Over the last 25 years, (ED) medications like Viagra and Cialis have become common fixtures in bedrooms around the world. These little pills have helped hundreds of millions of men get hard and stay hard. But what’s the best ED medication?
While pills like Viagra, Cialis, and Stendra might look similar, they’re unique medications with their own strengths and weaknesses for dealing with ED.
This means there’s no one-size-fits-all solution. The best ED medication is the one that works for your symptoms and lifestyle.
Below, we’ll discuss these health medications, how they work, the pros and cons of each, how long they last, side effects, and more.
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What Are the Most Common ED Medications?
The most popular ED medications currently on the market are:
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Sildenafil (Viagra)
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Tadalafil (Cialis)
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Vardenafil (Levitra)
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Avanafil (Stendra)
All of these meds belong to a class of drugs called phosphodiesterase type 5 inhibitors, or PDE5 inhibitors. They’re vasodilators, meaning they improve blood flow to the tissue inside your privates.
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How Well Do ED Medications Work?
With improved blood flow, PDE5 inhibitors make it easier for your privates to become firm and enlarged in response to stimulation, i.e., get an erection. It’s also easier to maintain the erection long enough to have satisfying intimacy.
These drugs are so effective that they’re typically recommended as first-line treatments for ED, regardless of whether symptoms are caused by psychological factors or physical ones.
The FDA (U.S. Food and Drug Administration) has approved all of these medications, and you’ll need a prescription to buy and use them as ED treatments.
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Beware of Over-the-Counter ED Pills
If you’ve come across over-the-counter ED pills that work fast — like “stay-hard pills” at the gas station — know they aren’t supported by solid scientific evidence. In fact, many are associated with serious safety risks.
So it’s best to avoid them.
We’ll profile the best ED treatments below to give you more insight into how FDA-approved prescription drugs work.
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How to Choose the Best ED Medication
Choosing the best erection pills is a personal decision. What might work for one guy may not work as well for another. It’s up to you and your healthcare provider to find a suitable plan for your needs.
Keep reading to compare the pros and cons of each of these prescription drugs for ED.
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Sildenafil (Viagra)
Sildenafil is the OG prescription medication for ED. It came onto the market in the late ’90s under the brand name Viagra. For several years, it was the only medication available for men with ED.
Today, sildenafil is available in its generic version, meaning it’s much more affordable than when it first hit the pharmacy shelves. And it’s still among the best ED pills.
Why? It works quickly, provides relief from ED for several hours, and is sold in just about every pharmacy, making it a reliable option for improving function.
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Best for: Guys who want a dependable treatment option for ED with a long track record and a good price per tablet.
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Advantages: Sildenafil starts working in less than an hour and provides relief from ED for about four hours per pill, making it great for a single night.
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Disadvantages: Sildenafil takes longer to work after a large, high-fat meal and can’t be taken more than once a day, making it less than ideal for twice-a-day (or more) intimacy.
Sildenafil Pros
Sildenafil is a reliable choice for treating ED. It’s been around for decades, is affordable, readily available, and has lots of data backing it.
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In research published by the FDA, 63 to 82 percent of men with ED showed improvements after taking Viagra.
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In a more recent study published in the International Journal of Clinical and Experimental Medicine, over 98 percent of men with ED who used sildenafil reported improved erections.
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A typical dose of sildenafil lasts roughly four hours, making it a good option if you want an ED pill designed to last for one night of activity.
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The relatively short duration of sildenafil can also mean the side effects are short-lived.
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Finally, sildenafil is a good ED treatment from a cost perspective. If you stick to generic Viagra, each pill only costs a few dollars, so you won’t have to spend much to enjoy better intimacy.
Sildenafil Cons
Sildenafil is only active for about four hours, so you’ll need to take it close to the time you plan to have intimacy.
This means you might have to plan ahead of time if you’re going out on a date and want to make sure it’s working its magic once you get home.
You can also only use sildenafil once every 24 hours. So this ED pill might not be the best option if you and your partner like to have intimacy more than once a day.
Sildenafil is affected by food and could take longer to start working if you eat a fatty meal (like a cheeseburger and greasy fries) just before or after you take it.
It can also cause side effects, including:
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Headaches
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Flushing
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Dyspepsia (indigestion) and upset stomach
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Changes in vision
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Nasal congestion
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Muscle soreness
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Back pain
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Nausea
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Dizziness
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Rash
But keep in mind most side effects of sildenafil can also develop with other ED medications.
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Tadalafil (Cialis)
Tadalafil is the active ingredient in Cialis, which was approved by the FDA as an ED medication in 2003. These days, it’s available in its generic form and as a brand name for use as needed or as a daily tablet.
Thanks to its very long duration of action — something we’ll get into more below — tadalafil is sometimes referred to as the “weekend pill” for treating ED.
Like sildenafil, tadalafil has a long track record. It’s been researched extensively, meaning both its effects and side effects are well-known.
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Best for: Men who like a long-lasting pill to treat ED, allowing for spontaneous intimacy or intimacy more than once a day.
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Advantages: Tadalafil lasts longer than any other ED treatment, with one pill providing relief from ED for up to 36 hours. It can also be taken daily at a lower dosage.
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Disadvantages: Tadalafil might last longer than needed for some men. Its long duration means side effects could last longer than with other ED pills.
Tadalafil Pros
Tadalafil has a half-life of 17.5 hours — it remains active in your body for far longer than other ED medications. A single dose of tadalafil can improve blood flow to your privates and make it easier to get hard for up to 36 hours.
This makes tadalafil a great choice if you want to get aroused more than once a day, or only want to take one pill over the course of an entire weekend.
Another advantage of tadalafil is that it’s also available as a daily-use medication. This version of tadalafil is ideal if you want to have intimacy spontaneously or prefer to take your ED tablet on a daily basis instead of as needed.
You can also take tadalafil without regard to food, meaning there’s no need to avoid large meals or fatty foods (like with Viagra) before using this medication.
Tadalafil Cons
Tadalafil’s biggest strength is also its biggest weakness. Since it’s such a long-lasting drug, it can cause side effects that continue for up to 36 hours.
If you’re prone to side effects from oral medication for ED, you might prefer to use a shorter-acting ED medication, like sildenafil, vardenafil, or Stendra.
A second disadvantage is the price of tadalafil. Tadalafil is slightly more expensive than sildenafil on a per-tablet basis, though this may be less of a concern if you have intimacy more than one time per dose.
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Vardenafil (Levitra)
Vardenafil is the active ingredient in Levitra, and the FDA approved it in 2003. It’s similar to sildenafil but lasts longer — research suggests it provides better blood flow and stronger erections for five to seven hours per dose.
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Best for: Men who want a slightly longer-lasting ED medication than sildenafil but don’t want the all-day effects of tadalafil.
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Advantages: Vardenafil lasts longer than sildenafil and usually starts working faster.
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Disadvantages: Vardenafil is typically more expensive than sildenafil. Like sildenafil, it can only be taken once a day.
Vardenafil Pros
Vardenafil has several pros, most of which are related to time.
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First, it lasts slightly longer than sildenafil, meaning you have a little extra flexibility regarding when you take it prior to having intimacy.
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This longer duration also means vardenafil could be a good choice if you like to have intimacy twice a night.
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It starts working quickly. Research suggests it kicks in less than 10 minutes after taking it in some men. (Still, it’s best to take it at least 30 minutes before intimacy.)
Vardenafil Cons
Like sildenafil, vardenafil can only be used once daily. This means it may not be the best ED pill if you plan to have intimacy several times in a day with a break between rounds one and two — for example, once in the afternoon and once at night.
Vardenafil side effects are similar to other ED drugs. Common adverse effects of vardenafil include:
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Headaches
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Flushing
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Nasal congestion
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Indigestion
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Sinusitis (sinus inflammation)
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Flu-like symptoms
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Increased creatine kinase (CK) levels
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Dizziness
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Back pain
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Nausea
Vardenafil prices are usually higher than sildenafil on a per-dose basis. This could make it less appealing as an ED pill if you’re budget-conscious and only need relief from ED for a few hours at a time.
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Stendra (Avanafil)
Stendra contains the active ingredient avanafil and is a newer ED medication that received FDA approval in 2012.
Avanafil is a PDE5 inhibitor that’s less likely to cause side effects than older medications and begins working faster. However, it’s only available under the brand name Stendra, with no generic.
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Best for: Guys who want a fast-acting ED pill that can be taken almost right before intimacy without having to worry about avoiding certain foods.
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Advantages: Stendra acts quickly — often in as little as 15 minutes — and is less likely to cause side effects than ED pills that have been around longer.
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Disadvantages: Stendra isn’t available as a generic medication because the manufacturer still has the patent, so it costs more per tablet than other ED drugs. While side effects are less common, they can still occur.
Stendra Pros
As a second-generation PDE5 inhibitor, Stendra has several advantages over older drugs for treating ED.
The first is that it’s fast. Stendra is designed for use 30 minutes before intimacy, although research suggests it’s effective at treating ED when taken 15 minutes before activity.
Since avanafil is more selective for PDE5 than older ED medications, it’s less likely to cause some side effects.
If you’re prone to side effects from sildenafil, tadalafil, or vardenafil, switching to avanafil might be a helpful way to access the benefits of ED medication with a milder side effect profile.
Stendra Cons
The main disadvantage of Stendra is its cost. Since Stendra is a new ED treatment, it’s still under patent protection. This means there’s no generic form of avanafil yet — its active ingredient — available in the U.S.
Some of the most common side effects of avanafil include:
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Headache
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Flushing
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Back pain
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Nasal congestion
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Nasopharyngitis (cold-like symptoms in nasal passages)
Although certain side effects are less common and more mild with avanafil than with older medications for ED, they can — and often do — still occur.
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Chewable ED Meds
If you’re looking for something a little different, try discreet chewable ED meds in the form of hard mints. They’re personalized with several active ingredients to match your specific symptoms and needs.
These hard mints are made with the same active ingredients found in Viagra and Cialis (sildenafil and tadalafil) and customized at different dosages. Unlike traditional ED pills, they’re chewed instead of swallowed.
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Best for: Guys looking for ED medication with a proven track record but in a newer, modernized format and men who don’t like swallowing pills.
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Advantages: They have the same proven ingredients found in popular ED drugs like Viagra and Cialis but in chewable form. These chewable meds also have a fresh, wintergreen taste and discreet packaging you won’t mind carrying around.
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Disadvantages: Chewable sildenafil and tadalafil have the same side effects as other PDE5 drugs.
Chewable ED Meds Pros
Our hard mints ED meds are a fresh take on old favorites. They’re made with the same active ingredients in well-known drugs like Viagra and Cialis, but they’re chewable.
Like those popular prescription drugs, they can also be used as needed or daily, depending on your needs. But they taste better.
Chewable ED medications are compounded drugs, which means they can be customized and personalized to meet your specific needs at the dosage you require.
Chewable ED Meds Cons
As a compounded medication, chewable ED meds aren’t approved by the FDA. But they’re totally legal and made with the same ingredients as Viagra and Cialis, which are FDA-approved drugs.
Side effects can include:
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Headaches
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Flushing
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Upset stomach
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Back pain
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Nasal congestion
If you experience side effects with sildenafil or tadalafil tablets, you might experience the same side effects with hard mints.
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ED Pill Interactions and Risks
Sildenafil, tadalafil, vardenafil, and Stendra are all safe and effective medications when used as prescribed.
However, all medications for ED have the potential to interact with other medications, including several prescription drugs for health conditions like hypertension (high blood pressure), heart disease, and kidney disease.
If you’re considering using any type of ED medication, you should be aware of the following potential drug interactions:
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Nitrates. When used with nitrates for chest pain or cardiovascular disease, ED medications can cause extremely low blood pressure that may be life-threatening. Nitrates include nitroglycerin and poppers used for recreational purposes.
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Antihypertensives. Certain other medications used to treat high blood pressure, such as alpha-blockers, may interact with ED medications.
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CYP3A4 inhibitors. Medications that inhibit the enzyme CYP3A4 — including some protease inhibitors, antifungals, and antibiotics — may cause interactions when used with ED pills.
Although very uncommon, ED medications may also cause priapism — prolonged, painful climaxes that can damage the tissue of your privates. It’s important to seek medical help as soon as you can if you develop a persistent or painful climax.
Before you use any type of ED medication, talk to your medical provider about any medications you currently use, as well as any medical conditions you have.
Our guides to sildenafil interactions, tadalafil interactions, and avanafil side effects discuss these serious side effects and risks in more detail and explain how to use ED medication safely.
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A Final Word on the Best ED Treatments
What’s the best ED medication? That depends. Since ED symptoms can differ from person to person and everyone’s needs are unique, there isn’t a “best” erectile dysfunction pill for every man.
Each pill offers a slightly different experience, from a longer duration of action to a reduced risk of side effects.
If you’re considering ED medication and don’t know which pill is the best treatment for you, keep the following in mind:
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Sildenafil (Viagra) and vardenafil (Levitra) are short-acting. These “one-night” ED medications are both available as generics, making them good medications to try first.
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Tadalafil (Cialis) is much longer-lasting. This is a good option if you prefer “all-day” relief from ED.
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Stendra (avanafil) is newer. If you’re looking for the best medicine for erectile dysfunction without side effects, this one comes close. It kicks in fast and doesn’t cause as many adverse reactions as older ED pills, but it does cost more per tablet.
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Chewable ED meds are a fresh way to treat ED. Our hard mints contain the same active ingredients in drugs like Viagra and Cialis. They can be taken as needed or daily. Plus, they come in discreet packaging and are personalized to meet your exact needs.
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Other treatments are available. We consider these drugs to be among the top 10 ED pills, but there are many more options to consider. This includes therapy for mental health issues that may be causing ED and lifestyle changes to support health, like following a healthy diet, exercising, and cutting back on alcohol.
Above all, you’ll want to provide your healthcare provider with as much information as possible about your symptoms. And closely follow their medical advice to get the best results from any ED medication.
When used right, ED pills can do more than just give you firmer erections — they can also boost your self-confidence in bed.
Need help getting started? We offer a full range of FDA-approved medications for ED and (PE) following a virtual consultation with a healthcare provider, who’ll determine if a prescription is appropriate.
This article originally appeared on Hims.com and was syndicated by MediaFeed.org.
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