Sexual Health · sildenafil · prescription telehealth
Reliable, on the nights that matter.
FDA-approved generic · as-needed tablet · prescription only
For erectile dysfunction. Generic sildenafil, prescription only: one tablet about an hour before, for a firmer erection that holds through the moment. 1 A licensed clinician confirms it's appropriate for you, sets your strength, and adjusts it if the first one isn't right.
About eight minutes online. A licensed clinician reads every answer — and can say no.
a licensed clinician decidesFDA-approved generic · prescription only
Care
a licensed clinician decides — and can say no
Strength
set for you, adjusted if the first one isn't right
Discretion
plain box · nothing named on the outside
About Sildenafil
What sildenafil does, and what to expect.
What it does
Sildenafil is a PDE5 inhibitor. With sexual stimulation it relaxes the blood vessels of the penis so blood flows in more easily, and an erection is easier to get and keep. 1 It does not create desire and does nothing on its own — arousal still has to happen. 2
How it's taken
One tablet about an hour before, though it can be taken anywhere from half an hour to four hours ahead. 3 Lighter meals help: a heavy, fatty meal slows it down. 4 Your clinician sets the strength and can move it up or down after you've tried it. Never more than one dose in a day. 3
What to expect
In the clinical trials of sildenafil, most men reported firmer erections; the effect builds with stimulation and lasts around four hours. 5 Headache, a flushed face and a stuffy nose are the most common effects, usually mild and passing with the dose. 6 Your clinician will ask you to give it a few tries at the right conditions before judging it — a light stomach, real arousal, no rush.
Timing, on one line.What the intake asks, and why.
Every fact on this page carries a numbered source; the list is at the foot of the page.
The other routes
What you may have tried, and why it stalls.
Most men arrive here having tried something else first. Here is what each route can and can't do — plainly, without pretending the alternatives don't exist.
What you have tried
Why it stalls
What calibrated care does
What you have tried
The gas-station pill
Why it stalls
Sold as a supplement, so nobody measured what is in it. The FDA keeps finding hidden, unlabelled sildenafil in these products 8 — an unknown dose, with no check on your heart, your blood pressure or the medicines you take.
What calibrated care does
A known tablet at a known strength, dispensed by a licensed U.S. pharmacy, prescribed only after a clinician has read your history. 9
What you have tried
The website that asks no questions, or a friend's stash
Why it stalls
Nearly all sites selling prescription-only drugs without a prescription operate illegally, and tablets bought that way have tested mostly counterfeit, at a fraction of the labelled dose. 1011 A friend's tablets were prescribed for a different heart, a different history and a different medicine list.
What calibrated care does
Every order here starts with an intake a licensed clinician reads, and the medicines you take are checked one by one. If it isn't safe for you, you'll be told — that is what the consult is for.
What you have tried
The 'natural' supplement
Why it stalls
Evidence is thin and doses are unlabelled — and many of the products on the FDA's tainted-supplement list are sexual-enhancement supplements found to contain sildenafil that isn't on the label. 8
What calibrated care does
A medication with decades of clinical evidence behind it, at a labelled strength, with its side effects known and stated on this page. 5
What you have tried
A compounded chewable or 'fast-acting' version
Why it stalls
The evidence for sildenafil was built on the plain tablet. A chewable is a different dosage form, and 'fast-acting' is a claim, not a study.
What calibrated care does
The plain tablet the evidence was built on, at a labelled strength, dispensed by a licensed U.S. pharmacy named on your label — with a clinician setting the strength, not a menu. 12
What you have tried
An in-person appointment
Why it stalls
A perfectly good route — if you'll book it. Many men don't, for years, because of the waiting room and the pharmacy counter.
What calibrated care does
The same clinical questions, answered privately, with a licensed U.S. clinician deciding. If you'd be better served in person, you'll be told that too.
What you have tried
Waiting for it to pass
Why it stalls
Erectile dysfunction is often a signal about circulation, and it tends not to improve on its own. 7 Waiting also lets the 'what if it happens again' loop set in.
What calibrated care does
An intake that looks at the causes, a clinician who can say whether this tablet is the right answer or your own doctor is, and a treatment that helps on the nights that matter, when it is appropriate.
Not one of those routes asks about your blood pressure or the medicines you take. The intake here does — because erectile dysfunction can be the first sign of something worth checking. 7
Sometimes the answer is no. That's what the consult is for.
A principle of the house
How care works
Medicine, measured.
Results are personal, so treatment shouldn't be one-size. Here is the whole process, plainly.
01
An intake worth reading
About eight minutes of real questions — your erections, your heart and blood pressure, every medicine you take, what you have tried before. It is the basis of every decision that follows.
02
A clinician decides
A licensed U.S. clinician reviews your answers and decides whether sildenafil is appropriate for you, and at what strength. Sometimes the answer is no — you'll hear it straight.
03
Filled and delivered
If prescribed, your tablets are dispensed by a licensed U.S. pharmacy — named on your label — and shipped in plain, unmarked packaging.
04
Adjusted to you
Tell your clinician how the first tablets went. The strength can move up or down, with notice before anything about your plan changes.
Plans & pricing
Straight terms, before you pay.
Each plan includes the clinician evaluation, the prescription if appropriate, the pharmacy fill, shipping and follow-up. No visit fee, nothing billed on top — what you see here is what you're agreeing to.
50 mg
The usual starting strength — one tablet about an hour before, active for around four hours.
50 mg · monthly supply
Sildenafil 50mg
$59/ per month
renews at $59 per month · cancel anytime
Generic sildenafil, as-needed tablet, prescription only
One tablet about an hour before — active for around four hours
Strength set by your clinician, adjusted if the first one isn't right
Filled by a licensed U.S. pharmacy, named on your label
Plain, unmarked packaging
The whole price shown — cancel from your account before your next billing date
50 mg · 3-month supply
Sildenafil 50mg
$159/ every 3 months
renews at $159 every 3 months · cancel anytime
Generic sildenafil, as-needed tablet, prescription only
One tablet about an hour before — active for around four hours
Strength set by your clinician, adjusted if the first one isn't right
Filled by a licensed U.S. pharmacy, named on your label
Plain, unmarked packaging
The whole price shown — cancel from your account before your next billing date
100 mg
For when 50 mg was well tolerated but not enough. Your clinician makes that call.
100 mg · monthly supply
Sildenafil 100mg
$79/ per month
renews at $79 per month · cancel anytime
Generic sildenafil, as-needed tablet, prescription only
One tablet about an hour before — active for around four hours
Strength set by your clinician, adjusted if the first one isn't right
Filled by a licensed U.S. pharmacy, named on your label
Plain, unmarked packaging
The whole price shown — cancel from your account before your next billing date
100 mg · 3-month supply
Sildenafil 100mg
$219/ every 3 months
renews at $219 every 3 months · cancel anytime
Generic sildenafil, as-needed tablet, prescription only
One tablet about an hour before — active for around four hours
Strength set by your clinician, adjusted if the first one isn't right
Filled by a licensed U.S. pharmacy, named on your label
Plain, unmarked packaging
The whole price shown — cancel from your account before your next billing date
The price shown is the whole price. Plans renew at the price and cadence shown until you cancel — from your account or by emailing support before your next billing date — and nothing further is charged or shipped after that. If your clinician changes your strength, your plan moves to that strength's published price, with notice before you are billed. HSA/FSA payment accepted on eligible plans.
Eligibility
See if it's appropriate. That's the consult.
Sildenafil is prescribed to adult men with erectile dysfunction when a licensed clinician confirms it is safe for them. The intake asks what a careful doctor would ask.
You may qualify if
You're an adult man aged 18 or over
You have difficulty getting or keeping an erection firm enough for sex, some or most of the time
Your blood pressure is in a range a clinician considers safe for sexual activity
A clinician confirms it fits your health history and the medicines you take
May not be suitable if
You take nitrates in any form — including nitroglycerin, isosorbide, or 'poppers' (amyl or butyl nitrite)
You take riociguat or vericiguat
You've had a recent heart attack or stroke, or have heart failure, unstable angina or uncontrolled blood pressure
You've been told sexual activity isn't safe for you because of your heart
You have retinitis pigmentosa, or have had a sudden loss of vision or hearing
You have severe liver or kidney disease, or a condition that predisposes you to prolonged erections
This is not an exhaustive list — your clinician reviews your full history before any prescribing decision. Some medicines (alpha-blockers, some blood-pressure drugs, certain antifungals and HIV medicines) mean care rather than a no. 13
Safety & honesty
What it feels like, what to watch for, and what we won't promise.
Sildenafil has decades of use and a well-documented profile. Here it is without the small print, so you know what the first tablet may feel like and when to stop.
Common, usually mild, passing with the dose
Headache — the most reported effect; more common at higher strengths 6
Flushing — a warm, red face and chest for an hour or two 6
Stuffy nose — congestion that passes as the dose wears off 6
Indigestion or heartburn — more likely on a full stomach 6
A blue tint to vision — temporary, and more common at the highest strength 6
Dizziness or back ache — less common, usually mild 6
Stop, and seek care straight away
An erection lasting more than four hours — get medical help immediately — untreated, it can cause lasting damage 13
Sudden loss or blurring of vision — stop taking it and seek care 13
Sudden hearing loss or ringing in the ears — stop taking it and seek care 13
Chest pain, fainting or severe dizziness during sex — stop, and treat it as an emergency 13
Not prescribed if
You take nitrates in any form — chest-pain tablets, sprays or patches, or 'poppers' 13
Your clinician judges sexual activity unsafe for your heart 13
You have had an allergic reaction to sildenafil or another erectile-dysfunction tablet 13
Medicines and habits that need care
Alpha-blockers and blood-pressure medicines — can add up to a drop in blood pressure — your clinician may choose a lower strength or a different timing 13
Certain antifungals and HIV medicines — raise sildenafil levels; the strength is set with that in mind 13
Other erectile-dysfunction tablets — never combined 13
Alcohol — a moderate amount did not add to the blood-pressure effect in the label's study; heavy drinking works against erections on its own 13
What it is for, and what it isn't
Sildenafil treats the physical side of an erection. It does not increase desire, treat premature ejaculation, or protect against sexually transmitted infections. 2
If you stop
Nothing lingers — sildenafil clears the body in about a day, and there is no tolerance to unwind. In a four-year study, most men kept the same response and stayed satisfied with it year after year. 14
Results vary. No outcome is guaranteed — your clinician will discuss what is realistic for you.
The full prescribing information travels with your tablets and is linked in the sources below. 1
What happens next
From the intake to the first tablet.
No waiting room, no counter. Here is the path, step by step, and what shows up at your door.
01
Today: the intake
About eight minutes. Your erections, your heart and blood pressure, your medicines, what you have tried. Every question is there because it changes what is safe to prescribe.
02
A clinician reviews
A licensed U.S. clinician reads your answers and decides whether sildenafil is appropriate for you, and at what strength. You'll hear by email either way — including if the answer is no, or if you'd be better seen in person.
03
Filled by a licensed U.S. pharmacy
If prescribed, your prescription goes to a licensed U.S. pharmacy — the one that fills it is named on your label. Nothing is made or handled by us.
04
Delivered, unmarked
Your tablets arrive in plain packaging with nothing on the outside — no medication named, no clinic named.
05
Adjusted to you
Try it a few times at the right conditions. If the strength isn't right, tell your clinician; it can move up or down, with notice before your plan changes.
What arrives
Outside
An unmarked box. No medication or clinic named.
Inside
Your tablets in the pharmacy's own labelled container, with its leaflet.
On the label
The pharmacy that filled your prescription, your name, and how to take it.
Prescription products require evaluation by a licensed clinician, who determines whether treatment is appropriate.
FDA-approved generic, filled by a licensed U.S. pharmacy named on your label
Questions, answered plainly
Questions about sildenafil
How long before should I take it?
About an hour before, on a light stomach. It can be taken anywhere from half an hour to four hours ahead and stays active for around four hours — but only with sexual stimulation. A heavy, fatty meal slows it down. 34
What if it doesn't work the first time?
Give it a few tries before judging it: a light stomach, an hour's lead, real arousal, no pressure. If it still isn't enough, tell your clinician — the strength can be raised, or a different tablet considered. Losing effect over months is uncommon, and is usually a reason to look at the underlying cause rather than the tablet. 14
Which strength will I get?
Most men start at the usual starting strength, and your clinician moves it up or down from there — from your history first, then from what you report after the first tablets. Both strengths on this page are the same medication. More strength mostly means more side effects, not a better result; the aim is the lowest strength that works. 3
Is what arrives the real thing?
It is prescription sildenafil, dispensed by a licensed U.S. pharmacy that is named on your label, after a licensed clinician has reviewed your case — not a supplement, not a 'research' product, and not something bought without a prescription. The class of medication you are prescribed is stated on this page, and the FDA sets what any approved generic must demonstrate: the same active ingredient, strength and dosage form as the reference product, and proof it performs the same way in the body. 912
Sildenafil or tadalafil — which should I choose?
Sildenafil is the one you take for the night: about an hour ahead, active for around four hours, best on a light stomach. Tadalafil lasts up to a day and a half, is unaffected by food, and also comes as a low daily dose so timing never matters. 15 Your clinician chooses with you; tadalafil has its own page in the treatments menu.
Can I take it with my other medicines?
Never with nitrates in any form — chest-pain tablets, sprays or patches, or 'poppers' — and never with riociguat. Alpha-blockers, some blood-pressure medicines, certain antifungals and HIV medicines mean care rather than a no. List everything you take in the intake; your clinician checks each one before prescribing. 13
Can I drink alcohol with it?
A moderate amount did not add to sildenafil's blood-pressure effect in the label's study. Heavy drinking works against erections on its own and lowers blood pressure — so if the night matters, keep it moderate. 13
Will anyone know?
The box is unmarked, with no medication or clinic named on it. Your information sits on a HIPAA-compliant platform and goes to the clinician who reviews your case and the pharmacy that fills your prescription — no one else. Sildenafil is not a controlled substance.
What if I want to stop, pause or change?
Cancel or change your plan from your account, or email support before your next billing date — no call needed. After that, nothing further is charged or shipped. If you stop taking it, nothing lingers; it clears the body in about a day.
Does it stop working over time?
There is no tolerance to sildenafil in the pharmacological sense: in a four-year study, most men kept the same response and stayed satisfied with it year after year. 14 When it seems to stop working, the usual reasons are a heavy meal, too little stimulation, anxiety, or a change in underlying health — worth telling your clinician about.
How does the telemedicine process work?
You complete an online intake, a licensed provider reviews your case, and if appropriate your treatment plan is prescribed and delivered directly to your door.
Do I need to visit a doctor in person?
No. All consultations, prescriptions, and follow-ups are handled 100% online through our secure telehealth platform.
Are the doctors licensed?
Yes. Every provider in our network is licensed and experienced in evaluating patients through compliant telemedicine workflows.
Is my personal information secure?
Your information is protected through secure systems and privacy-first processes designed to support HIPAA-aligned care delivery.
How is my medication delivered?
Approved medications are shipped discreetly to your home, with updates and follow-up support handled online for convenience.
Sources
What this page is based on.
15 sourcesshowhide
Facts about how sildenafil works, what it feels like and who shouldn't take it come from the FDA-approved prescribing information and the peer-reviewed studies behind it.
Eligibility screening and a prescription are required for prescription
treatments. Individual results vary and no specific outcome is guaranteed. A licensed clinician
determines whether treatment is appropriate — treatment is not guaranteed.
Sildenafil is an FDA-approved generic medication, dispensed by a licensed
U.S. pharmacy when prescribed.
