Firmer erections when you want them. One tablet about an hour before sex, reviewed by a US clinician.
$5.81/tabletBilled $209 every 90 days
Medication is charged only if your clinician prescribes it.
90-day supply
$5.81/tablet
Start with a $20 clinician review
82%
of men on 100 mg reported better erections, vs 24% on placebo (four trials, 1,797 men)
Source: Viagra prescribing information, section 14118 trials
and 31,195 men: oral ED tablets beat placebo for erectile function in a network meta-analysis
Source: Yuan J, et al. Eur Urol 2013;63(5):902-12 (systematic review and network meta-analysis)57%
of men with diabetes reported better erections on sildenafil, vs 10% on placebo (268 men)
Source: Viagra prescribing information, section 1452%
of men aged 40 to 70 had some degree of ED in a large 1987 to 1989 community survey
Source: Feldman HA, et al. J Urol 1994;151(1):54-61 (Massachusetts Male Aging Study)Trial results are for brand sildenafil (Viagra) and for approved ED tablets as a group. Our sildenafil is compounded by a licensed US pharmacy and was not studied in these trials. Individual results vary.
Firmer erections when you want them, from a clinician-reviewed prescription that arrives privately at your door.
Licensed clinician review
A US-licensed clinician checks your health history, blood pressure and medicines before prescribing.
Prescription sildenafil tablets
Compounded and dispensed by a licensed US pharmacy, in the 100 mg strength your clinician can halve.
Free, plain-packaged shipping
Ships 2 to 5 business days after approval.
Care-team messaging
Tell us how it went and your clinician can change the dose.
Free lab panel at month 3
Testosterone Check, as a progress check.
“I do not want to talk about this face to face.”
No appointment, no waiting room
Questions online, review within 24 hours, tablets at your door.
“What if it is too strong, or not enough?”
A dose you can adjust
Half a tablet or a full one, changed with your clinician after you try it.
“Is it safe with my other medicines?”
Blood pressure and medicine screening included
Nitrates, alpha blockers and heart history are checked before anything ships.
Testosterone Check
When you are aroused, your body releases nitric oxide, which relaxes the muscle in the penis and lets blood flow in. An enzyme called PDE5 then breaks that signal down. Sildenafil blocks PDE5, so the signal lasts longer and the erection comes more easily. It needs arousal to work and does not raise desire.
Erections depend on healthy blood vessels, which is why ED often travels with high blood pressure, diabetes and high cholesterol. In the Massachusetts Male Aging Study, heart disease, hypertension and diabetes were all linked to ED. Your clinician reviews those first, then prescribes only if sildenafil is safe and right for you.
Take it about an hour before. One dose a day at most. Your clinician picks the strength, from half a tablet to a full one.
Your health, your blood pressure and every medicine you take. No video call, no waiting room.
A few minutes
A US-licensed clinician screens for nitrates, heart health and blood pressure, and prescribes only if sildenafil fits.
Within 24 hours
From a licensed US pharmacy, with free shipping.
2 to 5 business days
Half a tablet or a full one, never more than one a day. Tell your care team how it went and they adjust it with you.
Ongoing support
Take one tablet about an hour before sex, anywhere from 30 minutes to 4 hours ahead. Arousal still has to do its part.
Dose, timing and meals change the result. Message your care team about what you noticed, and they can move you between half a tablet and a full one.
Headache, flushing, indigestion and a stuffy nose are the most common. In the brand trials 2.5% stopped because of side effects, against 2.3% on placebo. Tell us if any bother you.
Ask about a blood panel. Blood pressure, blood sugar and low testosterone can all stand behind it, and fixing them can help the tablet work.
Three things you can do alongside your treatment.
ED shares its risk factors with heart disease: blood pressure, blood sugar and cholesterol. Bring a recent blood pressure reading, and ask about a panel covering fasting glucose, A1C, lipids and free testosterone.
Long sitting and low muscle mass are linked to poorer metabolic health, and metabolic health and erections run together. Walking breaks and strength training are the cheapest upgrade.
Chronic stress keeps cortisol up and performance worry loud. A short walk or slow breathing before sex helps, and a lighter meal gets sildenafil working sooner.
| Feature | Sildenafil | Tadalafil daily | PT-141 |
|---|---|---|---|
| What it does | Boosts blood flow to the penis once you are aroused | Same blood flow pathway, kept steady by a daily dose | Acts on desire in the brain, not on blood flow |
| When you take it | About 1 hour before sex, as needed | One tablet every day, whether or not sex is planned | At least 45 minutes before sex, as needed |
| How long it lasts | Up to about 4 hours, strongest in the first 2 | Stays active between daily doses (half-life 17.5 hours) | Set by the dose; one in 24 hours at most |
| Format | Tablet | Tablet | Injection or nasal spray |
| Best for | Planned moments | Not wanting to plan around a tablet | Low desire more than erection trouble |
| Regulatory status | Compounded, not FDA approved | Compounded, not FDA approved | Compounded, not FDA approved; off-label in men |
Your clinician recommends one from your health history. Windows come from brand prescribing information.
Take 1 tablet (100 mg) by mouth about 1 hour before sex. You may take half a tablet (50 mg) if side effects occur. Do not take more than one tablet in 24 hours.
Tell your care team straight away if an erection lasts longer than 4 hours, you lose vision in one or both eyes, your hearing drops suddenly or you get ringing in your ears, or you get chest pain or dizziness or nausea during sex.
Common side effects
Rare but serious
Do not take this if you take nitrates in any form, you take riociguat or a similar drug, or you have reacted badly to sildenafil before.
This is not a complete list of side effects. Message your care team about any symptom that worries you.
Take it about an hour before sex. The brand label allows anywhere from 30 minutes to 4 hours ahead, and in one study the effect lasted up to 4 hours but was weaker than at 2 hours.
Yes. Sildenafil helps blood flow once you are aroused. It does not create desire. If low desire is the main issue, ask about PT-141.
A high-fat meal slows absorption and delayed the peak by about an hour in the brand label data. A lighter meal, or an empty stomach, gets you the quickest start.
Dose, timing and meals all change the result, so message your care team before you give up. If it is still not enough, ED sometimes points to a cause worth checking, such as blood sugar, blood pressure or low testosterone.
It has the same active ingredient, but ours is compounded by a licensed US pharmacy and is not FDA approved. The numbers above come from trials of the brand, which did not test our version.
Sildenafil suits planned moments. Our tadalafil is a low daily tablet for men who would rather not plan. Answer the quiz and a clinician suggests one.
Not always, but ED and heart disease share risk factors: high blood pressure, diabetes and high cholesterol all raise the odds of both. That is why we ask for your blood pressure and medicines, and why a blood panel can be worth adding.
90-day supply · $5.81/tablet · Billed $209 every 90 days
