Medically reviewed by: Thomas Fischer (Pharmacist). This article has been written according to strict guidelines and medical standards. More InfoThis content is based on the current state of medical knowledge. All information has been carefully researched and sources are listed at the end of the article. Our articles meet a high quality standard. Our goal is to present medical topics in a comprehensible language.
Medically reviewed by: Thomas Fischer (Pharmacist) More InfoThis content is based on the current state of medical knowledge. All information has been carefully researched and sources are listed at the end of the article. Our articles meet a high quality standard. Our goal is to present medical topics in a comprehensible language.
If you’re struggling with erectile dysfunction (ED), you may be asking yourself what the best solution is. There are several different medications available to treat impotence. You can find a wealth of information about them on this page.
What is the Best Erectile Dysfunction Medicine?
This question is difficult to answer since what works for one person may not work for another. Finding the right medication and dosage for you may be a process of trial and error that your doctor can walk you through.
There are several medications used to treat impotence in the United States. They are:
- Viagra (sildenafil tablet)
- Cialis (tadalafil tablet)
- Stendra (avanafil tablet)
- Levitra (vardenafil tablet)
- Staxyn (vardenafil disintegrating tablet)
- Caverject, Edex (injectable alprostadil)
- Muse (alprostadil suppository)
More information about each of these medicines can be found in the next section.
Overview of Erectile Dysfunction Medicines
Viagra
Viagra is a prescription drug used for the treatment of erectile dysfunction. The active ingredient in Viagra is sildenafil. It is approved for males ages 18 and up. It is sold in the US as generic sildenafil as well as by the brand name Viagra.
Viagra pills are taken orally. They should be taken 30 minutes to an hour before sexual activity. Viagra is available in dosages of 25, 50, and 100 mg.
Like all medications, Viagra can cause side effects. Talk with your doctor about possible side effects before starting treatment and during your treatment with Viagra.
Stendra
Stendra is a drug whose active ingredient is avanafil. Like other impotence drugs, it works along with sexual stimulation to increase blood flow to the penis to cause an erection. It does not have a generic form currently legalized in the US.
Stendra is administered orally and can be taken with or without food. It is usually prescribed for use as needed. It cannot be consumed more than once a day.
Stendra acts a little faster than the other oral erectile dysfunction medicines. It can be taken 15 to 30 minutes before having sex.
Stendra is available in doses of 50, 100, and 200 mg. Your doctor will work with you to determine the correct dosage for you.
Levitra
Levitra is available in the US by its brand name and also as generic vardenafil. Like the previously mentioned medications, it works by increasing blood flow to the penis, allowing an erection to occur. It is effective only in the presence of sexual stimulation.
Vardenafil is administered orally. It can be taken with or without food, according to your doctor’s instructions. It is designed to be consumed about one hour before sexual activity and not more than once every 24 hours.
Available dosages of Levitra are 2.5, 5, 10, and 20 mg. Your doctor will advise which dosage is most suitable for you.
Staxyn
Staxyn is a form of vardenafil that is different because the tablets disintegrate in your mouth. It is only available in the 10 mg dosage. It is provided as a generic, as well.
To take this medication, put the pill on your tongue and let it dissolve in your mouth. Do not crush or split the tablet, and do not take it with liquid.
The body absorbs vardenafil disintegrating tablets differently than film-coated tablets that are meant for swallowing. Be sure to talk with your doctor if you want to switch between the two forms of vardenafil.
Caverject and Edex
Caverject and Edex are injectable forms of the medication alprostadil. This medication is injected into the side of the penis. Caverject and Edex come as a powder that has to be mixed with liquid before injecting. Caverject must be combined with a bacteriostatic water solution, while Edex is mixed with a sodium chloride base.
The appropriate solution comes with the medication and may already be in the syringe or contained in a vial. Before using, check the liquid for particles or discoloration. If you see either in the solution, do not use it.
To apply the injection, first clean the injection site with rubbing alcohol. Vary that place each time to avoid damaging the skin in one specific area. It is advisable to alternate sides of the penis from one dose to the next. After injecting the medication, apply pressure to the site with an alcohol swab for about five minutes to stop the bleeding and avoid bruising. The drug usually starts working within five to twenty minutes.
Available dosages of these injectables are:
- Caverject - 20 and 40 mcg
- Caverject Impulse - 10 and 20 mcg
- Edex - 10, 20, and 40 mcg
Muse
Muse is alprostadil in a suppository that is inserted into the opening of the urethra. The pellet is about the size of a grain of rice. The medication typically begins to work between five and ten minutes after insertion. The pellets come in dosages of 125, 250, 500, and 1000 mcg. The manufacturer recommends using not more than two pellets per day.
What is the Safest Erectile Dysfunction Medicine?
Since all medications have side effects that can vary from one person to another, it is difficult to say which drug is the safest (s. also Erectile Dysfunction Treatments – The Best ED Cure in Check). Sildenafil (Viagra) has been around the longest and therefore has the longest safety record. Other comparisons are difficult to make because results vary from one person to the next.
Some men have been fortunate to have no side effects with this medication, while others have had to stop taking it almost immediately. Where it becomes unsafe is if it’s purchased online from an unauthorized source. More about that later.
How Do Erectile Dysfunction Medicines Work?
Viagra, Cialis, Stendra, Levitra, and Staxyn are all PDE5 inhibitors. Phosphodiesterase type 5 (PDE5) is an enzyme in the blood that prevents the protein cyclic guanosine monophosphate (cGMP) from doing its job. That is to increase the effect of nitric oxide in the body, relaxing muscles in the penis. This increases the blood flow to the penis and allows a man to achieve an erection when sexually stimulated.
Alprostadil belongs to a class of drugs called vasodilators. It works by relaxing muscles and blood vessels in the penis. This, in turn, does a similar job of allowing enough blood to flow to the penis to assist in generating an erection.
How Effective are Erectile Dysfunction Medicines?
Medications work for the treatment of impotence in about 70% of men that try them. One survey of Viagra users showed 81% had satisfactory results using it. However, results can vary significantly from one person to another. Sometimes ED medications do not work because a patient has nerve or artery damage. This damage can be caused by diabetes, cardiovascular disease, or prostate surgery.
There are mechanical treatments like pumps available for use by men who do not obtain favorable results using impotence medicines. Lifestyle changes, such as diet, exercise, or counseling, can also make a difference when medications do not work.
What is the Best Erectile Dysfunction Medicine with the Fewest Side Effects?
Several research studies have looked at the prevalence of side effects in men using erectile dysfunction medicines. One study showed that a 50 mg dose of Stendra resulted in the lowest rate of side effects of any oral medication – 8.5%.
The highest rate of side effects found was with a 50 mg dose of Stendra, which produced side effects 25% of the time. Higher doses of Cialis and Viagra led to side effects 21-22% of the time.
Contraindications to Erectile Dysfunction Medicines
Oral medication (PDE5 inhibitors) for erectile dysfunction might not work or might be dangerous for you if you:
- Have kidney disease that requires dialysis
- Have severe liver disease
- Have uncontrolled high blood pressure or very low blood pressure
- Take drugs that contain nitrates (like isosorbide mononitrate, isosorbide dinitrate, and nitroglycerin)
The use of alprostadil is not indicated for use by people with:
- Leukemia
- Multiple myeloma
- Peyronie disease
- Polycythemia vera
- Sickle cell disease or trait
- Thrombocythemia
Contraindications to the use of alprostadil intraurethral suppositories are:
- Urethral strictures
- Urethritis
What is the Best Over The Counter Erectile Dysfunction Medicine?
There is a lot of controversy surrounding over the counter (OTC) medications. The Food and Drug Administration (FDA) has warned about the hidden risks of medicines that are sold online to treat erectile dysfunction.
OTC products for the treatment of impotence are not submitted to the rigorous standards of the FDA. As such, they may contain ingredients that are not listed on the label, or ingredients may be of inferior quality. These may be dangerous to those who take the product.
That being said, several supplements have been reported to make a difference in cases of erectile dysfunction. They are listed below, with a few details about each.
Dehydroepiandrosterone (DHEA)
DHEA is a steroid hormone found in yams and some soy products. One study has found that low levels of DHEA correlated with a higher risk of erectile dysfunction. Thus, increasing DHEA levels may improve erectile function.
Korean red ginseng
Ginseng has long been used as a sexual enhancer in Chinese traditional medicine. A 2012 study found that men with mild to moderate erectile dysfunction reported improvement in their symptoms after taking Korean ginseng for four to eight weeks.
L-arginine
L-arginine is an amino acid that may improve impotence symptoms by improving blood flow to the penis. Possible side effects are nausea and mild cramping.
Propionyl-L-carnitine
Propionyl-L-carnitine occurs naturally in the body and has been used to treat issues of the circulatory system, including blood flow. This makes it ideal for treating erectile dysfunction, which stems from insufficient blood flow to the penis. Studies have shown this compound enhances the effects of Viagra (sildenafil).
Yohimbe
Yohimbe (also known as yohimbine) is another supplement purported to treat erectile dysfunction by stimulating blood flow to the penis. It increases the production of norepinephrine, which is necessary for erections to occur. This supplement has been linked to side effects like high blood pressure and increased heart rate.
Can I Buy Erectile Dysfunction Medications Online?
Buying online can be dangerous if you cannot verify the legitimacy of the pharmacy. Overseas pharmacies present unique risks because they are not subject to FDA regulations regarding the manufacture and labeling of the pharmaceuticals sold.
However, there are ways to get erectile dysfunction medicines online safely. Look for the following when you want to purchase medications online:
- A licensed pharmacy with a US address. (Check credential with the National Association of Boards of Pharmacy or your state board of pharmacy.)
- A licensed pharmacist who is available to answer your questions
- A pharmacy that asks for a prescription from your doctor
- Clearly stated privacy policy that protects your credit card number and other personal information
- Containers that are clearly labeled with the name of the drug and the dose
- Drugs that are approved by the FDA
- Phone number to call if you have questions or problems
One way to be sure you find a pharmacy is by using an online doctor service. Such telehealth clinics provide online doctor appointments and prescriptions from board-certified physicians. They also partner with online pharmacies that are licensed in the US and can send your medication by mail.
Risks and Dangers of Buying Erectile Dysfunction Medicine Online
If you search “buy erectile dysfunction drugs online,” you’ll find over 25 million web sites in the results list. How can you know if these medications and supplements are safe to buy? Medications and herbal remedies sold online are not always what they seem to be. One FDA investigation found that more than a third of products marketed as “dietary supplements” for impotence contained prescription drugs.
Some contained the medication sildenafil, the active ingredient in Viagra. Others included the fertility drug clomiphene or the antibiotic metronidazole, substances that have nothing to do with ED. Even when the drug contained the correct active ingredient, it was not always the right dose. Tests of Viagra tablets purchased online showed only 10% were close to having the advertised strength.
Buying from an unknown company online puts you at risk of acquiring counterfeit medications. Some estimate that over half of ED medicines sold online are fakes. Samples have been found to include ingredients as absurd as paint, printer ink, gypsum, and talcum powder.
The FDA has found several products to contain harmful compounds. Others contain ingredients that are not listed on the label. This makes it very risky to purchase online at just any pharmacy that advertises erectile dysfunction medicines.
Be very vigilant before purchasing these drugs online. Legitimate telehealth services are the solution; here are some things to look out for.
Buying Erectile Dysfunction Medicine with an Online Prescription - How it Works
Online pharmacies that are licensed to operate in the United States often partner with telehealth services that also offer doctor appointments and prescriptions online. They could be your one-stop solution to getting ED medicine via the internet.
Telehealth services are a convenient way to get prescription medication, legally, and without the hassle of physically going to an appointment at a GP’s clinic. Here’s how it works.
While the process may vary slightly from one online doctor service to another, the basic steps are the same. You will access their site and indicate your interest in a particular medication or treatment. You will need to fill out a health questionnaire regarding your current symptoms and pertinent medical history.
Depending on your state’s regulations, the online doctor may be able to issue a prescription based solely on your answers on the questionnaire. In states with more rigid requirements for issuance of a script, you will first need to talk with the physician by phone or video chat.
Most telehealth services partner with online pharmacies that can receive your prescription electronically and dispense the medication automatically. You can usually opt to have the medicine sent directly to your home, or the script can be forwarded to your local drug store for you to collect the medication yourself.
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