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How to Choose Medication (or Pills) for Erectile Dysfunction

Erectile dysfunction (ED) occurs when a man is unable to sustain an erection and have a fulfilling sexual experience. It can occur due to many different causes. (Learn More) ED is a relatively common condition in men over the age of 40. (Learn More)

There are four FDA-approved medications to treat ED. They all have different profiles you will want to consider before you choose one. (Learn More)

In addition to understanding how the drugs work, you should be aware of the side effects and interactions associated with each one. (Learn More)

ED drugs can be expensive, but there are some things you might be able to do to reduce the cost. (Learn More)

When choosing a medication to treat erectile dysfunction, don’t attempt to buy different ED medications and combine them. (Learn More) Don’t buy prescription medications online, as many can be counterfeit and even dangerous. (Learn More) Also, avoid buying ED treatments that are not approved by the FDA. (Learn More)

Erectile Dysfunction

Erectile dysfunction (ED) may result from psychological or emotional factors, including a psychiatric condition like depression, a physical disease or disorder like diabetes or heart disease, or side effects of other medications. It may also not have any recognized cause.

In many cases, the condition is treatable with medications. You will need to look at the way the medication works before you decide which one might be best for you.

How Many People Have ED?

Erectile dysfunction is relatively common. According to the Cleveland Clinic, nearly half of males between the ages of 40 and 70 have some degree of ED, but only about 10 percent of these men report not being able to get an erection at all.

In men who are generally healthy, the use of a medication produces an erection that is sufficient to begin intercourse in about 70 percent of cases. There are four medications approved by the Food and Drug Administration (FDA) to treat ED.

FDA-Approved Medications for ED

The medications approved by the FDA to treat erectile dysfunction have different onsets and durations of action. Depending on your personal needs, you may want to choose a medication that works relatively quickly or one that remains active in your body for a longer period of time.

In general, you can expect the following from the FDA-approved medicines to treat ED:

  • Viagra (sildenafil) typically begins to work 30 to 60 minutes after you take it. The drug has a duration of action for about 4 to 5 hours.
  • Cialis (tadalafil) typically begins to work within 30 to 45 minutes after you take it. Its effects last between 24 and 36 hours. There is also a low-dose version of Cialis that can be taken daily, and the effects of this medication are continuous.
  • Stendra (avanafil) has a quick onset of action of about 15 to 30 minutes after you take it. The drug remains active in your body for 6 to 12 hours in most cases.
  • Levitra (vardenafil) works 30 to 60 minutes after taking it. The drug remains active in the body for about 4 to 5 hours.

Interactions and Side Effects

All the ED drugs listed above that are approved by the FDA have interactions with various medications and even foods you may eat.

For instance, you should not eat grapefruitf or drink grapefruit juice when you are taking the above medications, or you risk a potential untoward interaction, leading to increased levels of the drug in your system and the potential for serious side effects.

You should not drink alcohol while taking these drugs due to the potential for significantly decreased blood pressure.

There are many other potential interactions that can occur. You should be familiar with these before you pick any particular drug for ED.

All drugs have side effects. The following are the most common side effects that can occur with medications used to treat erectile dysfunction:

silhouette of man with headache

  • Flushing
  • Headache
  • Nasal congestion or increased potential for respiratory infections
  • Back pain
  • Dizziness
  • Blurred vision

Rare, dangerous side effects can occur with these drugs, including a sudden loss of vision or hearing. This can be potentially serious and requires that you immediately stop using the drug and contact your physician.

It is always a good idea to discuss possible side effects of any medication with your physician before you begin using it. You can then know what actions to take if you experience them.

The Cost of ED Drugs

Cost is always an issue to consider for any medication. Depending on your insurance coverage, you may be limited on the number of pills you are allowed to get per prescription. Discuss the situation with your insurance company so you know ahead of time how many pills you are allowed for each prescription.

Copays and out-of-pocket costs vary between insurance companies and policies. Familiarize yourself with the limits of your coverage for each medication you qualify for.

To save money, try the following:

  • Ask your physician if you can get a higher dose of the medication. Then, split each pill in half and only take half of a pill at a time.
  • Shop around to the different pharmacies in your area and check the prices of each medication.
  • Inquire about manufacturer’s discount programs that allow you to get a limited supply of medications that may not be covered by your insurance plan.
  • Look for discount options like com. You can get significant discounts on medications.

Combining ED Medications

One of the actions of ED medications is that they dilate blood vessels in the body.

Unless your physician prescribes you more than one, you should not combine ED medications due to a serious potential to experience significantly decreased blood flow, extremely low blood pressure, and other potential health risks.

Generic Forms of Medications Online From Overseas Companies

You may be tempted to save a lot of money by buying generic medications for ED online from an overseas pharmacy or some other source. Do not do this.

You should only buy prescription medications from licensed and registered pharmacies in the United States. There are no quality controls, regulations, and other governing factors to protect you when you buy something from an online pharmacy that is not licensed in the U.S.

You may not even be getting the medication you think you are when you buy drugs from these sources. It could be dangerous if you take medications purchased in this manner.

Other Medications to Avoid

The FDA has issued a warning regarding advertisements on the radio and other forms of the media that offer alternatives to erectile dysfunction medications. The FDA warns specifically that individuals should not purchase treatments for ED that are not approved for that purpose. This includes numerous products, such as herbal products and dietary aids that are reputed to treat ED.

Again, you cannot be sure what you are purchasing when you buy these products.


When choosing a medication to treat erectile dysfunction, discuss the situation with your physician. Consider the following:

  • How long it takes the drug to start working
  • How long the drug remains active in your body
  • Potential side effects the drug can produce
  • Interactions with other medications or foods
  • Your general health
  • The cost of the medication and how your insurance covers the cost


Erectile Dysfunction. (March 2018). Mayo Clinic.

Erectile Dysfunction. (June 2018). Cleveland Clinic.

Development & Approval Process (Drugs). (June 2018). Food and Drug Administration.

Viagra. (October 2018). RxList.

Cialis. (March 2018). RxList.

Stendra. (August 2018). RxList.

Levitra. (November 2018). RxList.

FDA Warns Consumers Not to Use Unapproved Erectile Dysfunction Products Advertised on the Radio. (March 2018). Food and Drug Administration.

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