
Works when you are aroused
Sildenafil relaxes the blood vessels in the penis so more blood flows in during sexual stimulation. It supports your natural response, it does not force one.









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RxSexual Health
Your starting dose, and the step up if you need it.
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The standard option for on-demand ED treatment, available in 50mg and 100mg. A board-certified physician reviews your file and prescribes the strength that's clinically appropriate for you.
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50mg · 10 doses/mo
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Common questions

Dinner for two
The people pictured are models, not patients.

Sildenafil relaxes the blood vessels in the penis so more blood flows in during sexual stimulation. It supports your natural response, it does not force one.

Take one tablet about an hour before sex. There is nothing to take on the days you do not want it.

Sildenafil is the same active ingredient found in branded Viagra, compounded by a US-licensed pharmacy at 50 mg or 100 mg.

A US-licensed provider checks your health history and heart risks before prescribing. Real pricing, shown up front.
How we compare
Understand your treatment
Sildenafil inhibits PDE5, an enzyme involved in breaking down the chemical signal that helps blood vessels relax during sexual stimulation. That mechanism explains its place in erection-focused care. It also explains why sildenafil is a different conversation from a medication aimed at desire. When comparing options, the practical questions are the planned timing, tablet strength and whether you prefer an as-needed approach.
A closer look
A focused option for the physical response.
Make a more informed choice
Both are PDE5 inhibitors. Their duration and treatment schedules differ. Sildenafil is commonly discussed as an as-needed option; the tadalafil catalog includes both as-needed and daily formulations.
HealthRX.com verified facts
Sildenafil starts at $35 per month on 12-month plan; the lowest checkout charge is $44 (billed monthly). A prescription is never guaranteed. A licensed provider reviews each request before a pharmacy can dispense treatment.
Catalog verified August 26, 2026. Source: HealthRX.com checkout catalog and refund policy. Monthly equivalent divides the discounted plan charge by the number of months; checkout may collect a multi-month total.

Choose your treatment options and complete secure checkout. Then complete the online health intake.
A US-licensed provider reviews your history and prescribes sildenafil if it is appropriate for you.
A US-licensed pharmacy compounds your dose and ships it free in discreet packaging.
Message your care team anytime, and your provider can move you between 50 mg and 100 mg based on how you respond.
Sildenafil belongs to the PDE5 inhibitor class. It works by blocking the PDE5 enzyme responsible for breaking down cGMP in penile tissue, which lets smooth muscle there relax and blood flow rise once stimulation begins. That last part matters: sildenafil requires sexual arousal to work, so it won't produce an erection in your body on its own, no matter how much time has passed since your dose. The mechanism is identical at 50mg and 100mg; what changes at the higher dose is how much drug is available to occupy the enzyme, and trial evidence shows no additional benefit from exceeding 100mg.
Arousal releases nitric oxide
Sexual stimulation signals the release of nitric oxide, which raises cGMP in the smooth muscle of the penis.
Sildenafil blocks the PDE5 enzyme
PDE5 normally breaks cGMP down. Sildenafil inhibits it, so cGMP levels stay higher.
Smooth muscle relaxes, blood flows in
The vessels widen and blood fills the erectile tissue, supporting a firmer erection.
More blood flow during arousal, which is why sexual stimulation is still required.
Sildenafil is one of the most studied medications for erectile dysfunction, with decades of randomized controlled trials. Here is what that research found.
69% versus 22%
of intercourse attempts succeeded on sildenafil compared with placebo in a randomized controlled trial.
Goldstein et al., N Engl J Med 1998
57% versus 21%
of attempts succeeded on sildenafil versus placebo across pooled trials of 2,283 men.
Fink et al., Arch Intern Med 2002
As needed, by mouth
An oral tablet taken about an hour before sex, with no injections or in-office visits required.
Two proven options, different timing
| Sildenafil | Tadalafil | |
|---|---|---|
| Onset | About 30 to 60 minutes | About 30 to 60 minutes |
| Duration | About 4 to 6 hours | Up to 36 hours |
| Food effect | A heavy meal can slow it | Not affected by food |
| If side effects occur | Clear sooner, shorter half-life | Can persist longer |
| Best for | Planned, shorter windows | Spontaneity across a longer window |
| Active ingredient | Same as branded Viagra | Same as branded Cialis |
Most people notice an effect within thirty to sixty minutes, with concentration peaking near the one-hour mark, the same timeline at either strength. A high-fat meal slows absorption and can delay that peak by roughly an hour, so if precise timing matters to you, a lighter meal beforehand helps. Once active, the effect holds for about four to six hours at 50mg or 100mg. 100mg is generally reserved for people whose response to 50mg wasn't strong enough, and the documented side-effect pattern runs somewhat more pronounced at that dose: headache, mild indigestion, flushing, occasional blue-tinted vision, and nasal congestion, most of it transient.
30 to 60 minutes
Taken about an hour before sex, sildenafil reaches peak levels near the one hour mark.
1 to 4 hours
The effect is strongest in this window, and sexual stimulation is still needed for it to work.
4 to 6 hours
Levels taper and the medication clears, since sildenafil has a short half-life.
After a few tries
If 50 mg is not enough, or side effects bother you, your provider can adjust between 50 mg and 100 mg.
Sildenafil is absolutely contraindicated with nitrate medications; combining the two can trigger a severe, dangerous fall in blood pressure. Your provider will also want to know about certain medications and health history before confirming a prescription at either strength: alpha-blockers, CYP3A4-inhibiting drugs such as some antifungal or HIV treatments, uncontrolled blood pressure, a prior heart attack or stroke, cardiovascular disease more broadly, or a personal history of NAION, a rare condition affecting the optic nerve. Side effects run somewhat more pronounced at 100mg than at 50mg.
This is not a complete list of side effects. Never take sildenafil with nitrate medications such as nitroglycerin, or with recreational poppers, because the combination can cause a dangerous drop in blood pressure. Tell your provider about alpha-blockers, heart conditions, and every medication you take. Sildenafil is not for use by women or by anyone under 18.

An independent US-licensed clinician reviews every request. If they decide the treatment is not right for you, you get a full refund for the medication.
Prescriptions are filled by a US-licensed pharmacy and shipped free, in discreet packaging, on every plan.
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Compounded medications are prepared by a US-licensed pharmacy and are not reviewed by the FDA for safety or effectiveness. Products are dispensed only after a licensed provider determines they are appropriate. Information here is educational and is not a substitute for medical advice.