ED medication: what works, how to use it, and what to watch for

Erectile dysfunction meds work for most men, but choosing the right one and using it safely matters. This page breaks down the common drugs, quick dosing tips, common side effects, who should avoid them, and smart ways to buy prescriptions online.

Common drugs and how they work

The most-used treatments are PDE5 inhibitors: sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra) and avanafil (Stendra). They boost blood flow to the penis when you’re sexually aroused. Sildenafil and vardenafil usually take effect in 30–60 minutes and last 4–6 hours. Tadalafil can start in 30 minutes for some and lasts up to 36 hours, which is why people call it the "weekend pill." Avanafil often works faster with fewer side effects for some men.

Dose matters. Common starting doses: sildenafil 50 mg, tadalafil 10 mg, vardenafil 10 mg, avanafil 100 mg. Doctors adjust based on age, health, and other meds. Never mix PDE5 inhibitors with nitrates (like nitroglycerin) — that combo can dangerously drop blood pressure.

Side effects, interactions, and when to see a doctor

Typical side effects are headache, flushing, stuffy nose, indigestion, and muscle aches (more with tadalafil). Serious issues are rare but possible: sudden vision loss, sudden hearing loss, or an erection lasting more than four hours (priapism). If any of those happen, get emergency care immediately.

Drug interactions matter. Avoid nitrates entirely. Be cautious with alpha-blockers for prostate problems and some HIV, antifungal, or antibiotic drugs that change how the body clears PDE5 inhibitors. Tell your doctor about heart disease, low blood pressure, liver or kidney problems, and any bleeding disorders before starting treatment.

If pills don’t work, ask your doctor about alternatives: penile injections, intra-urethral suppositories, vacuum erection devices, or surgical implants. Often a combination of medical and lifestyle changes helps: stop smoking, lose weight, control blood sugar, and limit heavy alcohol.

Buying online? Only use licensed pharmacies that require a prescription, list a physical address, and offer pharmacist contact. Avoid sites that sell pills without asking questions or that are dramatically cheaper than established pharmacies — counterfeit meds are common. If you use a telehealth service, pick one that verifies your health history and prescribes based on a medical review.

Want a simple next step? Talk to your doctor about which drug fits your health and schedule. If you’re trying an ED pill for the first time, pick a low starting dose, avoid heavy meals and excessive alcohol that day, and test it when you have time and privacy. That gives you the best shot at seeing if it works.