The History of ED Medications 



Erectile dysfunction (ED) is a common condition that affects an estimated 150 million men worldwide. That number could be even higher considering the stigma surrounding the subject. Fortunately for many men, that has changed with the improved ease of getting treatment over recent years. Plus, several treatment options are now available, including the most famous one: as ED Medications. 

Before Viagra came onto the market in 1998, there were limited treatment options for ED. Many men turned to talk therapy or penile implants as their only option. Other men found success with testosterone replacement therapy. Now, many healthcare providers tend to prescribe an ED pill like Viagra since it’s reliable and works quickly as needed. 

Before we dive deeper into the use of these ED medications, we need to understand their history and how they became so popular today. 

The Discovery of Viagra

It may come as a surprise that the creation of the little blue pill was an accident. Before Viagra, no other pill provided the same effects of generating an erection. Many doctors relied on psychotherapy or penile implants. Thus, there was no previous research to go off on to create a new ED drug. 

Instead, scientists developed a drug to help treat high blood pressure and chest pain. That drug was called sildenafil citrate. However, as clinical trials wore on, the situation looked bleak. The drug was not providing any significant benefits for high blood pressure or chest pain as initially intended. 

Strangely enough, participants of the study began to report an odd side effect of the drug they were given: an erection. This side effect, while surprising, was not unwelcome for many men who may have had a history of ED. That’s when researchers saw the drug’s potential and shifted gears to testing the drug for treating ED. The trials were successful, and sildenafil citrate was approved and marketed as Viagra in 1998. The drug went on to make around $1 billion that year in sales for Pfizer, the manufacturer of the drug. 

Viagra is available now as a brand-name and generic drug. It’s usually taken no more than once per day, 30 minutes to four hours before sex, and it is available as a pill or tablet in strengths of 25 mg, 50 mg, and 100 mg. The dosage prescribed will depend on the individual’s overall condition and response to the drug. However, healthcare providers may recommend starting with a lower dose. 

Viagra is one of the most popular, safe, and effective treatments for ED. But it’s not the only drug that can help treat ED. The release of Cialis and Levitra quickly followed that of Viagra. 

Development of Other ED Medications

Nowadays, you can find several ED pills for sale at your local pharmacy or even online. OZ Meds provides one of the complete selections of ED medications online. Most, if not all, ED medications, including Viagra, fall under a group of drugs called phosphodiesterase type 5 (PDE5) inhibitors. 

PDE5 inhibitors work by inhibiting or blocking; an enzyme called PDE5, which is responsible for breaking down a chemical called cGMP. Blocking PDE5 helps increase the amount of cGMP in the walls of the blood vessels, which helps dilate and relax the blood vessels. Relaxing the blood vessels leads to improved blood flow to the spongy tissue of the penis, leading to an erection. One thing to note is that these medications don’t immediately cause an erection out of nowhere; sexual arousal is required. 

Cialis (tadalafil)

As the success of Viagra started to become well-known, other drug manufacturers sought to create similar, if not better, drugs. That’s where Cialis and Levitra come in. In May 2002, researchers reported on the effects of Cialis at the 97th Annual Meeting of the American Urological Association (AUA). Cialis, which contains tadalafil as its active ingredient, was later approved to treat ED in 2003. Eli Lilly manufactures it.  

Cialis is an effective drug like Viagra, but it has a longer half-life of almost 18 hours. Many men prefer Cialis because it allows more room for spontaneity. In other words, they don’t have to worry about timing their sexual activities with Cialis as they would with Viagra. In fact, the effects of Cialis can last up to three days. 

You can take Cialis daily or as needed. A daily dose of Cialis is also approved to treat an enlarged prostate. So, in effect, Cialis kills two birds with one stone.

Other ED Drugs

Choosing an ED pill will depend on an individual’s personal preference and how a particular drug works. Other factors to consider, include the potential cost of the medication and whether the individual has tried an ED drug previously without success. The other ED drugs are:

  • Levitra (vardenafil)
  • Staxyn (vardenafil, orally-disintegrating)
  • Stendra (avanafil)

The active ingredient in Levitra and Staxyn, vardenafil, was initially approved to treat ED in 2003. While both brand-name drugs contain the same active ingredient, they are formulated differently. 

Levitra is the original ED pill containing vardenafil. It starts working in as little as 30 minutes and can last for five hours. Staxyn is an orally disintegrating tablet that can dissolve in the mouth without the need for a glass of water. Staxyn may start working more quickly than Levitra. Both Levitra and Staxyn are manufactured by Bayer HealthCare Pharmaceuticals and can usually be found at similar prices. 

Stendra contains the active ingredient avanafil, and Vivus manufactures it. Stendra was a latecomer to the field of ED drugs with its approval in 2012. However, it has been approved as an effective treatment for ED that can be taken 30 minutes before sexual activity or as needed. Stendra starts working quickly with effects that last up to six hours.  

Brand-Name Versus Generic ED Drugs


Most ED pills like Viagra and Cialis are now available as generic drugs. You may have heard about brand-name and generic drugs. But what exactly do these terms entail? 

After the initial approval of Viagra, Pfizer was granted a patent that allowed them exclusivity to manufacture a drug containing sildenafil. This patent was in effect until 2019. Since then, other pharmaceutical companies have been able to create generic drugs containing sildenafil. Generic versions of Cialis and Levitra are also currently available. There is no generic version of Stendra available at this time. 

Generic drugs contain the same active ingredients as their brand-name counterparts. Means they essentially work the same as the brand-name version. However, they may contain different inactive ingredients, such as binding materials, preservatives, and dyes.

Another main difference between brand-name and generic drugs is the cost. Generic drugs are typically 30 to 60 percent less expensive than brand-name drugs. Because generic and brand-name drugs work the same, most people prefer to pay less for generic drugs without losing any benefits. 

Things to Keep In Mind With ED Medications

While ED meds are effective drugs, they are only available with a prescription in most countries. The UK is the first country to deem Viagra safe enough to be purchased over the counter. Still, it’s best to use Viagra under the supervision of a healthcare provider to ensure it is used as safely and effectively as possible. 

Side Effects of ED Medicines

As with any other medication, side effects are possible with ED medications. However, for most people, side effects are mild and temporary. The side effects tend to go away as the effects of the medication wear off. 

Common side effects of PDE5 inhibitors include:

  • Headache
  • Skin flushing
  • Indigestion
  • Muscle aches
  • Dizziness 
  • Runny nose

Serious side effects of ED drugs are also possible, such as sudden losses or severe changes in vision or hearing. An ED drug can cause a painful, long-lasting erection (priapism) in rare cases. It’s essential to seek emergency medical attention if an erection is painful or lasts longer than four hours. Some people may have a higher risk of experiencing priapism than others. People with any abnormal physical problems of the penis, including Peyronie’s disease and cavernosal fibrosis, may need to use caution with ED drugs. 

Drug Interactions

ED medications should not be taken in men who are allergic to any ingredients of ED drugs. Healthcare providers do not advise taking a PDE5 inhibitor if you take certain medications, such as nitrates. Nitrates, such as nitroglycerin, isosorbide dinitrate, isosorbide mononitrate, amyl nitrate, and sodium nitroprusside, should never be mixed with a PDE5 inhibitor like Viagra. Mixing a nitrate and PDE5 inhibitor can lead to a severe drop in blood pressure, also known as hypotension, which may cause severe dizziness and fainting.  

Other blood pressure drugs, such as alpha-blockers and riociguat, can interact with Viagra and other ED medications. Mixing these blood pressure drugs with an ED medication could also increase the risk of hypotension. 

PDE5 inhibitors like Viagra and Cialis are processed in the body by the liver. Enzymes in the liver called CYP3A4 enzymes help process and break down the drug to be used and cleared from the body. Certain drugs can block this enzyme and cause increased levels of the ED drug, which can lead to increased side effects. Drugs that block the CYP3A4 enzyme include ketoconazole and ritonavir. 

Other drugs can promote the activity of the CYP3A4 enzyme and cause decreased levels of an ED drug. Taking certain drugs like rifampin with ED drugs may reduce how well the ED drugs work. It’s essential to consult with a doctor about any other medications before starting treatment with an ED drug.

Food and Alcohol

Most ED drugs can be taken with or without food. However, fatty foods may delay the time it takes for the ED drug to be absorbed and start working. Regarding alcoholic drinks, alcohol is a natural vasodilator that can cause changes in blood pressure. A doctor may advise setting aside the cheeseburger, fries, and beer for a day when you are not expected to take an ED drug. These foods and substances may affect physical performance anyway. 

Other Medical Conditions

It’s important to tell a doctor about any medical conditions you may have before starting treatment with an ED drug. Tell your doctor if you have any of the following before starting treatment:


  • Heart problems
  • Blood pressure problems
  • History of a stroke
  • Liver or kidney problems
  • Stomach bleeding or ulcers
  • Penile conditions
  • Blood cell problems, such as anemia 

A doctor may recommend adjusting the dosage of the ED drug if you have other health conditions. A doctor may also recommend avoiding an ED drug altogether if these other health conditions occur. 

ED can be considered a severe condition because of its links to other health conditions, such as diabetes, high cholesterol, and high blood pressure. These health conditions and unhealthy habits such as smoking can damage or narrow the blood vessels. Without healthy blood vessels, blood flow to the penis becomes impeded. In many cases, a doctor will want to treat these other conditions to help improve ED in the long term. 

The Future of ED Treatments

ed meds

The future of ED treatments is bright. What was once a frustrating endeavor for many doctors is now easily treated with a pill, in addition to ED drugs, such as penile implants and surgery. However, these other options are often reserved for more severe cases of ED. 

Lifestyle changes can also help improve ED. Regular exercise and a healthy diet can help keep the body working at peak performance. Keeping away from alcohol, smoking, and drugs can help maintain healthy blood vessels while promoting a clear, positive mindset. After all, ED is as much of a psychological condition as it is a physical one. 

The invention of Viagra and the widespread availability of ED meds has opened up the doors for affected men to seek treatment. It also provided doctors with a simple and effective drug to prescribe for ED. With the rise of generic ED drugs, it is now easier and cheaper to get treated.