Exploring Different Brands of Prescription ED Medications
Here’s a quick look at some of its simpler combination chewables: Hims also offers more novel combinations that slightly outperform those Rugiet recently added to its catalog.
| Tests | Purpose | When Recommended | Typical Time Frame | Who Performs It |
|---|---|---|---|---|
| Blood Tests | Hormone levels, health markers | Initial diagnosis | 1-2 days | Primary care doctor, endocrinologist |
| Nocturnal Penile Tumescence Test | Determine physiological vs. psychological ED | Persistent issues | 1 night monitored | Urologist |
| Ultrasound Doppler | Blood flow assessment | When vascular issues suspected | 30 mins | Urologist or specialist in vascular health |
This product combines daily tadalafil (likely as a 2.5mg or 5mg dose) with an unspecified dose of fluoxetine, a prescription selective serotonin reuptake inhibitor (SSRI) that’s been studied for years in the context of premature ejaculation.26 Like Climax Control, this Sex Rx product uses daily tadalafil as its ED-fighting base, combined with oral finasteride and oral minoxidil.
Things to keep in mind before starting erectile dysfunction pills
The obvious downside to Rugiet is its cost. You can opt for larger shipments to reduce your cost per dose, and that can save you over 30%, but it results in significant up-front costs. For example, a monthly six-pack of medium strength Ready is $99. To get the best cost per dose, you can get 12 of those six-packs shipped to you quarterly for $799. That’s a lot of savings, but it’s likely cost-prohibitive for many men.
Is there a “female Viagra”?
To learn more about Rugiet’s offering, check out our comprehensive review of their services. Rugiet has also expanded its catalog to include a daily tadalafil combined with DHEA to boost testosterone, but we don’t regard DHEA as a very good option for improving testosterone levels with an OTC treatment. You can also get a combination of tadalafil with either minoxidil or paroxetine to treat hair loss or premature ejaculation concurrently with ED, but both treatments have less tadalafil in them than comparables from Hims. Hims has led ceridaviescampaigner co uk the way in the chewable combination space since they introduced their Hard Mints and Sex Chews. Recently, the company has expanded these efforts to introduce several new combination treatments that combine common ED medications with ingredients to treat hair loss, premature ejaculation, and more. It’s unclear at this time if the medication can be delivered with just one of those two hair loss medications, but both have been shown to be very effective as oral treatments.27 Again, this drug combination starts with tadalafil, and Hims has combined it with atorvastatin, a statin designed to reduce your risk of certain cardiovascular events, like myocardial infarction.28 Then there’s Roman’s combination sex chew offering, called Sparks, which is only available as a combination of 22mg tadalafil and 55mg sildenafil for the constant rate of $12/dose. That 22mg tadalafil dose is much higher than we’d recommend for men new to ED medications.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Levitra Professional | 20mg | 90 + 2 Pills | 304.49€ 289.99€ | |
| Viagra Generic | 100mg | 360 + 10 Pills | 330.21€ 314.49€ | |
| Viagra Super Active | 100mg | 10 Pills | 28.76€ 27.39€ | |
| Kamagra Gold | 50 mg | 84 + 6 Pills | 224.77€ 214.07€ | |
| Levitra Generic | 40mg | 20 Pills | 67.56€ 64.34€ | |
| Cialis Generic | 40mg | 270 + 10 Pills | 382.19€ 363.99€ | |
| Viagra Original | 100mg | 14 + 2 Pills | 89.03€ 84.79€ | |
| Cialis Generic | 2.5mg | 270 + 10 Pills | 199.64€ 190.13€ | |
| Kamagra | 100mg | 60 + 4 Pills | 201.34€ 191.75€ | |
| Cialis Professional | 20mg | 60 + 2 Pills | 183.83€ 175.08€ | |
| Kamagra Polo | 100 mg | 180 + 8 Pills | 446.52€ 425.26€ | |
| Kamagra 100 mg | 100 mg | 20 Pills | 86.09€ 81.99€ | |
| Viagra Generic | 50mg | 30 + 4 Pills | 54.26€ 51.68€ | |
| Cialis Original | 20mg | 92 + 4 Pills | 377.99€ 359.99€ | |
| Kamagra Gold | 50 mg | 180 + 6 Pills | 371.27€ 353.59€ |
If you’re used to taking such a high dose, this might be a viable product, but there are superior options with more flexible dosing for lower prices from Hims. BlueChew Max combines tadalafil with either sildenafil or vardenafil, depending on your preference, making it a superior choice for men interested in putting those two together without adding apomorphine to the mix. BlueChew Gold expands in the opposite direction, combining the three medications seen in Rugiet Ready and adding oxytocin to the mix.
Adverse effects
Stendra is also our top choice for couples who enjoy morning sex. Tadalafil taken in the morning can sometimes require about an hour before it is fully effective. This experience with tadalafil varies — some men find tadalafil to be effective for a full 36 hours (which would make the prior morning’s dose still effective), while others find its effects wear off in closer to 18 hours. If you are in the latter camp, Stendra will be better for your morning rituals because you can take a dose as you wake up and then be ready for fun in as little as 15 minutes. However, Stendra will cost you significantly more than sildenafil or tadalafil.
What happens with ED?
Hims — our top choice for convenient access to Stendra — offers a monthly subscription for four 100mg Stendra tablets at $210 per month, billed quarterly. If you can afford the cost, this may be the best choice for you. If not, then we’d suggest you explore daily tadalafil. There are three standard dosage options for Stendra: Both the 100mg and 200mg dosages take effect in about 15 minutes. Sublingual dose requires no water to take FDA-approved for use in Parkinson’s patients May cause fainting in a small fraction of users Nausea is a common initial side effect Hard to find outside Rugiet’s blended ED treatment Apomorphine has been used since the 19th century as everything from a sedative to an aid in kicking heroin addiction, and it’s currently FDA-approved for treating Parkinson’s disease. Oral oxytocin boasts some evidence for improving female sexual desire, and its reputation as “the love hormone” implies that these effects could work just as well in men. But there’s not enough science backing this up just yet. That said, as we’ll discuss soon, mental health plays a big role in ED, and oxytocin has been shown to help in cases of anxiety and depression.
| Brand Name | Active Ingredient | Typical Dosage | Onset of Action | Duration | Common Side Effects | Approved Countries |
|---|---|---|---|---|---|---|
| Viagra | Sildenafil | 50 mg, 100 mg | 30-60 minutes | 4-6 hours | Headache, flushing | US, UK, EU, Canada |
| Cialis | Tadalafil | 10 mg, 20 mg | 30-60 minutes | Up to 36 hours | Muscle pain, headache | US, UK, Australia |
| Levitra | Vardenafil | 10 mg, 20 mg | 25-60 minutes | 4-5 hours | Nasal congestion, flushing | US, EU, Japan |
So, it’s possible that the oxytocin in Gold is there to address potential psychiatric complications around ED, rather than physiological ones.46 Given the current state of available doses, we don’t recommend combination therapies to men who haven’t tried ED medications before.
- Sildenafil is typically taken 1 hour before sexual activity.
- Tadalafil as-needed is taken at least 30 minutes prior, daily dose is taken same time daily.
- Vardenafil should be taken 25-60 minutes before sexual activity.
- Avanafil can be taken as early as 15 minutes before, with a window up to 30 minutes.
- High-fat meals can delay sildenafil and vardenafil absorption by up to 1 hour.
- Tadalafil daily dose (2.5mg or 5mg) allows for spontaneity without timing concerns.
- Do not take double doses if one tablet does not work; consult your doctor instead.
- Some men may experience nasal congestion or dizziness as side effects.
- Keeping a log of effectiveness and side effects can help optimize treatment.
- Patience is key; it may take a few attempts to find the right medication and dose.
If you discover that a monotherapy can work for you, there’s no reason to add another medication to the picture.
- Herbal and OTC supplements may not be FDA-approved.
- PDE5 inhibitors are the main class of ED drugs.
- Some ED tablets are available without a prescription in certain countries.
- Keep medications out of reach of children.
- Psychological counseling can complement medication treatment.
- Physical exercise can improve blood flow and ED outcomes.
- Side effects can include dizziness and vision changes.
- Combining ED tablets with recreational drugs is risky.
- Proper hydration can influence medication absorption.
- Not all ED conditions require medication; lifestyle may help.
- Document any adverse reactions to your healthcare provider.
- Regular check-ups help monitor cardiovascular health.
If you’ve tried monotherapies and had poor or mixed results at various doses, a combination therapy might be the way to go.
Stronger erections, better sex
If you’re looking for ED medications that aren’t technically PDE5 inhibitors (which sildenafil, tadalafil, and vardenafil all are), this may be a viable route. We’ll discuss these combination offering in our next section, which is all about combination therapies. May improve outcomes in men resistant to monotherapies Can offer treatment outside of just PDE5 inhibitors May increase the risk of side effects Combination therapies are exactly what they sound like: some combination of commonly prescribed ED medications. Studies have shown that certain combinations can be more effective than a monotherapy on its own.23 As with monotherapies, the exact combination and dosing will be a matter for your physician to prescribe. Combination therapies have become more popular among the providers in this guide.
Can you use baking soda for erectile dysfunction treatment?
Rugiet was the first to offer multiple drugs in a single product with its lozenges, but Hims and Roman soon followed suit. And BlueChew’s recently developed Max and Gold products combine several ED therapies into a single chewable tablet. Let’s start with Rugiet since it kicked off the combination craze with its product, Rugiet Ready. The specific combinations available to you from Rugiet depend on the results of your doctor’s consultation, but here’s a look at their standard mixes: As you can imagine, combining these three medications theoretically increases the chances that they will work for you quickly and remain active in your system for up to 24-36 hours (as long as tadalafil is one of them). However, side effect risks may also increase as you combine medications. In that case, we’d recommend starting with Hims, where you can choose between numerous combinations at slightly better prices and more reasonable doses than you’ll find from Roman, BlueChew, or Rugiet.
- ED tablets are not a cure but a temporary aid.
- Some men experience a 'headache' as a common side effect.
- Dietary supplements claiming instant results may be untrustworthy.
- Men should inform their doctor of all medications used.
- ED may be a symptom of underlying health issues.
- Using ED drugs without prescription carries risks.
- Sildenafil was originally developed for angina.
- Psychological factors like stress affect erection quality.
- Men with anatomical issues may require alternative treatments.
- Be aware of possible interactions with family medicines.
- Discontinuing medication suddenly can cause rebound effects.
- Combining therapies can sometimes provide better results.
Our testing also confirmed that Rugiet lozenges are susceptible to high temperatures and may melt if left in a hot car or even outside on a hot enough day. That makes them less ideal for certain situations and climates than more durable chews from Hims or Roman.
5 ways to treat ED that eliminate the need to take a pill
However, multiple studies indicate its potential as a treatment for ED.16 The name can be a source of confusion since most people outside the medical professions would likely hear the “morphine” part and assume opioid properties. But apomorphine doesn’t bind to opioid receptors and is nonaddicting. For Parkinson’s patients, apomorphine is delivered via subcutaneous injection at doses often higher than those used in ED treatment. Studies into its use for Parkinson’s revealed intense nausea as a potential side effect — often to the point that doctors would have to prescribe an antiemetic to deal with nausea and vomiting. ED patients taking apomorphine as a sublingual film — or, in the case of Rugiet, a lozenge — may also experience some nausea, but this appears to decline with regular use.17 Apomorphine appeared on target to become a viable alternative to Viagra in 2000, but the manufacturers behind its two branded forms intended for ED patients pulled it from FDA consideration despite what appeared to be a sure path to approval.
Everything you need to know
They cited the need for further study, particularly into the drug's interaction with nitrates and its potential to cause fainting in less than 0.2% of trial participants. Today, apomorphine remains FDA-approved for Parkinson’s disease but is only prescribed for ED treatment as an off-label use. The only major providers we recommend that offer apomorphine in any form are Rugiet and BlueChew, but they typically combine apomorphine with tadalafil and sildenafil in a lozenge. That lozenge’s sublingual administration may decrease the time it takes to fildena super active 150mg start working. It’s possible to get apomorphine-only lozenges from Rugiet, but they only come in the 3mg dose at a cost of $30 for six doses. With up to 40% of ED cases proving to be psychological in origin, a large number of men can find relief through mental health care, whether that’s talk therapy, psychiatry, or a combination of the two.44 You can try to find an in-person therapist or psychiatrist, but the industry has largely moved online over the last several years, so we’ll focus this section on teletherapy resources for mental health that can help men address psychogenic ED. While Cerebral is a little more expensive than some excellent competitors, it offers plans for talk therapy, psychiatry (medication access), or both. That makes it a great place to start for men concerned with psychological issues leading to ED, as they can start with talk therapy and expand their care to include medication if it becomes necessary, without having to switch to another platform. Cerebral also works with several insurance companies, so there’s a good chance you’ll only have co-pays to worry about if you’re covered.
| Medication | Average Cost per Dose | Cost for a 30-Day Supply | Over-the-Counter Options | Cost Range | Notes |
|---|---|---|---|---|---|
| Viagra (Brand) | $30-$50 | $900-$1500 | - | High | Prescription required |
| Generic Sildenafil | $1-$5 per tablet | $30-$150 | - | Low | Same effect as branded |
| OTC Supplements | $20-$70/month | N/A | Available online | Varies | Effectiveness is less certain |