Viagra Alternatives: What Works and What to Try First

Viagra (sildenafil) helps a lot of men, but it’s not the only option and it’s not right for everyone. If you have side effects, take nitrates, or want a treatment that fits your lifestyle better, there are several effective and safe alternatives. Below I’ll walk you through real choices — what they do, how fast they work, and when to talk to your doctor.

Prescription drug alternatives

Tadalafil (Cialis) lasts much longer than sildenafil — up to 36 hours for many men — so it’s a good pick if you want more spontaneity. It can be taken daily at a low dose or as-needed before sex. Vardenafil (Levitra) works similarly to sildenafil but might suit men who had side effects with Viagra. Avanafil (Stendra) is the fastest acting option, often working in 15–30 minutes.

No pill is magic. All these drugs need sexual stimulation to work. Common side effects are headache, flushing, nasal congestion, and upset stomach. The big safety rule: never combine PDE5 inhibitors with nitrates (chest pain meds). That combo can cause dangerous drops in blood pressure. If you have heart disease, uncontrolled blood pressure, or recent stroke, check with your doctor first.

Non-drug and lifestyle options

If pills aren’t for you, devices and procedures can help. Vacuum erection devices create an erection by moving blood into the penis and using a ring to hold it. They’re non-invasive and work for many men. Penile injections (usually alprostadil) and intraurethral suppositories can produce reliable erections, but they require instruction and carry local side effects like pain or bleeding for some men.

Don’t forget the basics. Weight loss, regular exercise, stopping smoking, and cutting back on alcohol often improve erectile function. If low libido or low energy is the issue, a simple blood test can check testosterone; replacement therapy helps some men but needs medical monitoring. For men whose ED is linked to anxiety or relationship tension, sex therapy or counseling often makes a bigger difference than switching pills.

Shopping and safety tips: always get a proper diagnosis and a prescription for ED meds. Many online pharmacies sell fakes or unsafe products. Avoid mixes promising instant results and talk to your clinician about interactions with your other medicines.

If you’re not sure where to start, ask your doctor about trying a different PDE5 inhibitor or a short trial of lifestyle changes plus counseling. If pills won’t work or aren’t safe, ask about devices or injections. There’s usually a workable option — you just need the right fit for your health and life.