Sexual Health
Sildenafil
Your starting dose, and the step up if you need it.
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.
Strength
Doses per month
Your provider confirms or adjusts your strength during your free online visit.
Purchase type
Save 10% today and on every refill. Auto-renews at your selected cadence, pause or cancel anytime.
Cadence
Strength set by your provider. They confirm the right strength and dose for you during your online visit.
Only available if prescribed after an online consultation with a licensed provider.
What's included
- ✓Medication and supplies
- ✓Provider visit and unlimited follow-ups
- ✓Free expedited shipping
Pause, change, or cancel anytime from your account.
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.
On your schedule, as needed
Take one tablet about an hour before sex. There is nothing to take on the days you do not want it.
The active ingredient in Viagra
Sildenafil is the same active ingredient found in branded Viagra, compounded by a US-licensed pharmacy at 50 mg or 100 mg.
A provider reviews you first
A US-licensed provider checks your health history and heart risks before prescribing. Real pricing, shown up front.
From quiz to your door
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.
Answer a few health questions
Complete a short online visit about your health, heart history, and the medications you take.
A provider reviews
A US-licensed provider reviews your history and prescribes sildenafil if it is appropriate for you.
The pharmacy ships free
A US-licensed pharmacy compounds your dose and ships it free in discreet packaging.
Adjust with follow-ups
Message your care team anytime, and your provider can move you between 50 mg and 100 mg based on how you respond.
About Sildenafil
- FDA-approved since 1998, the longest track record of any option your provider can prescribe here
- Evaluated across 21 clinical trials and more than 3,000 participants in the approval data
- Peaks in your system around the one-hour mark, ahead of tadalafil's roughly two-hour peak
- 100mg available in your file if 50mg isn't enough, with no documented benefit shown above it
- Active four to six hours at either strength, timed to your plans rather than a daily dose
What the studies show
Sildenafil is one of the most studied medications for erectile dysfunction, with decades of randomized controlled trials. Here is what that research found.
- Goldstein I, Lue TF, Padma-Nathan H, Rosen RC, Steers WD, Wicker PA. Oral sildenafil in the treatment of erectile dysfunction. N Engl J Med. 1998;338(20):1397-1404.
- Fink HA, et al. Sildenafil for male erectile dysfunction: a systematic review and meta-analysis. Arch Intern Med. 2002;162(12):1349-1360.
Two different approaches
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 |
Your first months
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.
It takes effect
Taken about an hour before sex, sildenafil reaches peak levels near the one hour mark.
Your window
The effect is strongest in this window, and sexual stimulation is still needed for it to work.
It wears off
Levels taper and the medication clears, since sildenafil has a short half-life.
Dial in your dose
If 50 mg is not enough, or side effects bother you, your provider can adjust between 50 mg and 100 mg.
What members say
“I take it about an hour before and it just works with the moment. My provider walked through my heart history before writing anything.”
“Started at 50 and it was fine, but we moved to 100 after a couple of tries and that dialed it in. Easy to message the team about it.”
“Pricing was on the page before I signed up and shipping was discreet. No pharmacy counter, no awkward conversations.”
Ratings and member reviews shown here are illustrative composites built from anonymized intake-to-outcome data; identifying details have been altered. Individual results vary. Compounded medications are not FDA-approved.
What to know about side effects
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. If your provider decides sildenafil isn't clinically appropriate for you, you won't be charged for the medication.
Most common
- Headache
- Flushing
- Nasal congestion
- Indigestion
Less common, talk to your provider
- Changes in vision or a blue tinge to vision
- Sensitivity to light
- Dizziness
Rare but serious, seek care
- An erection lasting more than four hours, called priapism, which needs emergency care
- Sudden loss of vision or hearing, or chest pain, seek care right away
Frequently asked questions
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.