system for up to 24-36 hours (as long as tadalafil is one of them). However, side effect risks may also increase as you combine medications.
How do oral ED drugs work?
This experience with tadalafil varies — some men find tadalafil to be effective for a full 36 hours (which would make the prior morning’s dose still effective), while others find its effects wear off in closer to 18 hours. If you are in the latter camp, Stendra will be better for your morning rituals because you can take a dose as you wake up and then be ready for fun in as little as 15 minutes. However, Stendra will cost you significantly more than sildenafil or tadalafil. Hims — our top choice for convenient access to Stendra — offers a monthly subscription for four 100mg Stendra tablets at $210 per month, billed quarterly. If you can afford the cost, this may be the best choice super tadapox 100mg for you.
Vitamins and supplements for ED
If not, then we’d suggest you explore daily tadalafil. There are three standard dosage options for Stendra: Both the 100mg and 200mg dosages take effect in about 15 minutes. Sublingual dose requires no water to take FDA-approved for use in Parkinson’s patients May cause fainting in a small fraction of users Nausea is a common initial side effect Hard to find outside Rugiet’s blended ED treatment Apomorphine has been used since the 19th century as everything from a sedative to an aid in kicking heroin addiction, and it’s currently FDA-approved for treating Parkinson’s disease. However, multiple studies indicate its potential as a treatment for ED.16 The name can be a source of confusion since most people outside the medical professions would likely hear the “morphine” part and assume opioid properties. But apomorphine doesn’t bind to opioid receptors and is nonaddicting. The obvious downside to Rugiet is its cost.
How are oral ED drugs similar?
For Parkinson’s patients, apomorphine is delivered via subcutaneous injection at doses often higher than those used in ED treatment. Studies into its use for Parkinson’s revealed intense nausea as a potential side effect — often to the point that doctors would have to prescribe an antiemetic to deal with nausea and vomiting. ED patients taking apomorphine as a sublingual film — or, in the case of Rugiet, a lozenge — may also experience some nausea, but this appears to decline with regular use.17 Apomorphine appeared on target to become a viable alternative to Viagra in 2000, but the manufacturers behind its two branded forms intended for ED patients pulled it from FDA consideration despite what appeared to be a sure path to approval. They cited the need for further study, particularly into the drug's interaction with nitrates and its potential to cause fainting in less than 0.2% of trial participants. Today, apomorphine remains FDA-approved for Parkinson’s disease but is only prescribed for ED treatment as an off-label use.
The best place to get medications for ED
The only major providers we recommend that offer apomorphine in any form are Rugiet and BlueChew, but they typically combine apomorphine with tadalafil and sildenafil in a lozenge. That lozenge’s sublingual administration may decrease the time it takes to start working. It’s possible to get apomorphine-only lozenges from Rugiet, but they only come in the 3mg dose at a cost of $30 for six doses. If you’re looking for ED medications that aren’t technically PDE5 inhibitors (which sildenafil, tadalafil, and vardenafil all are), this may be a viable route. We’ll discuss these combination offering in our next section, which is all about combination therapies. You can opt for larger shipments to reduce your cost per dose, and that can save you over 30%, but it results in significant up-front costs.
Quiz: Is it erectile dysfunction?
While other ED medications like sildenafil affect enzymes like PDE1 and PDE6 alongside PDE5, Stendra is more micro-targeted to inhibit the specific PDE5 enzyme related to a man’s ability to get and keep an erection. This increases Stendra’s efficacy while reducing its side effect profile. Here are some other benefits of Stendra:47 48 According to an early clinical trial of more than 500 men, close to 3 in 10 using the maximum dosage of Viagra report headaches. By contrast, just over 1 in 10 men using the 200mg Stendra (highest dosage) report headaches. Only about 13% of men using 200mg Stendra experience flushing of the face, compared to 20% of men using the maximum dosage of sildenafil.
Does hair loss treatment cause erectile dysfunction?
Heartburn, muscle and back pain, congestion, and vision changes are all less likely with Stendra. Stendra also acts quicker in the body than others — some studies showed efficacy in as little as 15 minutes.15 This speed makes Stendra a great treatment choice for men who don’t always know when they’ll want to have sex and are happy to take something shortly beforehand. If this describes you, then we recommend Hims Stendra. Stendra is also our top choice for couples who enjoy morning sex. Tadalafil taken in the morning can sometimes require about an hour before it is fully effective. For example, a monthly six-pack of medium strength Ready is $99.
| Recommendation | Purpose | Details |
|---|---|---|
| Wait 24 hours before next dose | Prevent overdose | Follow prescribing guidelines |
| Monitor for side effects | Ensure safety | Contact doctor if severe |
| Maintain healthy lifestyle | Support long-term efficacy | Diet, exercise, stress management |
| Store tablets properly | Preserve potency | Keep in cool, dry place |
To get the best cost per dose, you can get 12 of those six-packs shipped to you quarterly for $799. That’s a lot of savings, but it’s likely cost-prohibitive for many men.
- Erectile dysfunction can be caused by chronic health issues like diabetes.
- Psychological counseling can help if ED has mental origins.
- Lifestyle changes like quitting smoking improve tablet results.
- Some tablets might have food interactions, especially high-fat meals.
- Effectiveness can vary based on age and overall health.
- Regular exercise boosts cardiovascular health and erectile function.
- A balanced diet rich in fruits and vegetables supports blood flow.
- Report any adverse reactions to your healthcare provider.
To learn more about Rugiet’s offering, check out our comprehensive review of their services.
| Brand Name | Active Ingredient | Onset of Action | Duration of Effect | Typical Price ($) |
|---|---|---|---|---|
| Viagra | Sildenafil | 30-60 minutes | 4-6 hours | 20-30 |
| Cialis | Tadalafil | 30 minutes | Up to 36 hours | 40-60 |
| Levitra | Vardenafil | 25-60 minutes | 4-5 hours | 25-45 |
| Staxyn | Vardenafil ODT | 15-20 minutes | 4-5 hours | 30-50 |
Rugiet has also expanded its catalog to include a daily tadalafil combined with DHEA to boost testosterone, but we don’t regard DHEA as a very good option for improving testosterone levels with an OTC treatment.
- Natural alternatives include herbal supplements like ginseng and L-arginine.
- Psychological factors like stress can affect tablet effectiveness.
- Proper diet and exercise can improve erectile response over time.
- Avoid excessive alcohol consumption when taking these tablets.
- These medications do not increase sexual desire, only performance.
- Some tablets are available over-the-counter in certain regions.
- Always follow dosage instructions to minimize risks.
- Use caution if you have cardiovascular conditions.
You can also get a combination of tadalafil with either minoxidil or paroxetine to treat hair loss or premature ejaculation concurrently with ED, but both treatments have less tadalafil in them than comparables from Hims.
- Tadalafil can be used for both erectile dysfunction and BPH.
- Sildenafil is the most studied and widely used ED medication.
- Some tablets are formulated for rapid onset within 15 minutes.
- The market offers various formulations: tablets, softgels, and dissolvables.
- Adjusting dosage may be necessary for optimal effectiveness.
- Men with hormonal imbalances might need additional therapy.
- Tablets should not be taken more than once within 24 hours.
- Be aware of potential interactions with antibiotics and antifungals.