Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 10/26/2020
Erectile dysfunction, or ED, is an extremely common condition, affecting as many as 30 millions Americans at any time.
Although ED is often thought of as something that affects older men, men of all ages often deal with erectile dysfunction. In fact, large-scale study data shows that as much as 40 percent of all men will deal with some degree of erectile dysfunction by the age of forty — and that number only increases over time.
Numerous medications are available to treat erectile dysfunction, from well-known medications such as sildenafil (the active ingredient in Viagra®, AKA generic Viagra) to newer, second-generation ED treatments such as avanafil (Stendra®).
Safety is an important factor to consider before using any type of medication. While all of the Food and Drug Administration-approved ED medications on the market now are safe for healthy individuals, there are a few side effects and drug interactions that you should be aware of before using any type of medication to treat ED.
Below, we’ve explained how these medications work, their common side effects, potential drug interactions and other key safety data that you should be aware of.
We’ve also answered some common questions regarding which ED medication is the safest for you to use, with a focus on factors such as side effects and general safety.
Currently, there are four medications on the market that have been approved by the Food and Drug Administration (FDA) for treating erectile dysfunction. They are:
Sildenafil (Viagra). Sildenafil, the active ingredient in Viagra, is the most well-known erectile dysfunction drug. It’s been available since the 90s and is now sold under the Viagra brand name and as a generic medication.
Viagra is designed for use as needed. You’ll need to take it shortly before sex as it lasts for about three to five hours in the body.
Tadalafil (Cialis®). Tadalafil, the active ingredient in Cialis, is a longer-lasting ED drug that can treat erectile dysfunction for up to 36 hours per tablet. Because it lasts for such a long time, it’s sometimes referred to as the “weekend” erectile dysfunction medication.
Tadalafil is available for use as needed or as a daily-use medication. Since it lasts for a long time in the body, it’s a good option if you want an ED treatment that you don’t want to remember to take a pill shortly before sex every time you’re in the mood. Like sildenafil, tadalafil is available as a generic drug.
Vardenafil (Levitra®). Vardenafil, the active ingredient in Levitra, is another popular ED drug. It works similarly to sildenafil but has a slightly longer half-life, lasting for about five to six hours at a time. Vardenafil is also available as a generic drug.
Avanafil (Stendra). Avanafil is a second-generation ED medication. It produces similar effects to sildenafil or vardenafil, but starts working faster, is less affected by your eating habits and is less likely to cause certain side effects.
Because it’s a relatively new medication, avanafil is only available under the brand name Stendra and isn’t yet sold as a generic drug.
All four of the medications listed above are only available with a prescription. If you have erectile dysfunction and think that one of the medications above may be suitable for you, you can talk to a healthcare professional online and, if appropriate, receive a prescription for an FDA-approved treatment.
All medications, including the four ED drugs listed above, undergo clinical testing to check that they’re safe before they’re approved by the FDA.
Sildenafil, tadalafil, vardenafil and avanafil are all safe for most people to use. However, like all medications, there are certain side effects and drug interactions that you should be aware of if you’re considering using any of these medications to treat ED.
Currently, all of the ED medications approved by the FDA are in a class of medications called PDE5 inhibitors. They work by inhibiting the action of PDE5, or cGMP-specific phosphodiesterase type 5 — an enzyme that regulates the flow of blood to the erectile tissue of your penis.
This dilates the tissue of your penis that’s responsible for producing erections. As more blood is able to flow in, you’ll find it easier to develop and maintain an erection even if you have ED.
All PDE5 inhibitors have the potential to cause certain side effects. Most side effects associated with erectile dysfunction drugs are mild and temporary. Some of the most common are:
Slightly reduced blood pressure
Although the precise rate of side effects can vary from drug to drug, these side effects are all pretty common with first-generation ED drugs such as sildenafil (Viagra), tadalafil (Cialis) and vardenafil (Levitra).
We’ve explained these side effects in more detail in our full guides to Viagra, Cialis, and Levitra side effects. If you want to learn more about these drugs from the FDA, we also made sure to link to the most recent and up-to-date FDA labels on each one above, as well.
As a PDE5 inhibitor, avanafil (Stendra) can also cause the side effects listed above. However, as a second-generation ED medication, it has a more targeted effect in the body that makes it less likely to cause these side effects.
For example, the most recent FDA label for Viagra notes that 28 percent of men experienced headaches after using the strongest Viagra dosage. In comparison, only 10.5 percent of men who used Stendra at the strongest dosage experienced this side effect.
Erectile dysfunction drugs are safe to use with most other medications. However, some other medications, such as alpha blockers and nitrates used to treat hypertension, can interact with ED medications to produce dangerous side effects.
Interactions can occur with all ED medications, including second-generation ED drugs such as avanafil (Stendra).
Before using any type of ED medication, it’s important that you inform your healthcare provider about other medications you use, including over-the-counter medications and herbal supplements. They may recommend a different type of treatment if there is a significant risk of interaction.
All four of the ED medications listed above are safe for most people to use. However, just like with other medications, all ED medications have the potential to cause certain side effects and drug interactions.
You can learn more about these side effects and interactions in our full guides to Viagra, Cialis, Levitra, and Stendra.
Before using any ED medication, talk to your healthcare provider about your symptoms, health history and any other medications you use. Your healthcare provider will recommend a safe, effective treatment that is best suited to your needs and health.
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