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Several effective pills for erectile dysfunction (ED) are available. Learn which pills may be most effective for you based on dosage, onset, duration, and interactions with other medications.
Research suggests that anywhere from
No one pill is considered the most effective in all use cases. The best option for you will depend on your needs and what other medications you’re taking.
Read on to learn more about the FDA-approved ED pills available and how they compare in their effectiveness.
Sildenafil (Viagra) is a phosphodiesterase-type 5 (PDE-5) inhibitor.
PDE-5 inhibitors widen blood vessels in your penis so that blood flows more easily into the spongy tissues that help you get an erection. These medications also help break down the protein cyclic guanosine monophosphate (cGMP) so that you can keep your erection longer.
Viagra usually starts working 30–60 minutes after taking a 50-milligram (mg) dose. It can then last for about 4–6 hours before the effects start to wear off.
Don’t take Viagra if you’re taking any of the following medications:
- nitrate drugs
- alpha-blocker drugs
- blood pressure drugs
- HIV medications
- other ED pills
- drugs for pulmonary arterial hypertension
Talk with your doctor before taking Viagra if you have any of the following conditions:
- heart conditions
- penis abnormalities, such as Peyronie’s disease
- blood cell problems, such as sickle cell anemia
- eye conditions like non-arteritic anterior ischemic optic neuropathy
- low blood pressure
- bleeding disorders, such as hemophilia
- stomach ulcers
- allergic reactions to any PDE-5 inhibitors
- kidney or liver issues
Vardenafil (Levitra) is another PDE-5 inhibitor that helps increase blood flow into your penis so that you can get an erection and keep it longer. It’s also sometimes prescribed to treat pulmonary hypertension.
A 10-mg dose of vardenafil starts working after about 60 minutes. It also tends to last a little longer than sildenafil — up to 7 hours per dose.
Be careful taking Levitra if you’re drinking alcohol or grapefruit juice, which can increase your risk of side effects like experiencing dizziness, losing consciousness, or having too much Levitra in your bloodstream.
Avoid taking Levitra if you have any of the following conditions:
- high blood pressure
- history of heart attacks
- stroke
- loss of liver function
- conditions like Peyronie’s disease
- conditions that affect the prostate
Tadalafil (Cialis) is also a PDE-5 inhibitor. In addition to improving blood flow, PDE-5 inhibitors help improve the way that your body uses nitric oxide (NO) to relax blood vessels involved in that blood flow.
Tadalafil can also treat benign prostatic hyperplasia (BPH), or enlarged prostate, by
A 10-mg dose of tadalafil takes about 30 minutes to start working, and it can keep working for up to 36 hours. As with other PDE-5 inhibitors, be careful taking Cialis if you’re:
- drinking alcohol or grapefruit juice
- taking nitrates for angina (chest pain)
- taking alpha-blockers for high blood pressure
- taking medications that can interact with tadalafil, including antibiotics or antifungal medications
Avanafil is a newer PDE5 inhibitor There’s no generic version of avanafil, so it’s a little more expensive. A typical dose of avanafil is about 50–100 mg, and it takes about 45 minutes to start working.
Avanafil also carries similar risks of side effects and interactions as other PDE-5 inhibitors.
| Dosage options | Onset time | Duration | |
|---|---|---|---|
| Sildenafil (Viagra) | 20 mg, 25 mg, 50 mg, 100 mg | 30–60 minutes (up to 2 hours) | 2–5 hours |
| Tadalafil (Cialis) | 2.5 mg, 5 mg, 10 mg, 20 mg | 30 minutes to 2 hours | up to 36 hours |
| Vardenafil (Levitra, Staxyn) | 5 mg, 10 mg, 20 mg | 30–60 minutes | 4–5 hours |
| Avanafil (Stendra, Spedra) | 50 mg, 100 mg, 200 mg | 15–45 minutes | up to 6 hours |
Here’s how much each ED pill costs for both brand-name and generic versions:
- Sildenafil: Brand-name Viagra typically sells for $50 or more per dose. Generic sildenafil can sell for as low as $12 per dose.
- Tadalafil: Brand-name Cialis may cost up to $70 for a 20-mg dose. Generic tadalafil can sell for $12.99 per dose.
- Vardenafil: Brand-name Levitra costs about $40 for a typical dose. Generic vardenafil sells for as low as $37.99 per dose.
- Avanafil: Brand-name Stendra sells for about $70 per 100-mg dose. There’s currently no generic version of avanafil available.
You don’t always need to pay full price for PDE-5 inhibitors.
Check out discount and coupon programs from companies like Optum Perks, which is a sister site of Healthline. These companies collect and make discounts available for a wide variety of medications, including ED pills. You can often save hundreds of dollars on regular prescriptions of PDE-5 inhibitors using these coupons.
ED pills can only be purchased with a prescription from a licensed healthcare professional. You can either visit a doctor’s office or use a number of telemedicine companies that partner with doctors to prescribe ED pills online.
FDA-approved ED pills are considered safe for people to take if they don’t have any conditions or take medications that interact with the ingredients in the pills.
While these pills are safe, they may cause some side effects, including:
- headache
- flushing
- upset stomach
- stuffy or runny nose
- symptoms of a cold
- congestion in your nose
- pain in your back
- nausea
- skin rash
- heartburn
Seek immediate medical attention if you have any serious side effects, such as:
- allergic reaction that make it hard to breathe (anaphylaxis)
- forgetfulness (amnesia)
- severe pain in your chest
- an erection for longer than 4 hours (priapism)
- ear ringing (tinnitus)
- dizziness
- long-term muscle pain (myalgia)
- throwing up for more than a day
- hearing loss
- heart palpitation
- changes in your heartbeat
- dangerously low blood pressure
- losing vision
If you can’t or don’t want to take medication for ED, there are some other options you can try:
- Lifestyle changes: Lifestyle changes like stopping smoking, limiting alcohol intake, lowering stress, and following a healthy diet can all have a positive impact on ED.
- Implants: An inflatable or flexible rod can be surgically implanted in your penis. You can then use the rod to get and maintain an erection.
- Penis pumps: These devices go over your penis and use a pump to cause your penis to fill with blood. Once erect, you place a band around the base of your penis to keep your erection.
There’s some evidence that natural supplements may work for ED, but research shows mixed results:
- Dehydroepiandrosterone (DHEA): A
2018 research review suggests that lowered DHEA in your body reduces your ability to get an erection, which is why DHEA supplements are recommended to treat ED. But a 2020 literature review concluded that research doesn’t agree on whether it actually works. - L-arginine: Research suggests that L-arginine can help improve the effectiveness of
Cialis ,Viagra , andYohimbine . - Ginseng: Some
research from 2008 suggests that ginseng can help with ED, but it’s not conclusive whether it’s truly effective. A 2021 study showed that combining ginseng and vitamin E could help treat ED, but anotherreview from the same year found that ginseng seems to have a very small effect.
Keep in mind that just because supplements may be available over the counter doesn’t mean they’re safe to take.
Additionally, some supplements can negatively interact with prescription medications. It’s important to talk with your doctor before adding any supplements to your routine.
Most of the FDA-approved PDE-5 inhibitors are effective if you take them at the right doses and at the right time.
But Viagra is sometimes considered the most effective ED treatment because it’s been used for many years and has a lot of research supporting its effectiveness.
Cialis and Viagra are usually considered equally effective. But Cialis tends to work for a longer period than Viagra, lasting up to 36 hours.
ED pills are generally considered safe, though mild side effects can occur. More serious side effects may occur if you take the pills with other medications that can interact with the ingredients or have certain underlying health conditions.
PDE-5 inhibitors have been prescribed for ED since Viagra was first FDA approved in 1998.
Vardenafil (Levitra) is typically considered to have the fewest possible side effects compared with other FDA-approved PDE-5 inhibitors.
Taking certain other medications or having certain health conditions can make a difference in how likely you are to experience side effects from ED pills.
Some treatments for ED can help permanently cure the condition, especially if the cause is related to your mental health or to an underlying condition like diabetes or heart disease that can be treated.
Taking ED pills regularly before having sex can also reduce or eliminate ED.
Most of the FDA-approved ED pills are effective for most people who take them.
But you might experience different levels of effectiveness based on dosage, other medications you’re taking, and conditions that may increase your risk of side effects.
Talk with a doctor before you decide to take PDE-5 inhibitors for ED.
