In the United States, erectile dysfunction treatment is centered on FDA-approved prescription products, with one newer OTC device option. The main oral medicines are PDE5 inhibitors: Sildenafil sold as Viagra and generics, Tadalafil sold as Cialis and generics, Vardenafil products, and avanafil sold as Stendra. The American Urological Association states that men with ED should be informed about FDA-approved oral PDE5 inhibitors unless contraindications apply, with shared decision-making around onset, duration, adverse effects, and patient priorities.
These products differ mainly by timing and duration. Sildenafil and Vardenafil are usually taken before sexual activity. Tadalafil can be taken as needed and is also used once daily in selected patients, with labeling showing effect up to 36 hours after dosing. Avanafil is another as-needed PDE5 inhibitor indicated for adult males with ED.
For men who cannot use oral PDE5 inhibitors or do not respond adequately, FDA-labeled Alprostadil products are available. Edex, an Alprostadil injection, is indicated for ED due to neurogenic, vasculogenic, psychogenic, or mixed causes, while Caverject is another intracavernosal alprostadil product used in ED treatment and diagnostic testing.
The main non-prescription option is Eroxon, a non-medicated topical gel. FDA authorized Eroxon for marketing in 2023 as the first OTC gel intended to treat ED in adult males aged 22 and over; it is regulated as a medical device rather than an oral drug.
ED products should be selected after medical review, especially in men using nitrates, riociguat, alpha-blockers, heart medicines, or products marketed as “male enhancement,” because FDA has repeatedly found undeclared sildenafil or tadalafil in such supplements.
Generic Viagra (Sildenafil)
Generic Viagra is the generic form of Viagra containing Sildenafil Citrate, a PDE5 inhibitor taken before sexual activity to improve erectile response while requiring medical review for heart disease, blood pressure drugs, nitrates, and other ED treatments.
Generic Cialis (Tadalafil)
Generic Cialis is a Tadalafil-based drug for men with ED, available in daily and as-needed regimens, with treatment chosen around sexual timing, urinary symptoms, dose tolerance, heart status, and interaction risks such as nitrates or alpha-blockers.
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Generic Levitra (Vardenafil)
Generic Levitra is the generic form of Levitra containing Vardenafil, a PDE5 inhibitor taken before sexual activity to support erectile response in men with ED while requiring attention to dose timing, side effects, and drug interactions.
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Disclaimer
The information on this page is educational and should not be used as medical instruction. Speak with a licensed healthcare professional before purchasing or using any medicine, especially if you have health conditions or take other drugs.