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Erectile dysfunction (ED) is very common. In the United States alone, researchers estimate around 30 million men have ED.

ED is defined as the inability to develop and maintain an erection firm enough for sexual activity or penetrative sex.

Although this can be an upsetting diagnosis for some, many people find their condition is treatable with Viagra, also sometimes called the “little blue pill.”

If you’re looking for convenience or discretion, that little blue pill is available online for direct-to-consumer delivery. However, you still need a prescription. Thankfully, several telehealth companies such as Romans, Hims, and Lemonaid have doctors and other licensed medical professionals at hand to prescribe the appropriate medication, if necessary.

Keep reading to learn more about how Viagra works, the alternatives, and how Viagra compares with other ED medications.

Viagra is a brand-name prescription drug approved to treat ED. Viagra contains sildenafil, which belongs to a class of phosphodiesterase type 5 (PDE5) inhibitors.

Viagra is the well-known brand-name version of this medication. It works by increasing blood flow to your penis, which helps you have and keep an erection. However, it only works if you’re sexually aroused.

Viagra is approved for use in those who are 18 years and older.

Though Viagra is manufactured by Pfizer, plenty of other companies also make and sell less expensive versions of generic sildenafil pills.

Viagra and generic sildenafil are prescription medications, so you’ll need to consult a doctor before purchasing. Some companies have healthcare professionals on their team who can assess you before your purchase and make an accurate ED diagnosis.

Oral medications for ED are among the most counterfeited medications in the world. Online pharmacies can sell counterfeit medications, so it’s important to do your research before you buy from any retailer.

In 2014, the National Association of Boards of Pharmacy found that 97 percent of the internet pharmacies it examined were not compliant with federal laws, state laws, or industry standards.

Counterfeit Viagra is known to contain amphetamines, toxic chemicals, the wrong dose of active ingredients, and even blue printer ink.

It’s a good practice to stay away from international websites, as each country has its own governance when it comes to manufacturing. Stick to reputable sites and pharmacies you can trust.

Some ED medications are PDE5 inhibitors that relax smooth muscle tissue and increase blood flow. There are four main types of PDE5 inhibitors:

  • Stendra (avanafil)
  • Levitra (vardenafil)
  • Cialis (tadalafil)
  • Viagra (sildenafil)

If you’re interested in buying Viagra online, read on to learn more about the considerations you should make.

We chose the following brands based on user ratings, discreetness, and pricing. Hims, Roman, and Lemonaid all report that a doctor or other qualified or licensed medical professional is involved in determining the appropriateness of the prescribed medication.

The companies listed here, except for Eddie by Giddy, have a Better Business Bureau (BBB) accreditation and rating of A or above. We didn’t find any Food and Drug Administration (FDA) warning letters involving Giddy.

None of the services listed here are covered by insurance.

Best overall

Hims

Hims is a telehealth company that provides both prescription and over-the-counter generic and brand-name medications. The brand focuses mainly on five FDA-approved medications, including Viagra.

The first step is a consultation with an online qualified medical professional who will make a diagnosis and prescribe the best ED treatment for you. They’ll also answer any questions you have, and they may be contacted in the future to make treatment adjustments.

If you’re prescribed Viagra, you can purchase it in doses of 25, 50, or 100 milligrams (mg). Hims recommends taking Viagra anywhere from 30 minutes to 4 hours before sexual activity. You can purchase a one-time order or sign up for a subscription plan that sends you a monthly supply of the pills in discreet packaging.

Price: Subscriptions start at around $20 per month. Medication costs for subscribers include Viagra (five 50-mg pills for $425 each month).

Best for variety

Roman

Roman is a healthcare technology company that sells FDA-approved men’s health products.

The first step is to schedule a $15 consultation with one of their licensed healthcare professionals to assess your symptoms and come up with a treatment plan. If Roman’s products or telemedicine is not a good fit for you, Roman will refund you your money.

Not all of Roman’s ED products require a prescription. However, you need one for Viagra. Roman sells both generic Viagra and brand-name Viagra, and they’re available in 25-mg, 50-mg, and 100-mg tablets.

After you place your order, Roman will ship your items for free in discreet packaging. The company can also send your order to your local pharmacy for an added fee. If you want to make changes to your order, Roman offers free unlimited follow-ups with their healthcare professionals.

Price: Monthly subscriptions generally start around $31 per month for 12 20-mg pills of sildenafil. You can alter how often and how many pills you want. Branded Viagra costs $70, whereas sildenafil costs $34.

Best budget option

Lemonaid

Lemonaid is a telehealth medicine service that connects people with healthcare professionals. It offers highly competitive mail-order pharmacy pricing.

After you select the condition you want to be treated for, Lemonaid asks you to complete an online assessment.

If you’re a good candidate after the medical review, you pay a $25 flat fee for a consultation with a licensed medical professional. Lemonaid offers a range of ED pills, including 20-mg sildenafil pills.

Lemonaid will then prescribe you treatment for your ED, and send your prescription to the company’s mail-order pharmacy.

Price: Sildenafil costs $2 per pill with Lemonaid’s mail-order pharmacy. The company offers free delivery on all orders.

Best alternative device

Eddie by Giddy

Eddie by Giddy is an alternative to Viagra for anyone looking to avoid pills.

Eddie is an FDA-registered, Class 2 wearable ED device that keeps blood flowing in your penis, allowing you to maintain an erection without constricting your urethra or arteries.

It comes in four different sizes. Each package comes in a discreet box. Eddie’s design is meant to fit the penis comfortably and constricts only where it’s needed, thanks to the adjustable tension bands.

Giddy offers free shipping, free resizing, and a money-back guarantee if your ED symptoms don’t improve within 30 days. According to the company, Eddie should not result in any harmful side effects when used properly. Side effects resulting from misuse of Eddie should be minor and infrequent.

That being said, it’s important to make sure to talk with a doctor before using this product.

Price: For $188 you get the device, six tension bands (three sport, three comfort), and a 30-day training program to help you treat your ED.

To avoid buying counterfeit medications, look for the following:

  • reputable retailer
  • consultation with a licensed medical professional
  • licensed pharmacy that asks for a prescription from your doctor
  • licensed pharmacy with an address in the United States
  • FDA-approved medications
  • clearly labeled containers with the name of the medication and dosage
  • licensed pharmacist who is available to answer any questions afterward

What makes a reputable online pharmacy or health platform?

There should be multiple, clear ways to contact a customer service representative, such as a pop-up chat window, an email to send questions, a contact form you can submit, or a phone number you can call.

The company may have a medical advisory board and a network of licensed healthcare professionals.

As a user of their services or platform, it should be easy for you to see information about the nurse practitioners and physicians you work with, such as medical license and credentials.

Taking Viagra can cause mild or serious side effects. Mild effects may go away in a few days or a couple of weeks. They can include:

  • headache
  • flushing
  • indigestion
  • stuffy nose
  • back pain
  • muscle pain
  • nausea
  • dizziness
  • rash

If these side effects don’t go away after a week or so, talk with your prescribing healthcare professional or pharmacist.

Serious side effects are uncommon but may occur. Call your prescribing healthcare professional right away if you experience serious side effects, such as:

  • sudden vision loss in one eye
  • sudden decrease or loss of hearing
  • allergic reaction (hives, itching, or swelling of the face, lips, or tongue)
  • priapism (long lasting and sometimes painful erections)
  • low blood pressure
  • fast heart rate

If you’re interested in trying Viagra for ED, you’ll need to talk with a healthcare professional first. The FDA requires a prescription for Viagra, both for the brand-name medication and its generic, sildenafil.

Your doctor may offer you a prescription for Viagra if they decide it’s the safest treatment option based on your symptoms, medical history, and overall health.

If you experience a painful or erection that lasts longer than 4 hours, seek emergency care immediately, as it may be a sign of another uro­log­ic con­di­tion.

Seek a doctor immediately if you experience any of these serious side effects:

  • aller­gic reac­tion, like skin rash, itch­ing or hives, and swelling of the face, lips, or tongue
  • shortness of breath
  • chest pain
  • fast, irreg­u­lar heart rate
  • hear­ing loss
  • vision changes
  • seizures

Can I buy Viagra over the counter?

Viagra (sildenafil) is a prescription medication, meaning it’s not available over the counter from your local pharmacy.

But with telemedicine, you don’t need to visit your doctor in person to get a prescription for Viagra or another ED medication.

What are Viagra’s side effects?

According to the National Health Service, side effects occur in more than 1 in 100 people who take sildenafil. However, pills that contain sildenafil citrate are generally safe to use under a doctor’s supervision.

The side effects most commonly associated with Viagra include:

  • headaches
  • flushing
  • upset stomach
  • abnormal vision
  • runny or stuffy nose
  • muscle and back pain
  • dizziness

Seek immediate medical attention if you experience the following side effects:

  • chest pain
  • shortness of breath
  • vision changes

Keep in mind that this is not a complete list of side effects. Speak with a healthcare professional for medical advice about side effects.

These side effects often go away on their own. If they don’t, reach out to your prescribing healthcare professional.

How long does Viagra take to start working? How long does it last?

It really depends based on the person.

Most of the time, Viagra starts to work after 30 minutes. Some people note that Viagra works faster when taken on an empty stomach.

The effects of Viagra usually last around 4 to 5 hours and start to wear off after that. If your erection is painful or lasts longer than 4 hours, get medical attention immediately.

It’s important to talk with a doctor if you regularly experience ED and want to start taking Viagra.

When shopping for Viagra online, look for services that are FDA approved and involve a personalized approach with a medical professional. Only purchase medication from reputable retailers.

Iman Balagam is a writer based in Houston, Texas. When she’s not laughing at her own jokes, or buying overpriced chia pudding, she can be found reading fiction novels, catching a spin class, doomscrolling through TikTok, or waiting for her delayed Spirit flight to board. You can see more of her work on her website.