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Sildenafil (Pill)
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Sildenafil Pill: Fast-Onset ED Support
The original PDE5 inhibitor and the most familiar ED medication, in pill form.
Sildenafil is a PDE5 inhibitor and the active ingredient in Viagra, the first medication of its kind. It’s typically taken 30 to 60 minutes before anticipated intimacy and lasts about 4 hours. Because it’s been studied for decades, sildenafil has the longest clinical track record of any ED medication.
Physician-prescribed · FDA-approved active ingredient · Dispensed by licensed pharmacies · Ongoing care team support
Sildenafil (PDE5 Inhibitor): Sildenafil inhibits PDE5, the enzyme that breaks down cGMP in the penis. By preserving cGMP, it lets smooth muscle relax and blood flow increase in response to sexual stimulation. It does not cause spontaneous erections; arousal is still required.
Best for: Adult men with erectile dysfunction who want a fast-onset, well-studied option for as-needed use.
Not recommended for: Anyone taking nitrates or certain alpha-blockers, those with significant cardiovascular disease, severe liver or kidney disease, recent stroke, or a history of priapism.
Most common side effects are headache, flushing, nasal congestion, mild stomach upset, and visual changes (blue-tinged vision or light sensitivity, typically mild and reversible). Rare but more serious risks include priapism, significant blood pressure changes, sudden vision or hearing changes, and dangerous interactions with nitrates.
¹ 84% of men reported improved erections (100 mg) Goldstein I, Lue TF, Padma-Nathan H, Rosen RC, Steers WD, Wicker PA. Oral sildenafil in the treatment of erectile dysfunction. New England Journal of Medicine, 1998;338(20):1397-1404. → NEJM · PubMed
² Works within 30 to 60 minutes Padma-Nathan H, Eardley I, Kloner RA, Laties AM, Montorsi F. A 4-year update on the safety of sildenafil citrate (Viagra®). Urology, 2002;60(2 Suppl 2):67-90. (Onset typically 30 to 60 minutes; usable window ~4 to 6 hours.) → PubMed
³ Significant improvement across IIEF erectile function domains vs placebo Goldstein I, et al. (1998 pivotal trial, same as ¹). → PubMed
How it Works With EHRX
The entire process is online. No waiting rooms. Just straightforward, medically guided care.
Step 1
Choose your treatment and complete checkout
You'll receive a confirmation email with next steps.
Step 2
Complete a brief medical consultation
Check your email for a link to a short intake form and link to a virtual consult with a licensed physician.
Step 3
A licensed provider reviews your consultation
If approved, your prescription is written and sent to the pharmacy. If not, you receive a full refund.
Step 4
Your pharmacy ships within 3–5 business days
Your medication is shipped directly to your door in temperature-controlled packaging.
What to know before you start.
Sildenafil (Pill) is a compounded medication prepared by a licensed pharmacy for individual patient use.
It has not been reviewed by the FDA for safety or efficacy, and is prescribed based on the clinical judgment of a qualified healthcare provider. Compounded drugs are permitted to be prescribed but are not FDA-approved for safety and efficacy.
Clinical Evidence
Sildenafil at as-needed doses (25 to 100 mg) produces clinically meaningful improvements in erectile function across multiple international clinical trials. It was the first FDA-approved oral medication for ED, approved in 1998. (Source: Goldstein et al., New England Journal of Medicine, 1998)
Frequently Asked Questions
We aim to provide absolute clarity regarding your biological data and personalized wellness protocols.
30 to 60 minutes before anticipated intimacy. Effects last about 4 hours.
Sildenafil has a shorter duration (about 4 hours) but a faster onset. Tadalafil lasts up to 36 hours.
Yes. A heavy or high-fat meal can slow absorption. Take it on an emptier stomach for fastest onset.
Not typically required.
Yes. A medication review is required because sildenafil interacts dangerously with nitrates.
You won’t be charged for the medication.
Generic sildenafil is broadly covered. Brand Viagra coverage varies.
Yes, at any time before your next shipment, with no long-term commitment.
Initial check-in at 4 to 6 weeks, then on a recurring cadence.
Seek emergency medical attention immediately.
Moderate alcohol is generally fine. Heavy drinking can amplify blood pressure effects.
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