ED Medications: Options, Safety, and How to Choose

ED is common — nearly half of men over 50 notice it at times. If you're reading this, you want practical options, not a long medical essay. Below you'll find clear choices, safety checks, and steps to pick what fits you.

First, the pill options: sildenafil (Viagra), tadalafil (Cialis/Tadalista), vardenafil (Levitra) and avanafil (Stendra). These are PDE5 inhibitors. Sildenafil and vardenafil work fast and last about 4–6 hours. Tadalafil can work up to 36 hours and also has a daily low-dose option. Avanafil often starts working within 15–30 minutes. Most people try one of these first because they are effective and easy to use.

Other treatments that work

If pills don't help or you can't take them, there are other choices. Injections (alprostadil) into the penis give reliable results in minutes. A small urethral suppository is another option for on-demand use. Vacuum erection devices use a pump and a ring to keep blood in the penis; they are drug-free and useful when medications fail. For severe, lasting ED, penile implants are a surgical solution with high satisfaction when other methods fail.

Safety, interactions, and side effects

Don't mix PDE5 drugs with nitrates — that combo can dangerously drop blood pressure. Tell your doctor if you take nitrates, alpha-blockers, or certain HIV and heart medicines. Common side effects include headache, flushing, stuffy nose and mild upset stomach. Rare but serious risks are sudden vision loss, hearing loss, or an erection lasting more than four hours (priapism). Seek emergency care for those.

Start low and go slow. Many providers recommend a low dose first, then adjust. Tadalafil has a daily option that suits couples who prefer spontaneity. Generics (sildenafil, tadalafil) offer the same active drug at lower cost in most cases.

Common starting doses are: sildenafil 50 mg (range 25–100 mg), tadalafil 10 mg or 5 mg daily, vardenafil 10 mg, and avanafil 100 mg. Try a medication three to four times before deciding it doesn't work — timing, full meal size, and stimulation affect results. If you buy online, verify the pharmacy license, look for a pharmacist phone number, and check packaging and expiry dates when the meds arrive. If side effects are strong or you have heart disease, stop the drug and call your provider and book a follow-up soon.

Buying tips: use licensed pharmacies and expect to show a prescription. Avoid sites that sell ED meds without a doctor review — many of those sell counterfeit or unsafe products. Check pharmacy reviews, look for secure checkout, and compare generic names not just brand names.

Small changes help too. Losing weight, cutting back on alcohol, quitting smoking, and managing stress or anxiety often improve erections. Pelvic floor exercises can help men with mild ED.

If ED is sudden, painful, or linked to chest pain, shortness of breath, or fainting, get immediate medical care. For ongoing problems, see a doctor who can check hormones, blood sugar, and heart health and help pick the best treatment for your situation.