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Sildenafil (The Active Ingredient in Viagra) Sildenafil is the OG prescription medication for erectile dysfunction. It came onto the market in the late ‘90s under the brand name Viagra and, for several years, was the only medication available for men with ED. Today, sildenafil is available in its generic version, meaning it’s much more affordable than when it first hit the market. It works quickly, provides relief from ED for several hours and is sold in just about every pharmacy, making it a reliable option for improving your sexual function. Best for: Guys who want a reliable treatment option for ED, with a long track record and a good price per tablet. Advantages: Sildenafil starts working in less than one hour and provides relief from ED for about four hours per pill, making it great for a single night. Disadvantages. Sildenafil takes longer to work after a large, high-fat meal and can’t be taken more than once a day, making it less than ideal for twice-a-day (or more) sex. Tadalafil (the Active Ingredient in Cialis) Tadalafil is the active ingredient in Cialis, which was approved by the FDA as an ED medication in 2003. These days, it’s available in its generic form and as a brand name for use as-needed or as a daily tablet that improves blood flow and makes getting an erection easier. Thanks to its very long duration of action, tadalafil is sometimes referred to as the “weekend pill” for treating erectile dysfunction. Like sildenafil, tadalafil has a long track record. It’s been researched extensively, meaning both its effects and its side effects are well known. Best for: Men who like a long-lasting pill to treat ED, allowing for spontaneous sex or sex more than once a day. Advantages: Tadalafil lasts longer than any other ED treatment, with one pill providing relief from ED for approximately 36 hours. It can also be taken daily at a low dosage. Disadvantages: Tadalafil might last longer than needed for many men. Tadalafil’s long duration of action means side effects may persist for longer than with other ED pills. Vardenafil (the Active Ingredient in Levitra) Vardenafil is the active ingredient in Levitra, and was approved by the FDA in 2003. Vardenafil is similar to sildenafil but lasts longer, with research suggesting that it provides better blood flow and stronger erections for five to seven hours per dose. Best for: Men who want a slightly longer-lasting ED medication than sildenafil, but don’t want the all-day effects of tadalafil. Advantages: Vardenafil lasts for longer than sildenafil and usually starts working faster. Disadvantages: Vardenafil is typically more expensive than sildenafil. Like sildenafil, it can only be taken one time per day. Stendra (Avanafil) Stendra contains the active ingredient avanafil, and is a newer ED medication that received FDA approval in 2012. Avanafil is a newer-generation PDE5 inhibitor that’s more selective than older ED pills about how it inhibits enzymes. It’s less likely to cause side effects than older medications and begins working faster. However, it’s only available under the brand name Stendra, with no generic. Best for: Men who want a fast-acting ED pill that can be taken almost right before sex, without having to worry about avoiding certain foods. Advantages: Stendra acts quickly — often in as little as 15 minutes — and is less likely to cause side effects than older ED pills. Disadvantages: Stendra isn’t available as a generic medication, meaning it costs more per tablet than other ED drugs. While side effects are less common, they can still occur. 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