That honor goes to BlueChew’s as-needed chewable tadalafil (which starts at 6mg), and the company’s free trial makes them a more convenient place for men to start. If you’re comfortable titrating up to 8.5mg, you can save money by migrating to Hims, and you can always switch back to BlueChew if Hims’ 8.5mg dose causes side effects.
| Condition | Caution Level | Explanation | Advice |
|---|---|---|---|
| Heart Disease | High | Increased risk of adverse cardiovascular events | Consult cardiologist first |
| Liver Impairment | Moderate | Slows drug metabolism, increases side effect risk | Lower dose recommended |
| Nitrate Use (e.g., nitroglycerin) | Critical | Dangerous hypotension risk | Do not use |
| Blood Pressure Issues | Varies | Can cause blood pressure fluctuations | Medical consultation is essential |
Nitric oxide (NO) mediates vasodilation (widening of blood vessels) in the penis, increasing blood flow. PDE5 inhibitors promote the release of NO, improving blood flow, helping the muscles in the penis to relax, and causing the penis to enlarge and grow rigid, forming an erection.10 Meanwhile, PDE5 (phosphodiesterase-5) is a chemical that the body releases to signal that it’s time for the erection to end. PDE5 inhibitors slow the activity of PDE5, allowing the NO activity to continue, bringing forth a sustained erection. Taking one of these medications should not result in an instant erection — stimulation is still required.
But when stimulation occurs, the medicine helps boost NO and its effects. Every ED drug has contraindications (i.e., reasons why a person should not use it).
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Viagra Generic | 100mg | 90 + 6 Pills | 129.02€ 122.88€ | |
| Viagra Super Active | 100mg | 120 + 16 Pills | 198.37€ 188.92€ | |
| Viagra Generic | 200mg | 20 Pills | 61.69€ 58.75€ | |
| Viagra Super Active | 100mg | 360 + 30 Pills | 470.93€ 448.50€ | |
| Viagra Super Active | 100mg | 10 Pills | 28.76€ 27.39€ | |
| Viagra Original | 100mg | 22 + 2 Pills | 120.71€ 114.96€ | |
| Viagra Professional | 100mg | 20 Pills | 71.14€ 67.75€ | |
| Viagra Original | 100mg | 120 + 8 Pills | 470.39€ 447.99€ | |
| Viagra Oral Jelly | 100mg | 21 Sachets | 78.66€ 74.91€ | |
| Viagra Generic | 150mg | 30 + 2 Pills | 72.32€ 68.88€ |
Men with certain liver, kidney, or cardiovascular conditions may not be able to take ED medications safely. Men taking nitrates and alpha-blockers to treat hypertension may need to find other ways to treat their ED. Other health conditions could make PDE5 medications unsafe for men as well. These potential complications are why you need a prescription for ED medication. Your consulting physician will determine what will be safe and effective based on your medical history and any current medications that you use. Thankfully, PDE5 medications for ED are prescribed very widely, and the healthcare community considers them safe for most men, with the likeliest side effects being mild. When side effects happen, they tend to be mild and commonly include some of the following: A sensation of flushing in the face Though they rely on the same primary mechanism to treat ED, research confirms that these different PDE5 inhibitors tend to produce side effects to varying degrees.
For instance, a slightly higher percentage of people who take sildenafil (and Viagra) report flushing and headaches,11 while a slightly higher percentage of tadalafil (and Cialis) users report muscle pain.12 “It is quite common for patients to report muscle pain during the use of PDE5 inhibitors,” Dr. Urdaneta notes. “However, the daily dose of 5mg [tadalafil] is well tolerated.” Any of the PDE5 inhibitors can also cause your blood pressure to drop (though Stendra is less likely to cause this to happen). You might think that’s a good thing, but blood pressure that gets too low is also dangerous. If you get dizzy from taking any of these medications, you should share this observation with a healthcare provider; it could indicate a potentially unsafe drop in blood pressure.
One rare but noteworthy side effect of some PDE5 inhibitors is a change in visual color processing. This occurs when a PDE5 inhibitor collaterally inhibits PDE6. If you’re one of the relatively few men to experience this phenomenon, you should ask your doctor about vardenafil, which does not seem to cause this side effect. In response to reader requests, we created a comprehensive guide to the side effects of BlueChew, which is a useful resource if you're interested in learning much more about the likelihood of experiencing side effects while taking PDE5 inhibitors. When we break down your top choices for ED medication, we find it useful to refer only to the names of the active ingredients (i.e., sildenafil, tadalafil, etc.) as opposed to their brand names.
Unless you’re going through your insurance company, there’s almost never a good reason to buy branded ED medication — generic options are therapeutically identical. We always recommend that people start with generics for ED, so let’s look at which medications are available in generic form: During the course of your research or in conversation with your consulting physician, you might come across the term “authorized generic,” which is distinct from simply “generic.” Here’s how they differ: Generics — with no additional word to modify the meaning — are produced by companies other than the original manufacturer. They bear only the name of the active ingredient (i.e., sildenafil), and telemedicine companies typically advertise them as such. Effects on the body are identical to the original; the only differences may be in the appearance of the pills and the inactive ingredients used. Authorized generics are either made by the original manufacturer or by a company they’ve permitted to do the manufacturing. For instance, a slightly higher percentage of people who take sildenafil (and Viagra) report flushing and headaches,11 while a slightly higher percentage of tadalafil (and Cialis) users report muscle pain.12 “It is quite common for patients to report muscle pain during the use of PDE5 inhibitors,” Dr. Urdaneta notes. “However, the daily dose of 5mg [tadalafil] is well tolerated.” Any of the PDE5 inhibitors can also cause your blood pressure to drop (though Stendra is less likely to cause this to happen). You might think that’s a good thing, but blood pressure that gets too low is also dangerous.
That honor goes to BlueChew’s as-needed chewable tadalafil (which starts at 6mg), and the company’s free trial makes them a more convenient place for men to start. If you’re comfortable titrating up to 8.5mg, you can save money by migrating to Hims, and you can always switch back to BlueChew if Hims’ 8.5mg dose causes side effects. Nitric oxide (NO) mediates vasodilation (widening of blood vessels) in the penis, increasing blood flow. PDE5 inhibitors promote the release of NO, improving blood flow, helping the muscles in the penis to relax, and causing the penis to enlarge and grow rigid, forming an erection.10 Meanwhile, PDE5 (phosphodiesterase-5) is a chemical that the body releases to signal that it’s time for the erection to end. PDE5 inhibitors slow the activity of PDE5, allowing the NO activity to continue, bringing forth a sustained erection.
Taking one of these medications should not result in an instant erection — stimulation is still required. But when stimulation occurs, the medicine helps boost NO and its effects. Every ED drug has contraindications (i.e., reasons why a person should not use it). Men with certain liver, kidney, or cardiovascular conditions may not be able to take ED medications safely. Men taking nitrates and alpha-blockers to treat hypertension may need to find other ways to treat their ED.
Other health conditions could make PDE5 medications unsafe for men as well. These potential complications are why you need a prescription for ED medication. Your consulting physician will determine what will be safe and effective based on your medical history and any current medications that you use. Thankfully, PDE5 medications for ED are prescribed very widely, and the healthcare community considers them safe for most men, with the likeliest side effects being mild. When side effects happen, they tend to be mild and commonly include some of the following: A sensation of flushing in the face Though they rely on the same primary mechanism to treat ED, research confirms that these different PDE5 inhibitors tend to produce side effects to varying degrees. If you get dizzy from taking any of these medications, you should share this observation with a healthcare provider; it could indicate a potentially unsafe drop in blood pressure.
| Strategy | Dosage (mg) | Timing Before Activity | Additional Tips |
|---|---|---|---|
| Standard Dose | 50-100 | 30-60 minutes | Take on an empty stomach for quicker onset |
| High-Strength Dose | 150-200 | 15-30 minutes | Use only if prescribed and tolerated |
| Split Dosing | 50 + 50 | 30 minutes apart | May prolong effectiveness |
| Taking With Food | 50-100 | 60-120 minutes | Food delays absorption, adjust timing |
One rare but noteworthy side effect of some PDE5 inhibitors is a change in visual color processing. This occurs when a PDE5 inhibitor collaterally inhibits PDE6. If you’re one of the relatively few men to experience this phenomenon, you should ask your doctor about vardenafil, which does not seem to cause this side effect. In response to reader requests, we created a comprehensive guide to the side effects of BlueChew, which is a useful resource if you're interested in learning much more about the likelihood of experiencing side effects while taking PDE5 inhibitors.
These pills are completely identical to the original branded option, right down to the inactive ingredients and appearance, but they usually don’t include the original brand name on the label. To make matters more confusing, telemedicine providers will sometimes use original brand names when selling generics that are not “authorized generics” because it makes it easier for their customers to understand what they’re choosing. Others sell branded pills, authorized generics, and regular generics without doing enough work to explain the differences to their customers. This gets the most confusing with sildenafil and Viagra, and we’ll break that down a little later. If you’re confused by all of it, make sure to ask your doctor which one would be right for you.
Less viagra gel planning needed with its extended duration of action Can be taken daily or as needed Can be taken with or without food Tends to be preferred by men and their partners, compared to sildenafil Costs a little more than sildenafil in some as-needed cases Risk of mild side effects is slightly higher than Stendra Often known by the common brand name Cialis, tadalafil is a PDE5 inhibitor that you can take once per day to provide 18-36 hours of effectiveness. This significantly reduces the planning typically involved in using other treatments like sildenafil. That said, some users only take tadalafil as needed, and those dosages can sometimes be different. You and your doctor will decide what dosage and schedule are right for you. Side effects with tadalafil are about as common as with sildenafil and are similarly mild.
Dose for dose, as-needed tadalafil is often a little bit more expensive than sildenafil. However, tadalafil may be the better value, mainly because: In studies, men and their partners prefer tadalafil to sildenafil. Tadalafil has superior psychological outcomes to sildenafil, providing more sexual confidence.3 The larger window for sexual activity (18-36 hours, compared to 4-6 hours with sildenafil) for many people justifies the slightly higher expense. Daily tadalafil offers the lowest cost per dose among PDE5 inhibitors. Branded Cialis and generic tadalafil are available in the same dose increments across most platforms, with 2.5mg, 5mg, 10mg, and 20mg being the most common. When we break down your top choices for ED medication, we find it useful to refer only to the names of the active ingredients (i.e., sildenafil, tadalafil, etc.) as opposed to their brand names. Unless you’re going through your insurance company, there’s almost never a good reason to buy branded ED medication — generic options are therapeutically identical. We always recommend that people start with generics for ED, so let’s look at which medications are available in generic form: During the course of your research or in conversation with your consulting physician, you might come across the term “authorized generic,” which is distinct from simply “generic.” Here’s how they differ: Generics — with no additional word to modify the meaning — are produced by companies other than the original manufacturer. They bear only the name of the active ingredient (i.e., sildenafil), and telemedicine companies typically advertise them as such.
Effects on the body are identical to the original; the only differences may be in the appearance of the pills and the inactive ingredients used. Authorized generics are either made by the original manufacturer or by a company they’ve permitted to do the manufacturing. These pills are completely identical to the original branded option, right down to the inactive ingredients and appearance, but they usually don’t include the original brand name on the label. To make matters more confusing, telemedicine providers will sometimes use original brand names when selling generics that are not “authorized generics” because it makes it easier for their customers to understand what they’re choosing. Others sell branded pills, authorized generics, and regular generics without doing enough work to explain the differences to their customers. This gets the most confusing with sildenafil and Viagra, and we’ll break that down a little later. If you’re confused by all of it, make sure to ask your doctor which one would be right for you. Less viagra gel planning needed with its extended duration of action Can be taken daily or as needed Can be taken with or without food Tends to be preferred by men and their partners, compared to sildenafil Costs a little more than sildenafil in some as-needed cases Risk of mild side effects is slightly higher than Stendra Often known by the common brand name Cialis, tadalafil is a PDE5 inhibitor that you can take once per day to provide 18-36 hours of effectiveness. This significantly reduces the planning typically involved in using other treatments like sildenafil.
That said, some users only take tadalafil as needed, and those dosages can sometimes be different. You and your doctor will decide what dosage and schedule are right for you. Side effects with tadalafil are about as common as with sildenafil and are similarly mild. Dose for dose, as-needed tadalafil is often a little bit more expensive than sildenafil. However, tadalafil may be the better value, mainly because: In studies, men and their partners prefer tadalafil to sildenafil.
Tadalafil has superior psychological outcomes to sildenafil, providing more sexual confidence.3 The larger window for sexual activity (18-36 hours, compared to 4-6 hours with sildenafil) for many people justifies the slightly higher expense. Daily tadalafil offers the lowest cost per dose among PDE5 inhibitors. Branded Cialis and generic tadalafil are available in the same dose increments across most platforms, with 2.5mg, 5mg, 10mg, and 20mg being the most common. Daily doses typically start at 2.5mg, while as-needed doses typically start at 5mg. These are the doses you’ll see from Hims for its tadalafil tablets. Chewable tablets and lozenges often have different doses. 8.5mg and 11.2mg doses from Hims We’ll get a little more into complex offerings in the “Combination therapies” section later. Ultimately, you’ll decide with the prescribing doctor which dose and schedule are best for your lifestyle. Here’s a quick visual reference to let you know what kinds of branded and generic tadalafil our top choices carry: The tadalafil landscape has gotten a little more complicated in recent years. While BlueChew was steadily our top choice for tadalafil for years, Hims has caught up and surpassed it slightly, beating BlueChew to a chewable daily tadalafil offering that could undercut BlueChew’s tadalafil pricing if you only needed a low dose. That said, Hims’ low prices on tadalafil only apply to daily versions of those lower 2.5mg and 5mg doses.
Daily doses typically start at 2.5mg, while as-needed doses typically start at 5mg. These are the doses you’ll see from Hims for its tadalafil tablets. Chewable tablets and lozenges often have different doses. 8.5mg and 11.2mg doses from Hims We’ll get a little more into complex offerings in the “Combination therapies” section later. Ultimately, you’ll decide with the prescribing doctor which dose and schedule are best for your lifestyle.
Here’s a quick visual reference to let you know what kinds of branded and generic tadalafil our top choices carry: The tadalafil landscape has gotten a little more complicated in recent years. While BlueChew was steadily our top choice for tadalafil for years, Hims has caught up and surpassed it slightly, beating BlueChew to a chewable daily tadalafil offering that could undercut BlueChew’s tadalafil pricing if you only needed a low dose. That said, Hims’ low prices on tadalafil only apply to daily versions of those lower 2.5mg and 5mg doses. Both BlueChew and Hims lag behind Rocket Rx’s pricing for as-needed tadalafil at 10mg and 20mg doses, however. So, the provider that’s best for you will have a lot to do with the dose you need and whether you want to take tadalafil daily or as needed.
Here’s how those prices compare, with lower prices often coming from extended billing cycles (quarterly, biannually, etc.): If you’re new to ED meds and want to try as-needed tadalafil at a dosage no stronger than 5mg, then tadalafil from Hims could conceivably be your most economical option. That’s because you could request daily tadalafil tablets on a yearly billing cycle, which brings the cost per dose to nearly $1.00. You could then temporarily cancel your Hims subscription until you make your way through that stock of 360 doses and reinstate it whenever you need more. Canceling and restarting through Hims carries no financial penalty. That said, BlueChew offers a free month of as-needed tadalafil as a way to test their service; all you pay is a small shipping fee. Both BlueChew and Hims lag behind Rocket Rx’s pricing for as-needed tadalafil at 10mg and 20mg doses, however. So, the provider that’s best for you will have a lot to do with the dose you need and whether you want to take tadalafil daily or as needed. Here’s how those prices compare, with lower prices often coming from extended billing cycles (quarterly, biannually, etc.): If you’re new to ED meds and want to try as-needed tadalafil at a dosage no stronger than 5mg, then tadalafil from Hims could conceivably be your most economical option. That’s because you could request daily tadalafil tablets on a yearly billing cycle, which brings the cost per dose to nearly $1.00. You could then temporarily cancel your Hims subscription until you make your way through that stock of 360 doses and reinstate it whenever you need more. Canceling and restarting through Hims carries no financial penalty. That said, BlueChew offers a free month of as-needed tadalafil as a way to test their service; all you pay is a small shipping fee.
That means you can see if these medications work for your ED for a $5 shipping charge. So, if you want to maximize your savings and you don’t mind the hassle of dealing with two or three companies, your path may look something like this: Try BlueChew’s 6mg tadalafil chews (as needed) to see if the medication is effective for you. If it is, consider switching to Hims (either chews or pills) to get the best price per dose on your medication. If you find you need a stronger dose, you can head to Rocket Rx, which has the best prices for 10mg and 20mg doses. The window of effectiveness requires a bit of planning Loses efficacy when you take it with meals Mild side effects, such headaches, are more common than with other treatments like Stendra Most people can’t predict with complete certainty whether or not they’ll have sex on any given day.
Even if you’re accustomed to daily intercourse, your partner could get sick, you could strike out at the club, or your in-laws could pay you a surprise visit. For that reason, some men prefer not to take a daily tablet of Cialis or tadalafil when the prospect of sex is not guaranteed. Even if you’re accustomed to daily intercourse, your partner could get sick, you could strike out at the club, or your in-laws could pay you a surprise visit.
That means you can see if these medications work for your ED for a $5 shipping charge. So, if you want to maximize your savings and you don’t mind the hassle of dealing with two or three companies, your path may look something like this: Try BlueChew’s 6mg tadalafil chews (as needed) to see if the medication is effective for you. If it is, consider switching to Hims (either chews or pills) to get the best price per dose on your medication. If you find you need a stronger dose, you can head to Rocket Rx, which has the best prices for 10mg and 20mg doses. The window of effectiveness requires a bit of planning Loses efficacy when you take it with meals Mild side effects, such headaches, are more common than with other treatments like Stendra Most people can’t predict with complete certainty whether or not they’ll have sex on any given day. For that reason, some men prefer not to take a daily tablet of Cialis or tadalafil when the prospect of sex is not guaranteed.