ED Medication FAQ — 29 Answers by Licensed Pharmacists

Erectile dysfunction is the inability to achieve or maintain an erection firm enough for satisfactory sexual activity. It affects approximately 30 million men in the USA and is highly treatable with FDA-approved medications like Sildenafil (Viagra) and Tadalafil (Cialis).

ED is caused by physical factors (cardiovascular disease, diabetes, high blood pressure, low testosterone, obesity), psychological factors (anxiety, depression, stress), lifestyle factors (smoking, alcohol, lack of exercise), and medications. Most cases of ED have a physical component and respond well to PDE5 inhibitor medications.

ED becomes more common with age but is not a normal or unavoidable part of aging. It is a medical condition that is treatable at any age. Approximately 40% of men experience some ED by age 40, and 70% by age 70 — but effective treatments exist for all age groups.

Yes. ED in men under 40 is increasingly common and often has psychological causes (performance anxiety, stress, PIED) or lifestyle factors. COVID-19 has also been linked to new-onset ED in young men. Treatment is equally effective in younger men.

Promedic offers Viagra (Sildenafil 25/50/100mg), Cialis (Tadalafil 5/10/20mg), Generic Sildenafil, Generic Tadalafil 20mg, Sildenafil 50mg, Kamagra (Sildenafil 100mg), Levitra (Vardenafil), and Spedra (Avanafil). We also offer OTC medications including pain relief, allergy, and digestive health products.

Viagra (Sildenafil) works in 30–60 minutes and lasts 4–6 hours — best for planned occasions. Cialis (Tadalafil) works in 30 min–2 hours and lasts up to 36 hours — best for spontaneity. Tadalafil is also available as a daily 5mg dose. Both are equally effective; the choice depends on lifestyle preference.

All FDA-approved ED medications (Sildenafil 100mg, Tadalafil 20mg, Vardenafil 20mg, Avanafil 200mg) have comparable maximum efficacy. 'Strength' is less important than finding the right medication for your individual response. Sildenafil 100mg is the most commonly prescribed maximum dose.

Sildenafil (Viagra) typically takes effect within 30–60 minutes. For best results, take it on an empty stomach 60 minutes before sexual activity. High-fat meals can delay absorption. The effect lasts 4–6 hours.

Tadalafil begins working within 30 minutes to 2 hours. Unlike Sildenafil, food does not affect absorption. The 36-hour window means you can take it earlier in the day without worrying about precise timing. Daily 5mg Tadalafil takes 5–7 days to reach full steady-state effectiveness.

No. Never take two PDE5 inhibitors simultaneously. This can cause dangerous drops in blood pressure. If one medication is not effective, switch to the other — do not combine them.

PDE5 inhibitors work for approximately 70–85% of men with ED. They may be less effective in men with severe vascular disease, very low testosterone, or nerve damage from radical prostatectomy. Men who don't respond to one PDE5 inhibitor often respond to another.

The FDA-recommended starting dose is 50mg taken 30–60 minutes before sexual activity. This can be increased to 100mg if the 50mg dose is insufficiently effective, or reduced to 25mg if side effects occur. Never exceed 100mg in 24 hours.

For on-demand use, the starting dose is 10mg, which may be increased to 20mg. For daily use, the starting dose is 2.5mg or 5mg taken at the same time each day.

Daily dosing is approved for Tadalafil 5mg (and 2.5mg). This provides a continuous low-level effect, enabling spontaneous sexual activity without planning. Daily Sildenafil is not approved for ED but is used medically for pulmonary arterial hypertension.

Yes. All ED medications require a valid US prescription. Promedic connects you with licensed US physicians who can issue a prescription following a short online health questionnaire. No in-person visit or video call is required. The process takes under 10 minutes.

Fill in the contact form on our homepage or WhatsApp us at +1 (305) 202-0900. You'll complete a brief health questionnaire reviewed by a licensed physician, then receive your prescription and order confirmation. Payment is processed securely and your order ships within 24 hours.

Promedic delivers to all 50 US states. Our physician network is licensed across all states, ensuring legal prescription issuance regardless of your location.

Standard delivery takes 3–5 business days. Express 1–2 day shipping is available at checkout. All orders ship within 24 hours of prescription approval.

Yes. All Promedic orders ship in plain, unmarked packaging with no indication of contents. The return address does not reference any medical or pharmacy information. Billing on your statement appears as a neutral merchant name.

Standard shipping is FREE on orders over $75. Express shipping fees apply for 1–2 day delivery. Free discreet standard shipping is available on all orders during promotional periods.

It is safe when purchasing from a licensed online pharmacy with US physician oversight like Promedic. Risks arise from unregulated offshore sites that may sell counterfeit or mislabeled products. All Promedic medications are genuine and sourced from licensed manufacturers.

Do not take PDE5 inhibitors if you use nitrates (nitroglycerin, isosorbide) for heart conditions — the combination can cause life-threatening blood pressure drops. Also avoid if you have severe cardiovascular disease, recent stroke or heart attack, or severe liver impairment. Always disclose all medications in your health questionnaire.

Common side effects include headache (10–16%), facial flushing (5–18%), nasal congestion (3–9%), and indigestion. Tadalafil uniquely causes back pain or muscle aches in some men (resolves in 12–24 hours). Serious side effects are rare. Seek immediate care for: erection lasting over 4 hours (priapism), sudden vision or hearing loss, or chest pain.

Moderate alcohol (1–2 standard drinks) is generally safe. Both alcohol and PDE5 inhibitors lower blood pressure — excessive alcohol significantly increases this effect, risking dizziness, fainting, and cardiovascular events. Alcohol also independently reduces sexual performance and can counteract ED medications. Limit to 2 drinks maximum.

Generic Sildenafil (Sildenafil Citrate) is the most affordable prescription ED medication, available from $4.99 per pill at Promedic — compared to $50–$80 per pill for brand Viagra. It contains the identical active ingredient and is FDA-approved as bioequivalent to Viagra.

Tadalafil (Cialis) 20mg on-demand or daily 5mg is best for spontaneous sex due to its 36-hour window and lack of food timing restrictions. Daily Tadalafil 5mg is the ultimate option — no pill timing required at all.

In many cases, yes — especially when caused by lifestyle factors (obesity, smoking, inactivity), psychological factors (anxiety, stress), or correctable hormone imbalances. For men with vascular or nerve damage, ED is highly manageable with medication even if not fully reversible. Early treatment yields the best outcomes.

The right ED medication depends on: how often you have sex (daily vs occasional), whether food timing matters to you, how quickly you need it to work, your other medications, and individual response. A licensed physician can recommend the best option based on your health history — Promedic's online consultation makes this quick and private.

Yes. The FDA requires generic drugs to be bioequivalent to their brand counterpart, meaning they deliver the same active ingredient at the same rate and concentration. Multiple clinical studies confirm generic Sildenafil performs identically to brand Viagra at a fraction of the cost.