First-Line ED Medication
Viagra® & Cialis® (PDE5 Inhibitors)
Viagra® (sildenafil) and Cialis® (tadalafil) are PDE5 inhibitors — oral medications that improve blood flow to the penis on demand. They remain first-line ED treatment for most men because they work, they're safe, and dosing flexibility means we can match the medication to your lifestyle.
How it works
The mechanism
Both block phosphodiesterase-5, prolonging the cGMP signal that relaxes penile arterial smooth muscle. The result is improved erectile response when you're sexually aroused — neither medication produces an erection without arousal.
Who it's for
Best candidates
- Most men starting ED treatment
- Patients with vascular or psychological ED
- Men wanting either spontaneity (Cialis® daily) or fast onset (Viagra®)
Protocol
Sildenafil 25–100 mg as needed, ~30–60 min before activity. Tadalafil 10–20 mg as needed, or 2.5–5 mg daily for spontaneous performance.
Timeline
Sildenafil: ~30 min onset, 4–6 hour window. Tadalafil: ~30 min onset, up to 36 hours.
What to expect
Side effects & considerations
Headache, flushing, nasal congestion, mild GI symptoms, occasional visual changes. Not safe with nitrate medications.
Frequently asked
Viagra® & Cialis® (PDE5 Inhibitors) FAQs
Pairs well with
Related treatments
Reliable, On-Demand Erections
Trimix Injections
A compounded penile injection used when oral medications no longer give a reliable result.
Treat the Root Cause
Shockwave Therapy for ED
Low-intensity acoustic waves that regenerate penile blood vessels — drug-free, painless ED treatment.
Regenerative Sexual Wellness
P-Shot® (PRP for Penile Function)
Platelet-rich plasma drawn from your own blood, injected into the penis to support regeneration and performance.
Desire, Not Just Function
PT-141 Peptide Injections
A peptide that acts on the brain's desire pathway — useful when libido itself is the problem.
Take the first step
Feel like yourself again — book a free consult.
15 minutes. No pressure. A clear plan if you want one.