How to Treat ED with Maximum Safety

Have you been told by the doctor that you need to take an erectile dysfunction drug to maintain a relatively normal sex life? Here’s the information you’ll need to take such drugs safely and effectively.


Taking a new prescription medication can be a little bit intimidating. Will the drug’s benefits outweigh whatever side effects it might cause? How well will the drug treat your problem?

For men with erectile dysfunction, these and other questions arise when they begin treatment with Viagra or another of the popular ED medications known as PDE5 inhibitors.

To help remove some of those uncertainties and ease whatever fears you might have, we’ve put together answers to the most frequently asked questions about the safe and effective use of ED drugs. Hopefully, you’ll find the answers you’re looking for here.

Q: What dose of the ED drug is right for me?

A: Until you actually start taking the drug, it’s impossible to be certain. For that reason, doctors usually prescribe what is known as the recommended starting dose, which is the amount of the drug that’s been shown in clinical trials to be effective for the largest number of men. For Viagra, the granddaddy of PDE5 inhibitors, that dose is 50 milligrams. If you find that that dose fails to produce the desired results, your doctor will probably increase your dose to 100 milligrams. For some men who are particularly sensitive to Viagra’s effects, 25 milligrams of the medication is enough to get the job done.

The RSD for both Cialis and Levitra is 10 milligrams, which can be increased to 20 milligrams if necessary. Staxyn, which contains the same active ingredient — vardenafil hydrochloride — as Levitra, comes in orosoluble form, which means it literally dissolves in your mouth and can be taken without water. Staxyn is available only in 10-milligram tablets. The RSD for Stendra, which is available in tablets of 50, 100, and 200 milligrams, is 100 milligrams, which can be adjusted upward or downward as needed.

Because the RSD generally works for the vast majority of men using these drugs, it’s the logical starting point. With your doctor’s help, you can make changes until you find the dosage that’s just right for you.

Medical doctor holding a piece of paper labeled side effects.

Most side effects of ED drugs are mild and tend to disappear upon continued use of the drug.

Q: What about side effects?

A: Rare indeed is the medication that has no side effects. Even a drug as seemingly innocuous as aspirin can cause adverse effects in especially sensitive patients and if it’s not taken as directed.

Because ED drugs all belong to the same family of medications, they share many of the same side effects, most of which are mild and often disappear altogether if you continue to take the drug.

Common side effects of PDE5 inhibitors, according to, include back pain, changes in vision, flushing or feelings of warmth, headache, hearing loss, nasal congestion, and upset stomach.

In rare cases, these drugs can also cause more serious side effects, including priapism, an erection that persists for four hours or more, and a sudden reduction or total loss of hearing and/or vision. Should you experience any of these more serious side effects, seek medical attention immediately.

Q: Are there drugs that interact adversely with ED medications?

A: Certain medications, including specific antihistamines, blood pressure pills, antidepressants, and other drugs, can reduce or neutralize the effects of ED medications. While such interactions pose no serious threat to your health, they are bothersome and can usually be cleared up with the help of your doctor who can substitute alternative drugs that have little or no adverse effect on PDE5 inhibitors.

However, ED medications should never be taken by men who are taking nitrate-based drugs. These drugs are most often prescribed for the treatment of angina or intractably high blood pressure. They get the job done by lowering blood pressure. But PDE5 inhibitors also lower blood pressure. Taking them together could cause a life-threatening decline in blood pressure.

Nitrates are also present in the recreational drugs known as “poppers” and should never be used at the same time as ED medications.

Q: What options do I have if one of these drugs fails to work for me?

A: As previously noted, all of the ED drugs are similar in structure and thus are collectively known as PDE5 inhibitors. But each has its own unique chemical formula, so that they vary enough from one another that it’s entirely possible that switching to another drug will be enough to get you back on track.

If none of the available ED drugs works for you, other alternatives include penile injection therapy, penile implants, vacuum pumps, and low-intensity shockwave therapy.

Tabletop with apples, grapes, bananas and free weights.

Healthy lifestyle decisions can promote erectile function and help your ED medication to work as effectively as possible. 

Q: What can I do to help ED medications work most effectively?

A: Roughly 80 percent of all ED is caused by insufficient blood flow to the penis, which is most often the result of cardiovascular damage caused by unhealthy lifestyle choices. But it’s never too late to change your ways.

Eating a healthy diet, exercising on a regular basis, keeping your weight within acceptable parameters, kicking the smoking habit, and limiting your alcohol consumption can all go a long way toward improving cardiovascular health and thus erectile function.

If you make such changes early enough in life, you might eventually find that your need for Viagra or other ED medications is reduced or even eliminated. And even if that goal is no longer within your reach, living healthy can ensure that the ED drugs you take work as well as possible.

Q: How much is too much?

A: The maximum recommended daily dose of Viagra is 100 milligrams, which also happens to be the highest-strength tablet in which the medication is available. The recommended daily maximum for Levitra is 20 milligrams, and the maximum for Stendra is 200 milligrams.

Cialis stands apart from the rest of the PDE5 inhibitors because of its extraordinarily lengthy half life — 17.5 hours. For many men, its erection-friendly results can last for up to 36 hours. Because it lingers in the body much longer than the other PDE5 inhibitors, the maximum recommended dose for Cialis is 20 milligram every 48 hours.

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No matter which ED drug you prefer, you’ll find it available from longtime online facilitator The Arizona-based supplier offers a full range of ED medications, including all available brand-name and generic drugs. It can spare you the hassle of trips to and from the pharmacy and offers free shipping.

For men who don’t yet have a prescription, eDrugstore can schedule a complimentary online consultation with a licensed U.S. physician who can authorize a prescription if appropriate. To learn more, visit eDrugstore’s Erectile Dysfunction page.

Don Amerman has spent more than three decades in the business of writing and editing. During the last 15 years, his focus has been on freelance writing. For almost all of his writing, He has done all of his own research, both online and off, including telephone and face-to-face interviews where possible. Don Amerman on Google+