4 Best ED Pills of 2023: Which is Right For You?

Over the last 25 years, erectile dysfunction (ED) medications have become a common addition to the bedroom toolkit—helping hundreds of millions of men get hard and stay hard when it counts. 

While pills like Viagra®, Cialis® and Stendra® might look similar, they’re unique medications with their own strengths and weaknesses for dealing with ED

We’re broken down the advantages and disadvantages of each treatment—and how they work to help you get hard, maintain your erection, and improve sexual performance (and satisfaction).

The 4 Best ED Pills

Currently, only four pills on the market are scientifically-proven to improve erections and sexual performance in men with ED:

  • Sildenafil (the active ingredient in Viagra)

  • Tadalafil (the active ingredient in Cialis)

  • Vardenafil (the active ingredient in Levitra®)

  • Avanafil (a newer medication sold as Stendra)

These medications are approved by the FDA and belong to a class of drugs called PDE5 inhibitors, which improve the flow of blood to the tissue inside your penis. Making it easier for your penis to become firm and enlarged in response to sexual stimulation. To buy and use them as ED treatments, you’ll need a prescription.

Contrary to these medications, over-the-counter ED pills aren’t supported by any solid scientific evidence, and a few—including many of the ED pills sold in gas stations—are associated with serious safety risks that are best to avoid.

We’ve profiled all four FDA-approved ED treatments below, and which pill is best for each purpose.

Sildenafil (The Active Ingredient in Viagra)

Sildenafil is the OG prescription medication for erectile dysfunction. It came onto the market in the late ‘90s under the brand name Viagra and, for several years, was the only medication available for men with ED. 

Today, sildenafil is available in its generic version, meaning it’s much more affordable than when it first hit the market. It works quickly, provides relief from ED for several hours and is sold in just about every pharmacy, making it a reliable option for improving your sexual function.

  • Best for: Guys who want a reliable treatment option for ED, with a long track record and a good price per tablet.

  • Advantages: Sildenafil starts working in less than one hour and provides relief from ED for about four hours per pill, making it great for a single night.

  • Disadvantages: Sildenafil takes longer to work after a large, high-fat meal and can’t be taken more than once a day, making it less than ideal for twice-a-day (or more) sex. 

It can also cause side effects, including:

  • Headaches

  • Flushing

  • Dyspepsia (indigestion)

  • Changes in vision

  • Nasal congestion

  • Muscle soreness

  • Back pain

  • Nausea

  • Dizziness

  • Rash

However, it’s important to keep in mind that most side effects of sildenafil can also develop with other ED medications. 

Tadalafil (the Active Ingredient in Cialis)

Tadalafil is the active ingredient in Cialis, which was approved by the FDA as an ED medication in 2003. These days, it’s available in its generic form and as a brand name for use as-needed or as a daily tablet that improves blood flow and makes getting an erection easier.

Thanks to its very long duration of action — something we’ve discussed in more detail below — tadalafil is sometimes referred to as the “weekend pill” for treating erectile dysfunction.

Like sildenafil, tadalafil has a long track record. It’s been researched extensively, meaning both its effects and its side effects are well known.

  • Best for: Men who like a long-lasting pill to treat ED, allowing for spontaneous sex or sex more than once a day.

  • Advantages: Tadalafil lasts longer than any other ED treatment, with one pill providing relief from ED for approximately 36 hours. It can also be taken daily at a low dosage.

  • Disadvantages: Tadalafil might last longer than needed for many men. Tadalafil’s long duration of action means side effects may persist for longer than with other ED pills.

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Vardenafil (the Active Ingredient in Levitra)

Vardenafil is the active ingredient in Levitra, and was approved by the FDA in 2003. Vardenafil is similar to sildenafil but lasts longer, with research suggesting that it provides better blood flow and stronger erections for five to seven hours per dose.

  • Best for: Men who want a slightly longer-lasting ED medication than sildenafil, but don’t want the all-day effects of tadalafil.

  • Advantages: Vardenafil lasts for longer than sildenafil and usually starts working faster.

  • Disadvantages: Vardenafil is typically more expensive than sildenafil. Like sildenafil, it can only be taken one time per day. 

Vardenafil also has similar side effects to other ED drugs. Common adverse effects of vardenafil include:

  • Headaches

  • Flushing

  • Nasal congestion

  • Dyspepsia (indigestion)

  • Sinusitis (sinus inflammation)

  • Flu-like symptoms

  • Increased creatine kinase (CK) levels

  • Dizziness

  • Back pain

  • Nausea

Stendra (Avanafil)

Stendra contains the active ingredient avanafil, and is a newer ED medication that received FDA approval in 2012. 

Avanafil is a newer-generation PDE5 inhibitor that’s more selective than older ED pills about how it inhibits enzymes. It’s less likely to cause side effects than older medications and begins working faster. However, it’s only available under the brand name Stendra, with no generic. 

As a second-generation PDE5 inhibitor, Stendra offers several advantages over older drugs for treating erectile dysfunction.

  • Best for: Men who want a fast-acting ED pill that can be taken almost right before sex, without having to worry about avoiding certain foods.

  • Advantages: Stendra acts quickly — often in as little as 15 minutes — and is less likely to cause side effects than older ED pills. 

  • Disadvantages: Stendra isn’t available as a generic medication, meaning it costs more per tablet than other ED drugs. While side effects are less common, they can still occur. 

Although certain side effects are less common with avanafil than with older medications for ED, they can—and often do—still occur. Some of the most common side effects of avanafil include headache, flushing, back pain, nasal congestion and nasopharyngitis (cold-like symptoms in the nasal passages).

ED treatments, delivered

No matter the treatment plan, the best place to start is somewhere.

New

Hard Mints by Hims

Combination Chewable Treatment

From £3/use

These mint-flavored chewables are packaged in a discreet portable tin. Our personalised treatments contain active ingredients used to treat ED at different dosages to meet your specific needs.

Traditional Pill

SildenafilGeneric Viagra®

From £2.25/use

The most commonly prescribed ED treatment, contains the same active ingredient as Viagra® but is 80% more affordable than the brand name.

New

Hard Mints by Hims

Daily Chewable Treatment

From £26/month

These mint-flavored once-daily chewables are packaged in a discreet portable tin. Our personalised treatments contain active ingredients used to treat ED at different dosages.

Traditional Pill

Daily TadalafilDaily Generic Cialis®

From £21/month

A clinically proven treatment for erectile dysfunction that helps men achieve and maintain erections more easily. It gives you the freedom to enjoy spontaneous sex without needing to plan ahead.

Traditional Pill

As-Needed TadalafilGeneric Cialis®

From £2.25/use

The unbranded, more affordable generic form of Cialis® taken as needed. It is clinically proven to help men get and keep harder erections for up to 36 hours.

Traditional Pill

Viagra Connect®

From £5.83/use

The over-the-counter branded version of sildenafil. Viagra Connect® improves blood flow to the penis, helping you achieve and maintain strong and satisfying erections.

Important safety information for Sildenafil, Tadalafil, Tadalafil Daily or Viagra Connect.

ED Pill Interactions and Risks

Sildenafil, tadalafil, vardenafil and Stendra are all safe and effective medications when they’re used as prescribed.

However, all medications for ED have the potential to interact with other medications, including several medications for hypertension (high blood pressure) and heart disease.

If you’re considering using any type of ED medication, you’ll need to be aware of the following potential drug interaction: 

  • Nitrates. When used with nitrates, ED medications can cause a sudden drop in blood pressure that may be life-threatening. Nitrates include nitroglycerin and poppers used for recreational purposes.

  • Antihypertensives. Certain other medications used to treat high blood pressure, such as alpha blockers, may interact with ED medications.

  • CYP3A4 inhibitors. Medications that inhibit the enzyme CYP3A4, such as some protease inhibitors, antifungals and antibiotics, may cause interactions when used with ED pills.

Although very uncommon, ED medications may also cause priapism—prolonged, painful erections that can damage the tissue of your penis. It’s important to seek medical help as soon as you can if you develop a persistent and/or painful erection. 

Before you use any type of ED medication, make sure to talk to your healthcare provider about any medications you currently use, as well as any medical conditions you have. 

Our guides to sildenafil interactions, tadalafil interactions and avanafil side effects discuss these safety risks in more detail and explain how you can use ED medication safely. 

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What’s the Best Erectile Dysfunction Medication?

Since ED symptoms can differ from person to person and everyone’s needs are different, there isn’t a “best” erectile dysfunction pill for every man.

Each sex pill offers a slightly different experience, from a longer duration of action to a reduced risk of side effects. 

If you’re considering ED medication and don’t know which pill is best for you, you’ll want to keep the following in mind: 

  • Sildenafil (Viagra) and vardenafil (Levitra) are short-acting, “one-night” ED medications that are both available as generics, making them good medications to try first.

  • Tadalafil (Cialis) is much longer-lasting and is a good option if you prefer “all day” relief from erectile dysfunction.

  • Stendra (which contains the ingredient avanafil) is newer, kicks in fast and doesn’t cause as many side effects as older ED pills, but costs more per tablet. 

Above all, you’ll want to provide as much information as you can about your symptoms to your healthcare provider, then closely follow their recommendations to get the best results from any ED medication. 

Used right, ED pills can do more than just give you firmer erection—they can also boost your self-confidence in bed

Need help getting started? We offer a full range of FDA-approved medications for ED, following a consultation with a healthcare provider, who will determine if a prescription is appropriate.

We also provide chewable ED meds, which are personalized using several active ingredients to match your specific symptoms and needs.

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 or medication.

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