Prescription ED Medications: What Works and What to Watch

Struggling with erectile dysfunction? You're not alone — about half of men over 40 notice some trouble. Several prescription drugs can help most people get reliable erections. Below I explain the main options, how they work, and simple safety tips so you can make smarter choices with your doctor or pharmacist.

All common ED meds boost blood flow to the penis by affecting enzymes and blood vessels. They don't increase desire, but they help the physical response when you're sexually aroused. Knowing how each drug behaves makes real-life use easier.

Main prescription options

Sildenafil (Viagra) — starts in about 30–60 minutes, works 4–6 hours. Take on an emptier stomach for best results. Typical dose: 50 mg, adjustable to 25 or 100 mg.

Tadalafil (Cialis) — can start in 30 minutes but is famous for lasting up to 36 hours. Many people like the extra window. Standard as-needed dose: 10 mg; daily dose: 2.5–5 mg if your doc recommends it.

Vardenafil (Levitra, Staxyn) — similar timing to sildenafil, around 30–60 minute onset and 4–8 hours duration. It can be easier on the stomach for some people.

Avanafil (Stendra) — often fastest, working in 15–30 minutes and lasting about 6 hours. Usual dose: 100 mg, adjustable to 50 or 200 mg.

Safety, interactions, and buying tips

Never mix ED meds with nitrates for chest pain — that combo can drop blood pressure dangerously. Always tell your doctor about heart meds, alpha-blockers, and grapefruit. These can change how ED drugs act.

Common side effects include headache, flushing, stuffy nose, upset stomach, or muscle aches. If you get sudden vision or hearing changes, or an erection that lasts over four hours (priapism), seek emergency care right away.

Want to buy online? Use licensed pharmacies that require prescriptions. Check for a license number, secure checkout (HTTPS), clear contact info, and real customer reviews. Avoid sites that sell prescription drugs without asking for a prescription.

If cost is a concern, ask your provider about generic versions — sildenafil, tadalafil, vardenafil, and avanafil generics are usually much cheaper and work the same. Coupon programs and patient assistance can also cut out-of-pocket costs.

Choosing between on-demand pills and daily therapy depends on your life. Daily tadalafil often suits spontaneity and can help bladder symptoms (BPH). On-demand sildenafil or avanafil is fine if you need help occasionally. If anxiety is part of the issue, pairing medication with counseling gives better results.

Medical conditions like severe liver or kidney disease, recent stroke, or unstable heart problems may rule out these drugs. Simple lifestyle changes — lose weight, exercise, quit smoking, limit alcohol — often improve how well medications work. If ED appears with chest pain, breathlessness, or uncontrolled diabetes, see a doctor; ED can signal heart disease or hormone problems, and treating the root cause often helps erections.

Bring a list of current medicines and a brief health history to your appointment. That helps the prescriber pick the safest dose. Licensed online clinics usually require a short consult before issuing a prescription — that setup can be convenient and safe when the pharmacy and clinic are legitimate.

Try a medication a few times before deciding it doesn't work. Timing, food, alcohol, and nerves all affect results. Talk openly with your partner and your provider — small changes often make a big difference.