ED meds: the FDA-labeled ED pills compared
The FDA-labeled ED pills compared here are sildenafil (Viagra), tadalafil (Cialis), vardenafil and avanafil (Stendra). All are PDE5 inhibitors. Their labels differ on timing and half-life, not on a winner. Compounded combinations, such as Mendoxa's 3-in-1 tablet from $129 a month, are not FDA-approved.
Start your ED visit From $129/month. If prescribed · Cancel anytime · Available in 49 states (not California).
ED pills side by side, from the labels
| Medicine | Brand | Label starting dose | When to take | Peak level | Half-life |
|---|---|---|---|---|---|
| Sildenafil | Viagra | 50 mg | About 1 h before; 30 min to 4 h window | 30–120 min (median 60) | About 4 h |
| Tadalafil | Cialis | 10 mg as needed; 2.5 mg daily | Before sex; effect vs placebo up to 36 h | 30 min–6 h (median 2 h) | 17.5 h |
| Vardenafil | Levitra (brand discontinued) | 10 mg | About 60 min before | 30 min–2 h (median 60 min) | About 4–5 h |
| Avanafil | Stendra | 100 mg | As early as about 15 min before | Median 30–45 min | About 5 h |
Drugs@FDA lists brand Levitra as discontinued, with a Federal Register determination that it was not withdrawn for safety or effectiveness reasons. Generic vardenafil has a current DailyMed label.
Common side effects on each label
| Medicine | Most common side effects (2% or more) |
|---|---|
| Sildenafil | Headache, flushing, dyspepsia, abnormal vision, nasal congestion, back pain, myalgia, nausea, dizziness, rash |
| Tadalafil | Headache, dyspepsia, back pain, myalgia, nasal congestion, flushing, pain in limb |
| Vardenafil | Headache, flushing, nasal congestion, dyspepsia, sinusitis, flu syndrome, dizziness, increased creatine kinase, nausea, back pain |
| Avanafil | Headache, flushing, nasal congestion, nasopharyngitis, back pain |
Mendoxa ED plans and prices
The Mendoxa ED tablet is a compounded rapid-dissolve tablet with sildenafil (the active ingredient in Viagra), tadalafil (the active ingredient in Cialis) and apomorphine. It dissolves under the tongue. The Mendoxa ED page lists a maximum of 1 dose per 24 hours. A licensed clinician decides if it fits you and selects the strength. Compounded medicines are not FDA-approved.
| Plan | 1-month plan | Per tablet | 3-month plan | Per tablet (3 months) |
|---|---|---|---|---|
| 6 tablets / month | $129 | $21.50 | $329 | $18.28 |
| 10 tablets / month | $149 | $14.90 | $379 | $12.63 |
| 20 tablets / month | $179 | $8.95 | $449 | $7.48 |
If prescribed · Cancel anytime · Available in 49 states (not California). Prices from the Mendoxa intake at try.mendoxa.co/f/ed on Oct 17, 2026. The intake always shows the current price.
How a clinician chooses
The labels give the clinician the checklist. Nitrates and riociguat rule all four out. Heart status matters on every label. Alpha blockers, other blood-pressure medicines and strong CYP3A4 inhibitors such as ritonavir change the starting dose. The vardenafil label suggests a 5 mg start at age 65 or older. Kidney function changes the tadalafil dose. Then timing: a short window before sex, a longer window, or a daily dose.
The Viagra and Cialis labels list the same hard stops. Do not use them with organic nitrates in any form, or with a guanylate cyclase stimulator such as riociguat. Do not use them if sex is inadvisable because of your heart. Get emergency care for an erection that lasts more than 4 hours. Stop and get care for a sudden loss of vision in one or both eyes, or a sudden decrease or loss of hearing.
Other ED treatments
The NIH (NIDDK) lists more than pills: treating the underlying cause, lifestyle changes such as quitting smoking and limiting alcohol, counseling when anxiety or stress play a part, testosterone with a PDE5 inhibitor when testosterone is low, injectable medicines and urethral suppositories, vacuum erection devices, and surgery when other options fail.
The FDA warns that many “male enhancement” supplements are contaminated with dangerous hidden ingredients. They are not an ED medicine.
Compounded combinations
Some telehealth services prescribe compounded tablets that combine ingredients. The Mendoxa tablet combines sildenafil, tadalafil and apomorphine and dissolves under the tongue. The FDA says compounded drugs are not FDA-approved, and that the FDA does not verify their safety, effectiveness or quality before they are marketed. That applies to the Mendoxa tablet and to every other compounded ED product on this page.
The Viagra label says combinations with other PDE5 inhibitors or other ED treatments “have not been studied,” “may further lower blood pressure,” and are “not recommended.” The Cialis label says to tell patients not to take Cialis with other PDE5 inhibitors. So do not stack your own Viagra and Cialis. A compounded combination tablet is a separate prescription, and the clinician weighs these warnings before writing it.
See sildenafil and tadalafil in one tablet and Rugiet Ready alternative.
FAQ
What are the main ED meds?
The FDA-labeled ED pills are sildenafil (Viagra), tadalafil (Cialis), vardenafil and avanafil (Stendra). All are PDE5 inhibitors that need a prescription.
Which ED pill can be taken closest to sex?
On its label, avanafil can be taken as early as about 15 minutes before sex. Sildenafil is usually about 1 hour before, and vardenafil about 60 minutes before.
Which ED pill has the longest window?
Tadalafil. The Cialis label reports better erections than placebo for up to 36 hours after a dose.
Are ED meds safe with heart disease?
All four labels say not to use them if sex is inadvisable because of heart status, and never with nitrates. A clinician has to review your heart history.
Can I get ED meds online?
Yes, after a clinician review. Mendoxa's online visit can lead to a compounded 3-in-1 tablet, from $129 a month, if prescribed.
Start your ED visit: plans and prices
The Mendoxa ED tablet is a compounded rapid-dissolve tablet with sildenafil (the active ingredient in Viagra), tadalafil (the active ingredient in Cialis) and apomorphine. It dissolves under the tongue. The Mendoxa ED page lists a maximum of 1 dose per 24 hours. A licensed clinician decides if it fits you and selects the strength. Compounded medicines are not FDA-approved.
| Plan | 1-month plan | Per tablet | 3-month plan | Per tablet (3 months) |
|---|---|---|---|---|
| 6 tablets / month | $129 | $21.50 | $329 | $18.28 |
| 10 tablets / month | $149 | $14.90 | $379 | $12.63 |
| 20 tablets / month | $179 | $8.95 | $449 | $7.48 |
If prescribed · Cancel anytime · Available in 49 states (not California). Prices from the Mendoxa intake at try.mendoxa.co/f/ed on Oct 17, 2026. The intake always shows the current price.
References
- DailyMed: VIAGRA (sildenafil citrate) tablet, film coated, label revised 12/2017. Accessed Oct 17, 2026.
- DailyMed: CIALIS (tadalafil) tablet, film coated, label revised 3/2026. Accessed Oct 17, 2026.
- DailyMed: vardenafil hydrochloride tablet, label revised 7/2026. Accessed Oct 17, 2026.
- DailyMed: STENDRA (avanafil) tablet, label revised 10/2022. Accessed Oct 17, 2026.
- Drugs@FDA: LEVITRA (NDA 021400) marketing status. Accessed Oct 17, 2026.
- FDA (Drugs@FDA): STENDRA (avanafil) prescribing information, NDA 202276. Accessed Oct 17, 2026.
- NIH NIDDK: Treatment for erectile dysfunction. Accessed Oct 17, 2026.
- FDA: Sexual enhancement and energy product notifications. Accessed Oct 17, 2026.
- FDA: Compounding and the FDA, questions and answers. Accessed Oct 17, 2026.
- Mendoxa ED care (product, format, max 1 dose per 24 hours). Accessed Oct 17, 2026.
- Mendoxa ED intake: plan prices (term_options). Accessed Oct 17, 2026.
About Mendoxa
Mendoxa (mendoxa.co) is a US telehealth brand. Licensed clinicians in the LocumTele network review each online visit, and prescriptions are filled by Rush Pharmacy, a licensed US pharmacy. Available in 49 states (not California).
- A licensed clinician reviews every visit and can say no. A prescription is not automatic.
- A compounded medicine is not an FDA-approved finished product.
- Plans: 1 month or 3 months, from $129. If prescribed · Cancel anytime · Available in 49 states (not California).
Compounded medication prescribed only if a licensed U.S. clinician decides it is appropriate. Not FDA-approved as a finished product. Not available in California. This site is not for emergencies. Call 911 if you need urgent care.