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What are Erectile Dysfunction Medications?
About the Reviewer
How Should I Store Them?
Takeaway Tips from the Podcast
Erectile Dysfunction Medication and Treatment

Drugs for ED: Susceptible to abuse and counterfeiting

Why would Viagra be so much more expensive than sildenafil (the active ingredient in Viagra)?

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

Why does anyone opt for the more expensive Viagra if both have the same ingredient?

What are Erectile Dysfunction Medications?

If you’re confused by all of it, make sure to ask your doctor which one would be right for you. Less planning needed with its extended duration of action Can be taken daily or as needed Can be taken with or without food Tends to be preferred by men and their partners, compared to sildenafil Costs a little more than sildenafil in some as-needed cases Risk of mild side effects is slightly higher than Stendra Often known by the common brand name Cialis, tadalafil is a PDE5 inhibitor that you can take once per day to provide 18-36 hours of effectiveness. This significantly reduces the planning typically involved in using other treatments like sildenafil. That said, some users only take tadalafil as needed, and those dosages can sometimes be different. You and your doctor will decide what dosage and schedule are right for you.

Phenylephrine HCL

Side effects with tadalafil are about as common as with sildenafil and are similarly mild. Dose for dose, as-needed tadalafil is often a little bit more expensive than sildenafil. However, tadalafil may be the better value, mainly because: In studies, men and their partners prefer tadalafil to sildenafil. Tadalafil has superior psychological outcomes to sildenafil, providing more sexual confidence.3 The larger window for sexual activity (18-36 hours, compared to 4-6 hours with sildenafil) for many people justifies the slightly higher expense. Daily tadalafil offers the lowest cost per dose among PDE5 inhibitors.

How much do ED medications cost? Are they covered by insurance?

Branded Cialis and generic tadalafil are available in the same dose increments across most platforms, with 2.5mg, 5mg, 10mg, and 20mg being the most common. Daily doses typically start at 2.5mg, while as-needed doses typically start at 5mg. These are the doses you’ll see from Hims for its tadalafil tablets. Chewable tablets and lozenges often have different doses. 8.5mg and 11.2mg doses from Hims We’ll get a little more into complex offerings in the “Combination therapies” section later. Some men familiar with Viagra, having used it before successfully, want to stick with what works. They trust it, and the brain is the largest and most important sex organ after all; psychology can be a potent tool in combating ED. But a complete understanding of your options requires a little knowledge about the differences between Viagra, generic Viagra, and generic sildenafil.

Product	Dosage	Quantity + Bonus	Price
Levitra Professional	20mg	360 + 6 Pills	914.63€ 871.08€
Levitra Soft Tabs	20mg	90 + 6 Pills	241.31€ 229.82€
Cialis Original	20mg	12 Pills	78.32€ 74.59€
Kamagra 100 mg	100 mg	180 + 6 Pills	436.79€ 415.99€
Viagra Generic	100mg	180 + 8 Pills	199.37€ 189.88€
Kamagra Polo	100mg	20 Pills	83.56€ 79.58€
Kamagra Polo	100 mg	120 + 6 Pills	327.15€ 311.57€
Kamagra Polo	100mg	60 + 4 Pills	189.39€ 180.37€
Cialis Generic	40mg	30 + 4 Pills	74.97€ 71.40€
Cialis Original	20mg	22 + 2 Pills	129.20€ 123.05€
Kamagra	100mg	60 + 4 Pills	201.34€ 191.75€
Levitra Soft Tabs	20mg	10 Pills	52.27€ 49.78€

This is the original “little blue pill,” and it’s the most expensive option.

Oral ED medications increase blood flow to the penis.
Viagra was the first FDA-approved ED drug in 1998.
Tadalafil lasts up to 36 hours, longer than other ED meds.
Vardenafil is effective for up to 4-5 hours.
Avanafil has rapid onset, within 15 minutes.
PDE5 inhibitors are the most common ED treatments.
These medications require sexual stimulation to work.
Some ED drugs have contraindications with nitrates.
Side effects may include headaches, flushing, or nasal congestion.
Age and health condition affect medication choice.

Made by Pfizer, Viagra is available in 25mg, 50mg, and 100mg tablets from most providers.

About the Reviewer

The window of effectiveness requires a bit of planning Loses efficacy when you take it with meals Mild side effects, such headaches, are more common than with other treatments like Stendra Most people can’t predict with complete certainty whether or not they’ll have sex on any given day. Even if you’re accustomed to daily intercourse, your partner could get sick, you could strike out at the club, or your in-laws could pay you a surprise visit. For that reason, some men prefer not to take a daily tablet of Cialis or tadalafil when the prospect of sex is not guaranteed. This is even truer for men who’ve experienced some mild side effects from frequent or daily tadalafil use. On the flip side, sildenafil and Viagra (as well as a specific regimen of Cialis and tadalafil) offer you the choice to take them as needed. We consider Roman the best choice for branded Viagra thanks to their low per-dose pricing compared to Hims ($90 vs.

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

$138).

Patent Expirations: Led to the availability of cheaper generic versions.
Viagra (1998): First oral PDE5 inhibitor approved by the FDA.
Cialis (2003): Introduced the concept of a long-acting 36-hour medication.
Levitra (2003): Marketed as having a potentially faster onset than Viagra.
Stendra (2012): Approved as a faster-acting PDE5 inhibitor.
Alprostadil (1990s): First injectable and intraurethral treatments.
Ongoing Research: Continues for new formulations and delivery methods.

This is a generic form of Viagra either made by Pfizer or by an authorized company with which Pfizer has shared their exact formula. It’s identical to branded Viagra in every way except that it won’t say “Viagra” on the prescription label.

Vascular Health: ED can be an early warning sign of heart disease.
Diabetes: A leading cause of ED due to nerve and blood vessel damage.
Neurological Disorders: MS, Parkinson's, and spinal injuries can cause ED.
Metabolic Syndrome: A cluster of conditions that increases ED risk.
Prostate Cancer Treatment: Surgery and radiation often cause temporary or permanent ED.
Depression: Both a cause and a consequence of erectile dysfunction.
Medications: Antidepressants, antihypertensives can cause ED as a side effect.

This is one of the least expensive options, though it’s often pricier than generic sildenafil. This is a formula therapeutically identical to branded Viagra but with discrepancies in inactive ingredients, color, shape, and delivery mechanism. Doses are theoretically supposed to be the same, but there are caveats.

How Should I Store Them?

Ultimately, you’ll decide with the prescribing doctor which dose and schedule are best for your lifestyle. Here’s a quick visual reference to let you know what kinds of branded and generic tadalafil our top choices carry: The tadalafil landscape has gotten a little more complicated in recent years. While BlueChew was steadily our top choice for tadalafil for years, Hims has caught up and surpassed it slightly, beating BlueChew to a chewable daily tadalafil offering that could undercut BlueChew’s tadalafil pricing if you only needed a low dose. That said, Hims’ low prices on tadalafil only apply to daily versions of those lower 2.5mg and 5mg doses. Both BlueChew and Hims lag behind Rocket Rx’s pricing for as-needed tadalafil at 10mg and 20mg doses, however.

Learn More about Medications for Erectile Dysfunction

So, the provider that’s best for you will have a lot to do with the dose you need and whether you want to take tadalafil daily or as needed. Here’s how those prices compare, with lower prices often coming from extended billing cycles (quarterly, biannually, etc.): If you’re new to ED meds and want to try as-needed tadalafil at a dosage no stronger than 5mg, then tadalafil from Hims could conceivably be your most economical option. That’s because you could request daily tadalafil tablets on a yearly billing cycle, which brings the cost per dose to nearly $1.00. You could then temporarily cancel your Hims subscription until you make your way through that stock of 360 doses and reinstate it whenever you need more. Canceling and restarting through Hims carries no financial penalty.

Medication May Not Be the Solution

That said, BlueChew offers a free month of as-needed tadalafil as a way to test their service; all you pay is a small shipping fee. That means you can see if these medications work for your ED tadapox tablets for a $5 shipping charge. So, if you want to maximize your savings and you don’t mind the hassle of dealing with two or three companies, your path may look something like this: Try BlueChew’s 6mg tadalafil chews (as needed) to see if the medication is effective for you. If it is, consider switching to Hims (either chews or pills) to get the best price per dose on your medication. If you find you need a stronger dose, you can head to Rocket Rx, which has the best prices for 10mg and 20mg doses. This is often the least expensive option.

Takeaway Tips from the Podcast

So, if you want to spend all day in bed playing video games, you don’t have to worry about missing a daily pill. And if you know that sex is on the horizon, you can take these meds accordingly. You’ll need to take sildenafil/Viagra 30-60 minutes before sex. Some men report that chewables and lozenges kick in faster than pills, but this is not guaranteed. Viagra’s active ingredient is sildenafil, but you might not know it from looking around at your ED options. Sildenafil is also the active ingredient in Revatio, a drug designed to treat pulmonary arterial hypertension. The drugs are identical in almost every way — they’re even both made by Pfizer — but Revatio is made only in 20mg tablets.

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

Many providers that stock generic sildenafil for ED prefer these 20mg tablets because they allow for more dose flexibility from a single stockpile of pills.

Headache: Most common side effect due to vasodilation in the head.
Flushing: Redness and warmth in the face and upper chest.
Dyspepsia: Indigestion or upset stomach, common with Sildenafil.
Nasal Congestion: Stuffy or runny nose from dilated blood vessels.
Back Pain/Muscle Aches: More common with Tadalafil (Cialis).
Dizziness: Can occur due to blood pressure changes.
Visual Disturbances: Blurred vision or cyanopsia (seeing blue tint).

A doctor can prescribe 20mg, 40mg, 60mg, or 100mg, and the patient simply takes the corresponding number of 20mg pills.

Erectile Dysfunction Medication and Treatment

If you get dizzy from taking any of these medications, you should share this observation with a healthcare provider; it could indicate a potentially unsafe drop in blood pressure. One rare but noteworthy side effect of some PDE5 inhibitors is a change in visual color processing. This occurs when a PDE5 inhibitor collaterally inhibits PDE6. If you’re one of the relatively few men to experience this phenomenon, you should ask your doctor about vardenafil, which does not seem to cause this side effect. In response to reader requests, we created a comprehensive guide to the side effects of BlueChew, which is a useful resource if you're interested in learning much more about the likelihood of experiencing side effects while taking PDE5 inhibitors.

Highlights of Cialis:

When we break down your top choices for ED medication, we find it useful to refer only to the names of the active ingredients (i.e., sildenafil, tadalafil, etc.) as opposed to their brand names. Unless you’re going through your insurance company, there’s almost never a good reason to buy branded ED medication — generic options are therapeutically identical. We always recommend that people start with generics for ED, so let’s look at which medications are available in generic form: During the course of your research or in conversation with your consulting physician, you might come across the term “authorized generic,” which is distinct from simply “generic.” Here’s how they differ: Generics — with no additional word to modify the meaning — are produced by companies other than the original manufacturer. They bear only the name of the active ingredient (i.e., sildenafil), and telemedicine companies typically advertise them as such. Effects on the body are identical to the original; the only differences may be in the appearance of the pills and the inactive ingredients used.

ED Prescriptions for $1-2 Per Pill

Authorized generics are either made by the original manufacturer or by a company they’ve permitted to do the manufacturing. These pills are completely identical to the original branded option, right down to the inactive ingredients and appearance, but they usually don’t include the original brand name on the label. To make matters more confusing, telemedicine providers will sometimes use original brand names when selling generics that are not “authorized generics” because it makes it easier for their customers to understand what they’re choosing. Others sell branded pills, authorized generics, and regular generics without doing enough work to explain the differences to their customers. This gets the most confusing with sildenafil and Viagra, and we’ll break that down a little later.