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Over-the-Counter Viagra & ED Drugs: Why They Aren’t Worth the Risks

Jill Johnson

Medically reviewed by Jill Johnson, FNP

Written by Our Editorial Team

Last updated 8/26/2022

When you have a cold, you probably head to the drug store to buy cough medicine and throat lozenges. If you have a headache, you might pick up some acetaminophen or ibuprofen. 

Over-the-counter medications are available for a wide range of ailments, and the fact that they are usually inexpensive and easy to come by makes them convenient to use.

But what about over-the-counter erectile dysfunction medications that are marketed as working like Viagra®? Can these help to improve your erections and sexual health, all without any need for a prescription?

Not quite. Not only are many over-the-counter Viagra alternatives ineffective, but investigations into these products have found that they often contain unlabeled, unsafe ingredients. 

Below, we’ve explained the process of getting a prescription for Viagra (sildenafil) and other ED medications. 

We’ve also discussed over-the-counter “Viagra substitutes” and why these are best avoided in favor of real, proven options for ED, including brand-name Viagra and generic medications like sildenafil.

Can You Get Viagra Over the Counter?

Viagra is a prescription drug used to treat erectile dysfunction. So, if the question you’re asking is whether or not you can buy Viagra over the counter, the answer is no -- you’ll need to have a prescription from your healthcare provider. 

However, many “online pharmacies” claim to sell over-the-counter Viagra. Many times, this is a counterfeit medication that should be avoided at all costs. Many of these products not only use false ingredients, but are often made in unsafe, unsanitary conditions. 

Since they’re sold without a prescription, they may be particularly unsafe if you use other types of medication, especially for hypertension (high blood pressure) or heart disease.

The good news is that if you have erectile dysfunction (ED), getting a prescription for Viagra or similar medication isn’t as difficult, or as jarring, as you might think.

In fact, it’s something that you can do with ease, either by talking to your primary care provider, scheduling an appointment with a urologist or connecting with a licensed healthcare provider to access ED medication using our online platform. 

That said, affordability and the hassle of obtaining a prescription drug drive many men with ED to seek out other options, which sometimes include over-the-counter (OTC) erectile dysfunction drugs or “Viagra substitutes.”

What are Over The Counter Viagra Substitutes?

Search online for terms like “over the counter Viagra” and you’ll find page after page advertising Viagra “substitutes” that are available without a prescription.

Most of these products are supplements that haven’t been tested or approved by the FDA. For the most part, there’s no proof that they provide any real benefits for your sexual performance, or that they work effectively in the treatment of erectile dysfunction.

As well as online marketplaces, lots of Viagra substitutes are often sold at convenience stores, in gas stations, in local sex stores and in other local shops. 

However, as we mentioned above, since Viagra is an FDA-approved prescription medication, it isn’t something that you can find in these locations. 

Most over-the-counter Viagra substitutes usually contain herbal ingredients such as horny goat weed, ginseng and L-arginine. These pills are sold under a variety of brand names, from Rhino pills to Nizagara 100

The most recent scientific evidence on the effectiveness of these herbal ingredients is mixed, at best, with most performing no better in testing than placebos. 

Put simply, there’s very little evidence that these herbal supplements have any real benefits for erections, sexual desire or general sexual activity. As such, it’s best not to rely on them as any type of reliable treatment for ED.

In addition to their lack of effects, it’s especially important to avoid over-the-counter alternatives to Viagra due to the large amount of unknown, frequently unlabeled ingredients that are used in these products.

Not only are these supplements unlikely to work, but the few that do work are often spiked with drugs that aren’t legal to sell without a prescription.

This means that you face a real risk of experiencing drug interactions if you use these products with other prescription medications. 

So, when it comes to the questions, “Is Viagra over the counter?” or “Can you get Cialis without a doctor prescription?,” the answer is a definitive no. If you see over-the-counter Viagra, or any type of cleverly marketed “Viagra substitutes,” it should be avoided at all costs.

Popular Over-the-Counter ED Drugs and Risks

Let's get down to specifics. If you take a stroll through the aisles at your local drug store, you’ll probably come across a variety of options for over-the-counter erectile dysfunction supplements. 

Some OTC ED pills on the market include:

  • Extenze®

  • Libido Max®

  • Male Extra®

  • Virectin®

  • VigRX Plus®

When shopping for OTC erectile dysfunction remedies, you’ll find that most products are marketed as “male enhancement” pills. 

Many of these products claim to be designed for more than just boosting erectile function — some of them also claim to increase stamina, improve libido and boost testosterone levels. In the nutshell, they’re all billed as over the counter ED pills that work fast. But not quite. 

Below, we’ve taken a closer look at these over-the-counter male enhancement products and supplements.

Extenze

One of the more popular male enhancement products on the market, Extenze claims to be 100 percent natural and more effective than other products.

However, these claims don’t seem to hold water, as most of the ingredients in Extenze have not been proven to be safe or effective. The company has faced multiple lawsuits that challenge the legitimacy of the product’s claims -- most notably, that it can increase penis size.

Finally, there’s an FDA notice against Extenze, which states that the company’s products have been found to contain undeclared amounts of sildenafil, a well-known erectile dysfunction drug most commonly found in Viagra.

This is a serious concern, as the unlabeled sildenafil in Extenze may cause drug interactions if you use certain types of prescription medication. 

Libido Max

Alleged to be made with natural ingredients such as L-arginine, horny goat weed and yohimbe, Libido Max is designed to improve the flow of blood around the body and function as a natural testosterone booster.

Like most dietary supplements, Libido Max isn’t formally approved by the FDA, nor does it face the same level of scrutiny as a medication. There’s also debate about how effective it is, with a variety of users giving it mixed reviews due to side effects and lack of efficacy. 

All in all, although it’s available over the counter, there’s no guarantee that Libido Max is safe to use, or that it’s in any way effective at treating erectile dysfunction.

Male Extra

Manufactured by Marlia Health Innovations in the UK, Male Extra claims to produce larger and harder erections while also enhancing sexual ability. 

This male sexual performance supplement features natural ingredients such as pomegranate, L-arginine and creatine, which are purported to improve circulation.

Although L-arginine and creatine may offer some performance benefits, there’s very little in the way of clinical research to suggest that they have any effects on erections, performance in bed or general sexual desire.

Virectin

Virectin is a supplement that’s designed to improve testosterone levels, boost libido and improve pleasure sexual activity. It’s promoted as containing 16 active ingredients, including amino acids and pro-sexual nutrients that dilate blood vessels and help with sexual function. 

Like other supplements, Virectin doesn’t go through any testing for efficacy before it reaches the market, and it can’t be marketed as treating or preventing any disease. 

As such, there’s a long, detailed disclaimer on the packaging that reads as follows: 

“These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.”

Alrighty, then. Although some of the active ingredients in Virectin may offer mild benefits, there isn’t any high quality evidence to suggest that it improves sexual arousal or treats issues such as erectile dysfunction. 

VigRX Plus

Marketed as the world’s “leading male enhancement product, VigRX Plus contains red ginseng, saw palmetto, ginkgo biloba and other ingredients that can supposedly stimulate sexual activity and help with maintaining a firm erection.

Like almost all other over-the-counter Viagra alternatives, VigRX Plus comes with the usual long disclaimer that explains that its marketing claims haven’t been evaluated by the FDA.

Interestingly, there is some research on the effectiveness of VigRX Plus. In one study published in the journal BMC Complementary and Alternative Medicine, researchers found that the herbal product was more effective than a placebo in improving sexual function in men.

However, there’s currently no reliable, high quality research that compares VigRX to established medications for ED, such as sildenafil or other PDE5 inhibitors

Vimax

Vimax is another popular supplement for treating erectile dysfunction and other forms of male sexual dysfunction. It’s marketed as a “100% natural product” that contains herbal ingredients for enhancing male virility.

However, like many other erectile dysfunction pills sold over the counter, Vimax also contains ingredients that aren’t listed on its label, namely prescription ED medications.

In a 2015 notification, the FDA warned consumers that Vimax contains tadalafil, an ingredient that’s found in the prescription ED medication Cialis®. 

These ingredients can cause safety risks, especially when they’re as long-lasting as tadalafil, which has a half-life of almost 18 hours. 

For example, like sildenafil, tadalafil can interact with many common medications for treating high blood pressure and chest pain. It’s also often unsafe to use tadalafil if you’ve previously had a heart attack or other cardiovascular event.

Because of these risks, it’s best to avoid any supplements that contain unlabeled ingredients and instead stick to proven, FDA-approved treatments. 

OTC ED Supplements with FDA Warnings 

As nutritional supplements, over-the-counter erectile dysfunction treatments aren’t held to the same standards as FDA-approved, real-deal prescription medications.

This means that just because you see something in the drug store or on an online marketplace, it isn’t necessarily safe. 

Over the years, the FDA has issued numerous health warnings about tainted over-the-counter male enhancement pills. In fact, the FDA has issued so many warnings that it maintains a large online database that lists tainted sexual enhancement products.

Products on the list include several of the supplements we mentioned above, as well as brands such as:

  • Man Up Now®

  • Stiff Nights®

  • Rock Hard Weekend®

  • Duro Extend Capsules For Men®

  • Vigor-25®

  • Magic Power Coffee®

  • Time Out®

  • Mr. Magic Male Enhancer®

  • Vitalex®

  • Xiadafil VIP Tabs®

What is it about these products that made the FDA issue a health warning? For many of them, it was a problem with the purity or safety of the ingredients. 

For example, the product “Man Up Now” is made with sulfoaildenafil, a synthetic chemical that’s similar to the active ingredient in Viagra, sildenafil.

Some of these over-the-counter pills contain more than one active ingredient (for example, both sildenafil and tadalafil), meaning they may have a higher risk of causing side effects and/or drug interactions than the real medications. 

Others may contain unsafe, poorly measured doses of active ingredients that make them twice as strong as the highest-dose Viagra or Cialis tablets. 

For example, the FDA demanded that the manufacturers of “Mr. Magic Male Enhancer” take the product off the market because the two main ingredients, which were illegal sildenafil analogues hydroxyhomosildenafil and sulfoaildenafil, were not declared on the list of ingredients.

Many of these products have been found to contain other chemicals, some of which have yet to undergo testing. 

It’s important to keep in mind that a product being described as “natural” or as a “herbal remedy” doesn’t necessarily mean that it’s safe.

Health claims like this aren’t closely regulated, and there’s no official FDA-approved definition or checklist that manufacturers need to follow. Even in nature, certain substances can be harmful if misused or consumed in significant doses. 

This is concerning because many of these hidden ingredients can cause real problems if they’re used with other medications.

For example, all of the PDE5 inhibitors currently available to treat erectile dysfunction can cause interactions when used with medications for hypertension and some heart conditions, such as a risk of sudden decline in blood pressure. 

These issues can occur even with FDA-approved, legally prescribed medications. However, the process that you need to go through to access these medications, which involves talking to your healthcare provider, gives you a chance to learn about these potential issues.

It also lets you and your healthcare provider discuss things and find out if you’re currently using medications that could cause interactions, or if you have any underlying medical conditions that could make ED medications unsafe.

Not only can you discuss these issues, but your healthcare provider can choose a dosage that’s appropriate for you based on your needs and health conditions. 

This process isn’t available when you use an over-the-counter supplement. Not only are most of these potentially harmful ingredients not properly listed on the product labeling, but they’re often included in unsafe doses.

As such, it’s important to exercise caution if you’re considering an “all natural” over-the-counter alternative to Viagra. Keep the risks in mind if you’re trying to justify the lower price tag, or ease of access, compared to the prescription “little blue pill.” 

What About Natural Remedies for ED?

In addition to the over-the-counter ED drugs discussed above, there are also several nutritional and herbal supplements and natural remedies for ED that many men turn to for better erections  and sexual function.

Research on the benefits of natural ED treatments is mixed overall, although some products do appear to offer some benefits for sexual performance. 

Dehydroepiandrosterone (DHEA)

Dehydroepiandrosterone, or DHEA, is a hormone that’s produced by the adrenal cortex. It’s an important precursor for several sex hormones, including testosterone.

DHEA appears to decline with age, with low DHEA levels linked with an elevated risk of erectile dysfunction. Although research findings are inconclusive right now, some studies suggest that DHEA may have an effect on receptors that manage blood flow to the penis.

However, there isn’t yet a clear link between DHEA supplementation and improved erections of sexual performance.

L-arginine

Another supplement that may have an impact on erectile function is L-arginine, an amino acid that helps boost nitric oxide production in the body.

Nitric oxide plays a role in relaxing the corpora cavernosa -- the smooth muscle located inside your penis that plays a major role in producing erections. 

The precise role of L-arginine in nitric oxide production and erections is complex, but research suggests it may be useful as a treatment for mild ED.

For example, a meta-analysis published in the Journal of Sexual Medicine, which looked at 10 different randomized controlled trials, noted that arginine supplements may provide benefits for men with mild to moderate ED.

Our full guide to L-arginine and erectile dysfunction goes into more detail about how L-arginine works within your body, as well as its potential effects on your erectile health. 

Pycnogenol

Pycnogenol, a nutritional supplement derived from French maritime pine bark extract, may offer similar benefits for erectile dysfunction. In fact, pycnogenol and L-arginine are sometimes used together in natural supplements for ED. 

One study, which was published in the Journal of Sex & Marital Therapy in 2003, looked into the effects of L-arginine and pycnogenol as a combined treatment for erectile dysfunction.

The researchers found that men with erectile dysfunction who used a supplement that contained L-arginine and pycnogenol showed improvements in sexual function after three months of use.

By the end of the three-month study, 92.5 percent of the men that participated had experienced a normal erection.

Yohimbe

Yohimbe is a type of tree that’s native to central and western Africa. It’s widely used as a natural supplement thanks to the presence of yohimbine -- a traditional aphrodisiac -- that’s found in the tree’s bark. 

Although scientific research on yohimbe and erectile dysfunction is mixed overall, some studies have found that it may offer benefits for men with sexual performance issues.

For example, a recent review published in the Turkish Journal of Urology, which used data from eight studies, found that yohimbine -- the active ingredient in yohimbe -- was associated with an improvement in erectile function when it was used in combination with other treatments.

However, the researchers also noted that yohimbe wasn’t fully effective as a treatment for male sexual function issues when it was used on its own.

Propionyl-L-carnitine

Propionyl-L-carnitine, or PLC, is a natural supplement that’s widely promoted for its potential to increase energy levels.

Although research on propionyl-L-carnitine on its own isn’t conclusive, several studies suggest that it may offer benefits for erectile function when used with other ED medications. 

For example, one study published in the journal Current Medical Research and Opinion found that men with erectile dysfunction showed larger improvements with propionyl-L-carnitine and sildenafil (the active ingredient in Viagra) than with sildenafil alone.

Other Supplements

Other supplements that may help to increase blood flow and improve sexual function include:

  • Ginseng

  • Ginkgo biloba

  • Rhodiola rosea

  • Horny goat weed

Although these remedies may have some promise, it’s important to keep in mind that they, as well as other natural supplements, aren’t evidence-based medications, nor are they approved by the FDA to treat any type of disease. 

This means that they haven’t been thoroughly tested for efficacy and safety in the precise way that FDA-approved drugs have. 

Because of this, it’s important to talk to your healthcare provider before using any supplement, natural remedy or other non-medication product to treat erectile dysfunction.

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What Should You Use to Treat ED?

While over-the-counter alternatives to Viagra might seem appealing, you’ll get better results -- and keep yourself safer -- by working with your healthcare provider to find the right medication for your erectile dysfunction.

By talking to your healthcare provider, you’ll be able to identify the underlying cause of your ED and determine the best type of treatment.

Prescription ED Medications

If you have erectile dysfunction that’s caused by a physical health issue, using ED medication to improve your erections might be the best option.

Currently, there are several safe and effective FDA-approved medications for treating ED. With a prescription from your healthcare provider, you can purchase ED drugs such as sildenafil (the active ingredient in Viagra), tadalafil (Cialis), vardenafil (Levitra®) or avanafil (Stendra®). 

These medications work by increasing blood flow to your penis, which can make it easier to get and maintain an erection when you feel sexually aroused. 

Some of these medications are designed for daily use to improve your erectile function over the long term, while others can be used as-needed. 

We offer several ED medications via our online platform, following a consultation with a licensed healthcare provider. This allows you to quickly and easily access FDA-approved medications for ED from home, without any awkward visits to your primary care provider’s office.

Lifestyle Changes

In addition to using medication, making simple changes to your habits and lifestyle can improve your erections and sexual performance.

For example, exercising regularly, eating a balanced diet, maintaining a healthy weight, quitting smoking and avoiding excessive alcohol consumption can all help to reduce the severity of ED and prevent it from returning in the future.

Our guide to naturally protecting your erection shares actionable techniques that you can use to improve your erections, sexual drive and general health. 

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Frequently Asked Questions about Viagra and OTC ED Drugs

Am I Too Young For a Viagra Prescription?

When Pfizer first sold Viagra to the public in the 1990s, it was mostly marketed to middle-aged and older men as a treatment for erectile dysfunction. 

As a result, the medication -- at least in its first few years on the market -- got a reputation as a treatment for men in their 40s, 50s, 60s and up.

The reality is that although erectile dysfunction becomes more common with age, it isn’t only a condition that affects middle-aged and older men.

More than 30 million men in the United States are affected by ED, including many men in their 20s and 30s. For many younger men, factors such as mental health issues and consumption of porn may play a role in the development of ED. 

If you’re in your 20s or 30s and are concerned about erectile dysfunction, Viagra and other ED drugs can be an excellent treatment option.

They’re safe, effective and completely suitable for younger men, meaning you’re not too young to consider using Viagra or a similar medication as a form of ED treatment.

How Does Viagra Work?

Viagra belongs to a class of medications called PDE5 inhibitors. It works by making it easier for blood to flow to your penis when you feel sexually aroused.

Erections are all about healthy blood flow. When you feel aroused, blood flows into tissue inside your penis called the corpora cavernosa. This increase in blood supply causes the tissue to get larger and firmer, creating an erection.

After you reach orgasm and ejaculate, the same process occurs in reverse, causing your penis to return to its normal size. 

Contrary to popular belief, Viagra and similar medications won’t cause you to get an erection if you aren’t aroused. Erectile dysfunction medications have no known effects on sexual arousal, meaning you’ll still need to be exposed to stimulation in order to get and stay hard. 

How Long Does it Take for Viagra to Work?

Viagra should be taken approximately one hour before sex. It’s normal for the brand-name and generic versions of Viagra to start working after 30 to 60 minutes, although it might take slightly longer for Viagra to work if you’ve recently eaten a high-fat meal.

What’s the Best Way to Get a Viagra Prescription?

You can get a prescription for Viagra or other medications for ED by talking to your primary care provider about your symptoms. They may perform a physical exam and talk with you about your sexual function and performance.

Make sure to answer your provider’s questions honestly. If appropriate, they may suggest using a medication such as Viagra to treat ED and improve your sexual function.

If you feel awkward talking to your primary care provider, or if you simply want to access Viagra from home, you can take part in a consultation online using our telemedicine platform.

If appropriate, you may receive a prescription for Viagra, Cialis or a similar type of medication to treat erectile dysfunction.

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The Final Word on Over-the-Counter ED Drugs

Viagra is a prescription medication, meaning you’ll need to talk to a licensed healthcare provider and receive a valid prescription before you can legally purchase and use it.

Because erectile dysfunction is such a widespread issue for men of all ages, it’s no wonder that there are so many medications out there to treat it, both prescription and over-the-counter.

Unfortunately, many of the over-the-counter alternatives to Viagra that are marketed online and sold in gas stations, sex stores and elsewhere aren’t effective. 

Worse yet, many of these over-the-counter products contain unlabeled ingredients that could be dangerous if used with other medications. As such, if you’re considering trying those gas station boner pills you saw for sale for just a few dollars, you should think again. 

Instead of using ineffective and potentially unsafe over-the-counter alternatives, consider using an affordable generic medication, such as sildenafil or tadalafil. We offer these medications via our online health platform as part of our range of erectile dysfunction treatments

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Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.