Sildenafil
Generic sildenafil or tadalafil for ED. Your clinician picks the medicine and dose that fit your routine and how you handle side effects. Never take either one with nitrates, including "poppers," or riociguat.
See if I qualifyFrom $39/mo$0 until a clinician approves · FSA/HSA eligible
$0 until a clinician approves.
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To get a prescription, you need an online visit reviewed by a U.S.-licensed provider. Results vary from person to person.
Who it’s for
- Trouble getting or keeping an erection
- Not taking nitrates (including "poppers") or riociguat
- OK reviewing your heart health and medicines with a clinician first
Most men practice this conversation in their heads for months before they say it out loud.
How it works
Sildenafil is a PDE5 inhibitor pill for erectile dysfunction. It starts working in 30–60 minutes and lasts 4–6 hours.
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What we can and can't tell you
It helps blood flow, but it doesn't create desire. It only works when you're sexually aroused, because arousal releases the nitric oxide it needs. You find the right dose (25, 50, or 100 mg) by trying it. If a dose doesn't work well, that's useful information for your clinician.
This is an FDA-approved generic medicine. A licensed U.S. pharmacy fills your prescription.
What the first months look like
If you're prescribed sildenafil, take it 30–60 minutes before sex, on an empty stomach so it works faster. It keeps working for 4–6 hours. Tadalafil has its own timing, which your clinician explains.
Finding your dose. If your dose is too strong or too weak, your clinician adjusts it based on how it worked. For sildenafil, that's within the 25 / 50 / 100 mg range.
Use it as prescribed, no more than once in 24 hours. Check-ins cover how it's working, side effects, and any new medicines. Never take sildenafil or tadalafil with nitrates, including "poppers," or with riociguat. Alpha-blockers (some blood pressure and prostate drugs) also need your clinician's review.
This treatment covers sildenafil or tadalafil. Your clinician picks the one that fits your routine. Tadalafil lasts longer, so it's usually the next thing to talk about.
Dosing, step by step
| Doses (sildenafil) | 25, 50, or 100 mg — your clinician picks the first dose and adjusts it based on how it works; tadalafil uses different doses |
|---|---|
| Timing (sildenafil) | 30–60 min before sexual activity — take on an empty stomach; a heavy meal slows it down |
| Ceiling | Once per 24 hours, maximum — this is a firm limit |
You take it when you need it, not every day. Some medicines, called CYP3A4 inhibitors (like ketoconazole), mean you need a lower sildenafil dose. Your clinician decides that during your visit.
And when it gets rough
Show what helps
- Headache This is the most common one. Drink water. It usually fades as the dose wears off. If it's bad every time, tell your clinician. They'll decide whether to change your dose.
- Flushing or nasal congestion This happens because the drug widens blood vessels in other places too. It passes. Mention it at your check-in if it bothers you.
- Indigestion Take it on an empty stomach, which also helps it work faster. Don't lie down right after you take it.
- Blue-tinged vision, or an erection past 4 hours A mild blue tinge is usually short-lived. An erection lasting over 4 hours (priapism) is a medical emergency. So is any sudden loss of vision or hearing. This applies to sildenafil and tadalafil. Get care right away, then tell your clinician.
- Chest pain, or dizziness or fainting Stop and get emergency care. Tell them when you last took sildenafil or tadalafil. Never take either one with nitrates, including "poppers," or with riociguat.
Safety information
A U.S.-licensed clinician reviews every prescription and decides whether this medicine is right for you. During your visit, tell them if any of the following applies to you or your family.
- Common side effects
- Headache, Flushing, Stuffy nose, Indigestion
- Less common
- Vision changes (a blue tint), Back pain
- Rare
- Priapism (an erection lasting over 4 hours; a medical emergency), Sudden hearing or vision loss (get care right away)
- Interactions
- Nitrates, including "poppers": never take them together (blood pressure can drop dangerously)
- Riociguat (for lung blood pressure): never take them together
- Alpha-blockers: risk of low blood pressure
- CYP3A4 inhibitors (like ketoconazole): use a lower sildenafil dose
Trouble with erections deserves a medical check, and several treatments can help. Before choosing a medicine and dose, we review your heart health, blood pressure, and other medicines. Never take sildenafil or tadalafil with nitrates, including "poppers," or with riociguat. Get urgent care for an erection that lasts more than four hours, or for sudden changes in your vision or hearing. If you have chest pain, get emergency care and tell them when you last took your ED medicine.
Three steps, no insurance hoops
Take the quiz
About 5 minutes. Tell us your symptoms, history, and goals.
Clinician reviews
A U.S.-licensed clinician looks at your answers within 24 hours. If it's right for you, they write your plan.
Care ships free
Your medication arrives in days. Refills come on their own, and check-ins are included.
Common questions
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Read before you start
From the Zappy clinical team, in plain language.
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Ready when you are.
A licensed clinician reviews your visit within 24 hours.
See if I qualify · From $39/mo